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Purpose: The aim of this study was to investigate the perspectives of Australiabased hearing health care consumers regarding the (a) provision and utilization of teleaudiology services, (b) experiences with teleaudiology, and (c) barriers and enablers to future teleaudiology use. Method: A national prospective self-report online survey was completed between April and October 2020, amid COVID-19. Data were analyzed using descriptive statistics (closed-answer items) and content analysis (open-text responses). A total of 381 participants (Mage = 72.07 years ± 10.08, 142 females) were recruited from different states and territories of Australia. Results: Despite positive outcomes reported by those who undertook teleaudiology appointments during COVID-19, results indicate low-consumer teleaudiology uptake. It can be inferred that consumers were not aware of teleaudiology as an appointment option, clinicians/clinic staff had not informed and/or supported teleaudiology as an option, and biases existed that prevented teleaudiology being more widely adopted. It is unclear whether consumers who were eligible for government subsidies understood that teleaudiology appointments were reimbursed through government funding. Barriers to future teleaudiology uptake were largely related to concerns regarding confidentiality and privacy. Conclusion: Lowconsumer uptake of teleaudiology appointments appears to be driven by consumer preference for in-person services, which appears to be driven by lack of knowledge regarding the availability and effectiveness of teleaudiology. [ABSTRACT FROM AUTHOR]

To conduct the first phases in the development of a self-report measure of empowerment on the hearing health journey, specifically, item generation and content evaluation of the initial pool of items generated. A content expert panel survey and cognitive interviews were conducted. Descriptive statistics were obtained for the quantitative data, and the cognitive interviews were analysed using thematic analysis. Eleven researchers and clinicians participated in the content expert surveys. Sixteen experienced hearing aid users participated in the cognitive interviews, recruited from the USA and Australia. The items underwent five iterations based on feedback from the survey and interview data. This resulted in a set of 33 quality-tested potential survey items that were rated highly for relevance (mean = 3.96), clarity (mean = 3.70) and fit to dimensions of empowerment (mean = 3.92) (scale 0-4, where 4 was the maximum rating). Involving stakeholders in item generation and content evaluation increased relevance, clarity, fit to dimension, comprehensiveness, and acceptability of the items. This preliminary version of the 33-item measure underwent further psychometric refinement (Rasch analysis and traditional classical test theory testing) to validate it for clinical and research use (reported separately). [ABSTRACT FROM AUTHOR]

Objective: To explore the utilisation, safety, cost, and patient outcomes of delivering tele-audiology services during the COVID-19 pandemic. Design: A national cross-sectional self-report online survey asking participants to reflect on interactions with hearing services between April and October 2020. Data were analysed using descriptive statistics. The COM-B model of behaviour change guided survey creation and the presentation of a subset of the results. Study sample: 249 Australia-based hearing healthcare clinicians (age range 23–74 years; 162 female). Results: Clinicians reported an increase in the use of tele-audiology services, with key drivers relating to keeping their patients safe and keeping businesses running. Clinicians generally viewed the provision of tele-audiology services as successful and resulting in improved patient outcomes. Overall, clinicians were highly motivated to provide tele-audiology services, and they expressed being confident in their knowledge and understanding of tele-audiology service delivery. Barriers to providing tele-audiology services included concerns about the reliability of the results obtained from remote assessments, as well as concerns around information security and privacy issues. Conclusions: Clinicians’ motivations to use tele-audiology services appeared to be driven by their desire to maintain COVID-safe practices during the pandemic and by the COVID-driven increase in availability of funding for tele-audiology services. [ABSTRACT FROM AUTHOR]

To canvas the views of Australia-based hearing healthcare clinic owners/managers and reception staff regarding the utilisation, experiences and perspectives of providing tele-audiology services during the COVID-19 pandemic. A national prospective self-report survey was completed online. Data were analysed using descriptive statistics. Twenty-one clinic owners/managers (Mage 54.43 years, 15 female) and 58 reception staff (Mage 42.88 years, 49 female) from Australia-based hearing clinics. Clinic owners/managers reported an increase in use of tele-audiology services as compared to pre-COVID-19. Reception staff reported providing more advice and support to clients over the phone. Both clinic owners/managers and reception staff indicated key barriers to providing tele-audiology services to include concerns about their clients' digital and technological literacy and the perception that in-the-clinic appointments deliver better client outcomes than tele-audiology appointments. The increased utilisation of tele-audiology services observed appears to be largely influenced by COVID-19 related factors (e.g. maintaining client and staff safety and increased funding). It is therefore possible that utilisation of tele-audiology service may drop once the threat of the pandemic has subsided. Perceived barriers relating to clients' digital literacy and the effectiveness of tele-audiology services require attention to safeguard the future of tele-audiology service delivery in Australia. [ABSTRACT FROM AUTHOR]

To explore the lived experience of social challenges and emotional distress in relation to hearing loss and the coping mechanisms employed to manage them. Two focus groups and two one-on-one semi-structured interviews were conducted during February 2020. Transcripts were first inductively analysed to identify experiential categories of social and emotional difficulty, and then deductively analysed using Leventhal's self-regulation model to identify how individuals conceptualised these experiences and the coping mechanisms employed to manage them. Adults with hearing loss and self-reported emotional distress due to their hearing loss (n = 21) and their significant others (n = 9). Participants described their social and emotional experiences of hearing loss in terms of negative consequences (social overwhelm, fatigue, loss, exclusion), identity impact (how they perceive themselves and are perceived by others), and emotional distress (frustration, grief, anxiety, loneliness, and burdensomeness). While many participants described a general lack of effective coping strategies, others described employing coping strategies including avoidance (helpful and unhelpful), controlling the listening environment, humour, acceptance, assertiveness, communication repair strategies, and accepting support from significant others. Many participants described a lack of effective coping strategies and tended to rely on avoidance of social interaction,deepening their isolation and loneliness. [ABSTRACT FROM AUTHOR]

The aim of the study was to examine the mental well-being of audiologists in the midst of the COVID-19 pandemic. A cross-sectional online survey was conducted during the COVID-19 pandemic, between 23 June and 13 August 2020. A self-report survey included screening measures for psychological distress (PHQ-4: anxiety and depression) and loneliness (UCLA-3). 239 audiologists from around the world. The prevalence of psychological distress was 12.1% (subscales for anxiety 16.3% and depression 10.4%), and loneliness 32.2%. Depression and loneliness were higher in those participants self-reporting perceived job insecurity, with psychological distress (anxiety and depression) higher in those from South Africa. Accessibility to Employee Assistance Programs (EAPs) appears to be a protective factor. Well-being interventions, such as EAPS, are needed to support audiologists during challenging times like the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

To canvas the views of Australia-based hearing healthcare clinicians regarding group audiological rehabilitation practices. A national cross-sectional self-report survey. Data were analysed using descriptive statistics and content analysis. Sixty-two Australia-based hearing healthcare clinicians, with experience working in an adult rehabilitation setting. Clinicians appeared to positively view the provision of group audiological rehabilitation services, yet were limited in their ability to deliver these services due to organisational barriers. Although some organisational barriers were non-modifiable by the clinician (such as group AR services not prioritised within their workplace, a lack of support from colleagues/managers, lack of resources, and a lack of funding for the delivery of group AR services), others were within the clinicians' ability to change (such as habit formation for recommending these services during clinical appointments). Participants expressed a desire for resources to assist them in delivering group AR, including downloadable lesson plans and information sheets for clients, clinician training videos and client educational videos. Clinicians called for increased diversity in program offerings, specifically relating to the emotional, relational and social impacts of hearing loss. These results provide a framework for the development of interventional studies to increase the utilisation of group audiological rehabilitation services. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to (a) identify participant factors associated with hearing aid review (HAR) appointment attendance, (b) investigate whether the completion of self-report survey identifying hearing aid--related problems affects HAR appointment attendance, and (c) investigate whether hearing aid problems and hearing aid management deficiencies are adequately addressed during HAR appointments. Method: A prospective cohort study of adult hearing aid owners recruited from a single hearing clinic in Western Australia. Potential participants were invited to an annual HAR appointment via postal letter. The invitation included a paper-based self-report survey evaluating either (a) hearing aid problems, (b) hearing aid management skills, or (c) hearing aid outcomes, depending on which intervention/control group the potential participants were assigned to, and a reply paid addressed envelope. Two months later, potential participants were sent all three paper-based self-report surveys, irrespective of whether they had attended or not attended an HAR appointment. Results: (a) There was no significant difference in gender or source of funding for hearing services between HAR appointment attendees and nonattendees. HAR nonattendees lived a greater distance from their clinic and were younger than attendees. (b) Survey completion did not influence HAR appointment attendance rates. (c) A significant reduction in individuals' self-reported hearing aid problems was recorded following the attendance at the HAR appointment. No significant changes in hearing aid management skills or overall hearing aid outcomes were detected. Conclusions: Long travel distances may be a barrier to attendance at review appointments. HAR appointments appear to be effective in improving hearing aid problems. [ABSTRACT FROM AUTHOR]

Purpose: Audiology clinical guidelines recommend the use of mental health screening tools; however, they remain underutilized in clinical practice. As such, psychological concerns are frequently undetected in adults with hearing loss. This study aimed to better understand audiology clinic staff's perspectives (including audiologists, audiometrists, reception staff, and clinic managers) on how to improve detection of poor mental health by (a) exploring the role of audiology clinic staff in detecting psychological concerns in adults with hearing loss and (b) investigating the appropriateness, acceptability, and usability of several screening tools in an audiology setting. Method: Eleven audiology clinic staff (Mage = 33.9 ± 7.3, range: 25-51 years) participated in a semistructured focus group. First, participants discussed the role of audiology clinic staff in detecting psychological difficulties in adults with hearing loss, including current practices and needs for improving practices. Second, participants discussed the appropriateness, acceptability, and usability of nine standardized mental health screening tools commonly used in wider health care settings. Results: Audiology clinic staff described their role in being aware of, and detecting, psychological difficulties, as well as their part in promoting an understanding of the link between hearing loss and mental health. Participants described the need to provide support following detection, and highlighted barriers to fulfilling these roles. The use of mental health screening tools was considered to be client and context specific. The language used within the screener was identified as an important factor for its acceptability by audiology clinic staff. Conclusions: Audiology clinic staff acknowledged that they have an important role to play in the detection of psychological difficulties and identified the core barriers to using screening tools. Future research may explore the possibility of developing amental health screening tool specific to the unique experiences of adults with comorbid hearing loss and mental health concerns. Supplemental Material: https://doi.org/10.23641/asha.16702501 [ABSTRACT FROM AUTHOR]

Purpose: Online reviews have been used by hearing aid owners to share their experiences and to provide suggestions to potential hearing aid buyers, although they have not been systematically examined. The study was aimed at examining the hearing aid consumer reviews using automated linguistic analysis, and how the linguistic variables relate to self- reported hearing aid benefit and satisfaction ratings. Method: The study used a cross-sectional design. One thousand three hundred seventy-eight consumer hearing aid reviews (i.e., text response to open-ended question), self- reported benefit and satisfaction ratings on hearing aids in a 5-point scale with meta-data (e.g., hearing aid brand, technology level) extracted from the Hearing Tracker website were analyzed using automated text analysis method known as the Linguistic Inquiry and Word Count. Results: Self-reported hearing aid benefit and satisfaction ratings were high (i.e., mean rating of 4.04 in a 5-point scale). Examining the association between overall rating and the key linguistic variables point to two broad findings. First, the more people were personally, socially, and emotionally engaged with the hearing device experience, the higher they rated their hearing device(s). Second, a minimal occurrence of clinic-visit language dimensions points to factors that likely affect benefit and satisfaction ratings. For example, if people mention paying too much money (money), their overall ratings are generally lower. Conversely, if people write about their health or home, the ratings were higher. There was no significant difference in linguistic analysis across different hearing aid brands and technology levels. Conclusions: Hearing aid consumers are generally satisfied with their hearing device(s), and their online reviews contain information about social/emotional dimensions as well as clinic-visit related aspects that have bearing toward hearing aid benefit and satisfaction ratings. These results suggest that the natural language used by consumers provide insights on their perceived benefit/satisfaction from their hearing device. [ABSTRACT FROM AUTHOR]

Objective: To investigate hearing aid owners' decisions to attend or not to attend an annual hearing aid review (HAR) appointment. To investigate the possible factors associated with appointment attendance, including age, gender, transportation, travel time, and hearing aid outcomes. Design: A prospective cohort study. Potential participants were notified of their annual HAR appointment in the usual process employed by their clinic. Two months later, potential participants were identified as those who had attended and those who had not attended an appointment. Study sample: One hundred and twenty adult hearing aid users ranging in age from 26 to 100 (M=74, SD=11) years recruited from a single hearing clinic in Perth, Western Australia. Results: Factors found to be significantly associated with attendance at an annual HAR appointment included hearing aid funding source (government subsidised), participants valuing the importance and benefit of the appointment, and superior hearing aid outcomes. Conclusions: Within a controlled practice setting, appointment attendance is influenced by some factors modifiable by the clinician, including providing better education about the process and purpose of the HAR appointment. The value of the HAR appointment was emphasised by the positive association between better hearing aid outcomes HAR appointment attendance. [ABSTRACT FROM AUTHOR]

Background: Clinical studies have found up to 90% of hearing aid owners demonstrate difficulty with basic hearing aid management tasks and almost 50% of hearing aid owners self-report not receiving enough practical help from their clinician regarding how to use their hearing aid. Although studies have highlighted the overwhelming amount of information and training required to learn how to use a hearing aid appropriately, a gap remains in the literature regarding the range of methods by which hearing aid owners acquire the knowledge and skills for hearing aid use, and whether these approaches are considered beneficial. Purpose: To gain insight into how both hearing aid owners and hearing health clinicians view the acquisition of hearing aid management skills and the efficacy of currently used methods of hearing aid training. Research Design: Concept mapping techniques were used to identify key themes, wherein participants generated, sorted, and rated the importance of statements in response to the question "How do hearing aid owners learn the skills required to use, handle, manage, maintain, and care for their hearing aids?" Study Sample: Twenty-four hearing aid owners (aged 56-91 years; 54.2% male) and 22 clinicians (aged 32-69 years; 9.1% male). Data collection and Analysis: Participant perspectives were collected via group concept mapping sessions in October 2015. Hierarchical cluster analysis was used to identify themes and develop a framework for understanding how skill acquisition occurs. Participants rated each method of hearing aid skill acquisition as to how beneficial it was and how often it was used. Results: Participants identified 75 unique items describing how hearing aid management skills are acquired within six concepts: (1) Relationship with the clinician, (2) clinician as a source of knowledge and support, (3) hands-on experience, (4) seeking additional information, (5) asking support people for help, and (6) external resources. Conclusions: The results of this study highlight the diverse methods and sources by which hearing aid owners learn the skills necessary to use, manage, and maintain their hearing aids. Significant emphasis was placed on the role of the hearing health clinician to provide training, support, and an ongoing professional relationship, with lesser roles played by family, friends, and other health professionals. [ABSTRACT FROM AUTHOR]

Purpose: Hearing aid management describes the skills and knowledge required for the handling, use, care, and maintenance of the hearing aid. The importance of hearing aid management skills and knowledge is evidenced by their association with hearing aid outcomes. However, the nature of this association and the influence of participant factors on this association are unknown. Accordingly, the aims of the current study were to (a) investigate participant factors that influence hearing aid management skills and knowledge and (b) investigate the impact of hearing aid management skills and knowledge on hearing aid outcomes. Method: Factors associated with hearing aid management skills and knowledge were investigated through an e-mail-- and paper-based self-report survey, including the Hearing Aid Skills and Knowledge Inventory (Bennett, Meyer, Eikelboom, & Atlas, 2018b) and the International Outcomes Inventory for Hearing Aids (Cox & Alexander, 2002). The study sample included 518 adult hearing aid owners, ranging in age from 18 to 97 years (M = 71 years, SD = 14 years), 61% male and 39% female, recruited from seven hearing clinics across Australia. Results: Participant factors found to be associated with hearing aid skills and knowledge included participants' age, gender, style of hearing aid, age of current hearing aid, and total years of hearing aid ownership. Higher levels of hearing aid management skills and knowledge were found to be associated with better hearing aid outcomes, specifically higher self-reported satisfaction with hearing aids, perceived benefit from hearing aids, and overall outcome of the hearing aid fitting as evaluated by the International Outcomes Inventory for Hearing Aids. Conclusions: Hearing aid management difficulties were greatest for older people, women, and owners of behind-the-ear style of hearing aids, suggesting that clinicians need to be cognizant of the additional needs for these three groups. The positive association between hearing aid outcomes and hearing aid skills and knowledge emphasizes the importance of education and training on hearing aid management for successful aural rehabilitation. [ABSTRACT FROM AUTHOR]

Objective: Although clinician administered surveys evaluating hearing aid handling skills exist, the development of a self-administered version may reduce clinical load, save consultation time, and facilitate more frequent use than face-to-face consultations allow. However, there is currently no evidence to support whether hearing aid owners can accurately self-report hearing aid handling skills via self-report survey that systematically evaluates the ability to accurately perform the individual aspects of hearing aid handling required for effective hearing aid management.Design: An explorative pilot study using a prospective research design.Study sample: Nineteen adult hearing aid owners, aged between 65 and 93 years.Results: The self-administered survey demonstrated high sensitivity when compared with clinician evaluation of skills, with 93% of participants accurately self-identifying and reporting whether hearing aid handling skill training was required.Conclusions: Hearing aid owners are able to accurately self-report hearing aid handling difficulties when provided with an itemised list of skills. [ABSTRACT FROM AUTHOR]

Objective To examine whether self-reported hearing difficulty is an accurate measure of hearing loss compared with standard hearing screening with pure tone audiometry in rural and urban communities. Design Convenience sampling. Setting Urban and rural areas of Western Australia. Participants A total of 2090 participants (923 men; 1165 women; 2 unknown) aged 20-100 years presenting for community-based hearing screening in urban (982) and rural (1090) areas. Interventions Self-reported hearing difficulty assessed with the Hearing Handicap Inventory for the Elderly - Screening questionnaire. Hearing loss defined as average hearing thresholds >25 dB in the better ear using screening audiometry conducted at 500, 1000, 2000 and 4000 Hz. Main outcome measures Nil. Results The Hearing Handicap Inventory for the Elderly - Screening was sensitive (≥60 years = 76.69%; <60 years = 71.67%) but not specific (≥60 years = 45.15%; <60 years = 49.63%) for identifying hearing loss. The <60 age group had a hearing loss prevalence of 25.6%, and a false-positive rate of 67.12% compared with a prevalence of 69.12% and false-positive rate of 29.77% for the ≥60 age group. For all ages, rural participants were more likely to have a disabling hearing loss (odds ratio 2.04 (95% confidence interval, 1.55-2.67); χ2(1) = 27.28; P < 0.001), but there were no significant differences in hearing aid uptake. Conclusions Patients in rural areas presenting for hearing screenings are more likely to suffer hearing loss than adults in urban areas. We suggest rural health practitioners incorporate a self-reported hearing loss questionnaire into health check-ups for adults, particularly patients aged ≥60 years due to the high prevalence of hearing loss in this group. [ABSTRACT FROM AUTHOR]