Preliminary support for a brief psychological intervention to improve first‐time hearing aid use among adults

Abstract

ObjectivesSuboptimal hearing aid use extorts significant social, health, and economic costs. The aims of this study were to (1) test the novel hypothesis that the threat associated with being diagnosed with hearing loss could be ameliorated with a self‐affirmation manipulation and (2) gauge the feasibility of deploying the manipulation in routine clinical practice.DesignParallel groups randomized controlled trial with 10‐week follow‐up.MethodFifty people, newly prescribed with a hearing aid, completed either a questionnaire that included a brief self‐affirming exercise or an identical questionnaire with no self‐affirming exercise. The main outcome measure was derived from data logging automatically stored by the hearing aid. Perceived threat (‘anxiety about ageing’), behavioural intention, and self‐efficacy were measured as potential mediators.ResultsObjectively measured hours of daily hearing aid use were marginally higher in the intervention group compared with the control group (between‐group difference = 1.94 hr, 95%CI = −1.24, 5.12, d = 0.43). At follow‐up, participants in the intervention group were significantly less anxious about ageing and more accepting of older people than were participants in the control group (between‐group difference = 0.75, 95%CI = 0.26, 1.22, d = 0.87). There was no statistically significant effect of the intervention on behavioural intention or self‐efficacy.ConclusionsAlthough not statistically significant, the magnitude of the effect of the intervention on hearing aid use (d = 0.43) suggests that it would be worthwhile working towards a fully powered randomized controlled trial. The ability to reduce anxieties about ageing with this brief intervention could have far‐reaching benefits for multiple patient and general population groups. Statement of contribution What is already known on this subject? Hearing impairment is more disabling than diabetes, yet hearing aid use is suboptimal.Anxieties about ageing may undermine hearing aid use. What does this study add? The study tests a brief theory‐based psychological intervention to reduce anxiety about ageing and promote hearing aid use.Results show that the brief psychological intervention reduced anxiety and marginally increased objective hearing aid use.Further work is required to identify other situations in which anxieties about ageing undermine behaviour change efforts.The very brief, flexible nature of the intervention means it could be adapted and deployed in numerous other health care settings.

Beyond motivation: identifying targets for intervention to increase hearing aid use in adults

“…Participants reported being highly motivated and confident they could use a hearing aid as advised, consistent with Armitage et al (2017). This high level of motivation in participants was expected because, by definition, the participants had both acknowledged the possibility of a hearing loss and attended the hearing assessment appointment .…”

“…The questionnaire items of behavioural intention was adapted from Armitage et al (2017) using participants' responses to three items: "I intend to wear a hearing aid as advised definitely do not-definitely do", "I want to wear a hearing aid as advised definitely do not-definitely do" and "How likely is it that you will wear a hearing aid as advised? not likely-very likely".…”

“…Action self-efficacy was adapted from Armitage et al (2017) and was assessed using responses to three items: "My wearing a hearing aid as advised would be difficult-easy", "I believe I have the ability to wear a hearing aid as advised definitely do not-definitely do" and "How confident are you that you will be able to wear a hearing aid as advised? not at all-very much so".…”

Biopsychosocial Classification of Hearing Health Seeking in Adults Aged Over 50 Years in England

“…Few participants (1.2%) reported being offered a hearing aid but not having obtained one (category vi “Accepted a hearing aid”). The very high uptake of hearing aids may be because individuals sufficiently motivated to attend a hearing assessment may be likely to follow the advice of a hearing health care professional to obtain a hearing aid following a hearing assessment ( Armitage et al 2017 ). A high level of motivation to use hearing aids in individuals attending audiological clinics has been demonstrated in previous studies ( Meister et al 2008 , 2014 ; Ferguson et al 2016 ; Armitage et al 2017 ; Sawyer et al 2019b ).…”

What do hearing healthcare professionals do to promote hearing aid use and benefit among adults? A systematic review

“…an "action plan") may be important to translate motivation to use a hearing aid into consistent hearing aid use (Sawyer et al in press); evidence suggests that patients are already highly motivated to wear a hearing aid when present in audiology clinics (e.g. Armitage et al 2017;Sawyer et al in press). The challenge is translating good intentions into behaviour.…”