Construct Validity of the Ecological Momentary Assessment in Audiology Research

Abstract

Background Ecological momentary assessment (EMA) is a methodology involving repeated assessments/surveys to collect data describing respondents’ current or very recent experiences and related contexts in their natural environments. The use of EMA in audiology research is growing. Purpose This study examined the construct validity (i.e., the degree to which a measurement reflects what it is intended to measure) of EMA in terms of measuring speech understanding and related listening context. Experiment 1 investigated the extent to which individuals can accurately report their speech recognition performance and characterize the listening context in controlled environments. Experiment 2 investigated whether the data aggregated across multiple EMA surveys conducted in uncontrolled, real-world environments would reveal a valid pattern that was consistent with the established relationships between speech understanding, hearing aid use, listening context, and lifestyle. Research Design This is an observational study. Study Sample Twelve and twenty-seven adults with hearing impairment participated in Experiments 1 and 2, respectively. Data Collection and Analysis In the laboratory testing of Experiment 1, participants estimated their speech recognition performance in settings wherein the signal-to-noise ratio was fixed or constantly varied across sentences. In the field testing the participants reported the listening context (e.g., noisiness level) of several semicontrolled real-world conversations. Their reports were compared to (1) the context described by normal-hearing observers and (2) the background noise level measured using a sound level meter. In Experiment 2, participants repeatedly reported the degree of speech understanding, hearing aid use, and listening context using paper-and-pencil journals in their natural environments for 1 week. They also carried noise dosimeters to measure the sound level. The associations between (1) speech understanding, hearing aid use, and listening context, (2) dosimeter sound level and self-reported noisiness level, and (3) dosimeter data and lifestyle quantified using the journals were examined. Results For Experiment 1, the reported and measured speech recognition scores were highly correlated across all test conditions (r = 0.94 to 0.97). The field testing results revealed that most listening context properties reported by the participants were highly consistent with those described by the observers (74–95% consistency), except for noisiness rating (58%). Nevertheless, higher noisiness rating was associated with higher background noise level. For Experiment 2, the EMA results revealed several associations: better speech understanding was associated with the use of hearing aids, front-located speech, and lower dosimeter sound level; higher noisiness rating was associated with higher dosimeter sound level; listeners with more diverse lifestyles tended to have higher dosimeter sound levels. Conclusions Adults with hearing impairment were able to report their listeni...

The use of ecological momentary assessment in hearing research and future clinical applications

“…More recent studies involving the use of EMA in hearing research have investigated the experiences of individuals with tinnitus (Henry et al, 2012), the communication difficulties of HA users (Galvez et al, 2012), differences in HA performance (Hasan et al, 2014) and individual hearing difficulty in various listening situations (Timmer et al, 2017;Wu et al, 2015). All these studies adhered to the EMA guidelines outlined in Table 1 and the majority (Wu et al (2015) being the exception) used electronic devices to house the surveys and prompt participants. Henry et al (2012) reported a pilot study assessing the feasibility of EMA with a group of participants with chronic tinnitus.…”

“…A further study of HA wearers was conducted by Hasan et al 2014 Hasan et al (2014) concluded based on linear modelling that it was possible to predict HA outcomes based on listening situation and HA features, with an accuracy of 78%. Wu et al (2015) conducted two studies focused on the construct validity of EMA in audiology research. The first study aimed to investigate how accurately 12 participants could self-report their speech recognition in noise and how accurately they could report listening context.…”

“…The study compared subjective ratings of noisiness to objective noise dosimeter data and found adults with HI could describe their listening experiences and the acoustic environment with reasonable accuracy. Wu et al (2015) summarized that EMA can measure what it intends to measure and hence has construct validity in hearing research.…”

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“…On a monthly basis, days with more-than-normal HA usage is associated with higher-than-normal sound pressure levels (SPL) and more diverse sound environments. The diversity of the sound environment (here approximated by SPL var ) can be considered a proxy for life-style activity levels [35]. Thus, an overall louder and more active day seems to be associated with increased HA usage.…”