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BackgroundPeer support is an emerging form of person-driven active health care. Chronic conditions such as Ménière’s disease (a disorder of the inner ear) need continuing rehabilitation and support that is beyond the scope of routine clinical medical practice. Hence, peer-support programs can be helpful in supplementing some of the rehabilitation aspects. ObjectiveThe aim of this study was to design a computerized data collection system for the peer support of Menière’s disease that is capable in profiling the subject for diagnosis and in assisting with problem solving. MethodsThe expert program comprises several data entries focusing on symptoms, activity limitations, participation restrictions, quality of life, attitude and personality trait, and an evaluation of disease-specific impact. Data was collected from 740 members of the Finnish Ménière’s Federation and utilized in the construction and evaluation of the program. ResultsThe program verifies the diagnosis of a person by using an expert system, and the inference engine selects 50 cases with matched symptom severity by using a nearest neighbor algorithm. These cases are then used as a reference group to compare with the person’s attitude, sense of coherence, and anxiety. The program provides feedback for the person and uses this information to guide the person through the problem-solving process. ConclusionsThis computer-based peer-support program is the first example of an advanced computer-oriented approach using artificial intelligence, both in the profiling of the disease and in profiling the person’s complaints for hearing loss, tinnitus, and vertigo.

Purpose: This study examined intervention intensity and service delivery with school-age children with mild or mild-moderate speech sound disorders. The commonly used business-as-usual (BAU) service delivery model and a shorter, more frequent, individual model (experimental [EXP]) were compared. Method: A between-subjects group design was selected. In BAU, 11 children received group sessions, 2 times per week, 30 min per session for 6 weeks. In EXP, 11 children received individual session, 3 times per week, 5 min per session for 6 weeks. Group differences on measures of dose (i.e., therapeutic input and production trials) and cumulative treatment intensity were examined. The extent to which children, across both conditions, demonstrated gains in speech sound accuracy and the extent to which gains differed between BAU and EXP were examined. Results: There was a significant group difference on dose. Children in BAU received more therapeutic input and production trials than children in EXP. Cumulative treatment intensity was not statistically different between groups when dose was calculated as therapeutic input or production trials. Results from both conditions indicated statistically significant differences on measures of speech sound accuracy with large effect sizes. No group differences on gains were noted. Conclusions: Dose calculated as therapeutic input and production trials plays an important role in understanding the impact of cumulative intervention intensity. Children with mild or mild--moderate speech sound disorders may benefit more from a shorter, frequent, individual service delivery model than a BAU model.

Stakeholders within autism spectrum disorder communities use Twitter for specific purposes. The goal of this study was to characterize patterns and themes of tweet content and sentiment and intercommunications between users sending and retweeting content to their respective user networks. The study used cross-sectional analysis of data generated from Twitter. Twitter content, sentiment, users, and community networks were examined from a sample of tweets with the highest Twitter reach and the lowest Twitter reach. Results indicate that Twitter content from both samples was primarily related to empowerment and support. Differences between the number of tweets originating from an individual in the lowest reach sample (i.e. 41%) as compared to the individuals in the highest reach sample (i.e. 18%) were noted. The number of users belonging to an advocacy subcommunity was substantially larger than a clinical and research subcommunity. Results provide insight into the presuppositions of individuals with autism spectrum disorder, their families and significant others, and other stakeholders.

Purpose: This study explored user perspectives on the relationship between hearing aid cost and uptake, as well as cost-related recommendations for others with hearing difficulties, in a sample of prescription and over-the-counter (OTC) hearing aid users. Method: A secondary analysis was conducted on a cross-sectional survey using qualitative content analysis to analyze responses related to the cost of hearing aids. The study included a total of 241 adult participants, comprising 179 prescription hearing aid users from the Hearing Tracker website and 62 OTC hearing aid users from the Lexie Hearing U.S. database. Results: Prescription users had a mean age of 66.7 years (SD = 13.2), including 62.0% males, 37.4% females, and 0.6% nonbinary individuals. OTC users had a mean age of 63.0 years (SD = 13.4), with 48.4% males and 51.6% females. Three overarching domains were identified: perceived enablers to hearing aid uptake related to the cost, perceived barriers to hearing aid uptake related to the cost, and recommendations to others with hearing difficulties related to the cost, with 14 categories recognized for prescription users and 12 for OTC users. Both groups identified the high cost of hearing aids and lack of insurance coverage as significant barriers to uptake. Many prescription users reported external support (e.g., financial support and health insurance coverage) as an enabler, while OTC users frequently mentioned the affordability of OTC devices. The most common recommendation among prescription users was to seek professional support, whereas OTC users recommended researching hearing aids before making a purchase. Conclusions: Cost and insurance coverage consistently emerge as primary barriers to hearing aid adoption for both prescription and OTC users. To foster greater accessibility, initiatives should target these financial obstacles. Additional research is warranted on the relationship between hearing aid cost and uptake, especially among OTC users and those seeking financial assistance. Supplemental Material: https://doi.org/10.23641/asha.26496922 [ABSTRACT FROM AUTHOR]

Objective: This systematic review examined the audiological and non-audiological factors that influence hearing aid use, benefit and satisfaction in adults based on studies published during the last decade (2010 and 2023). Design: Studies were identified by using PRISMA guidelines for systematic searches on five platforms (Web of Science, Scopus, PubMed, EBSCOhost including CINAHL and Academic Search Complete). The National Institute of Health Quality assessment tool and the Oxford Centre for Evidence Based Medicine tool were used for quality assessment and grading of level of evidence. Results: Forty-six articles were included in the review. A total of 101 significant factors influencing hearing aid use (n = 47), benefit (n = 17) and satisfaction (n = 37) were identified. Clear determinants of hearing aid use, benefit and satisfaction included hearing sensitivity, self-reported hearing difficulty, speech perception, attitude and beliefs. 34 cross-sectional studies in this review were graded level 4, 9 cohort studies rated level 3, and 3 randomised control trials rated level 2. Conclusion: Factors associated with hearing aid outcomes identified in the past decade support previous evidence. New factors like social networks and service-delivery models, have also been identified. These factors require further investigations through high quality studies to further strengthen existing evidence. [ABSTRACT FROM AUTHOR]

Purpose: Hearing aids play a pivotal role in mitigating the impact of hearing loss, yet their adoption and consistent usage remains suboptimal. Understanding the hearing aid needs of individuals with hearing loss is important to support uptake, use, and outcomes. The current study describes users' perspectives on how hearing aids can be improved. Method: A cross-sectional, qualitative, content analysis design was used for an open-ended question from an online survey, exploring user perspectives on hearing aid improvements. Participants were adult hearing aid users in the United States, surveyed from the HearingTracker and Lexie Hearing user database. Results: A total of 628 participants (Mage = 66 years) were surveyed. The majority of participants used bilateral, behind-the-ear hearing aids that were obtained either through a hearing health care professional or online. Three domains, highlighting areas for hearing aid improvement, were identified. (a) The hearing aid features domain described user issues surrounding physical appearance and fit, general features, streaming, battery functionality, adjustments, smartphone applications, and hearing aid--related accessories. There was dissatisfaction with aesthetics and functionality, with a notable desire for improvements in physical appearance and fit (n = 161), and features to improve self-efficacy. (b) The sound quality domain described user issues surrounding sound perception and difficult situations. Participants highlighted unmet needs for clarity, especially in noisy environments (n = 143). (c) The service-delivery domain described user issues surrounding audiology services and general satisfaction, with criticisms centered on the high cost of hearing aids (n = 193) and the credibility of hearing health care professionals. Conclusions: Hearing aid users appreciated current technological advances but expressed a need for improvements, to better align devices with their requirements. Key areas included physical aesthetics, user control over device adjustments, sound clarity, cost accessibility, and trust between the user and hearing health care professional. Future designs should focus on features enhancing user autonomy and self-efficacy. [ABSTRACT FROM AUTHOR]

During the last decade, there has been a move towards consumer-centric hearing healthcare. This is a direct result of technological advancements (e.g., merger of consumer grade hearing aids with consumer grade earphones creating a wide range of hearing devices) as well as policy changes (e.g., the U.S. Food and Drug Administration creating a new over-the-counter [OTC] hearing aid category). In addition to various direct-to-consumer (DTC) hearing devices available on the market, there are also several validated tools for the self-assessment of auditory function and the detection of ear disease, as well as tools for education about hearing loss, hearing devices, and communication strategies. Further, all can be made easily available to a wide range of people. This perspective provides a framework and identifies tools to improve and maintain optimal auditory wellness across the adult life course. A broadly available and accessible set of tools that can be made available on a digital platform to aid adults in the assessment and as needed, the improvement, of auditory wellness is discussed. [ABSTRACT FROM AUTHOR]

Background: This study aimed to examine whether individuals with chronic tinnitus report more positive experiences following internet-based cognitive behavioral therapy (CBT). Methods: A mixed-methods design was used, nested in clinical trials evaluating internet interventions for tinnitus. Participants (n = 164) completed online questionnaires (both structured and open-ended) providing demographic information as well as health variables (e.g., tinnitus distress, anxiety, depression, insomnia). An open-ended question listing positive effects or outcomes related to having tinnitus was also included. Responses to the open-ended questions were analyzed using qualitative content analysis. Results: Of the 164 eligible participants, 32.3% (n = 53) provided at least 1 positive experience both at pre- and post-intervention, with 9.1% (n = 19) providing positive experiences only at pre-intervention, 49 (29.9%) providing positive experiences only at post-intervention, and 28.7% (n = 47) of the participants did not provide any positive experiences on either measurement occasion. Significantly more positive experiences were reported following the intervention in the overall sample (p < 0.0001, paired sample t-test). In addition, participants who reported positive experiences in both pre- and post-intervention also reported more positive experiences following intervention (p = 0.008, paired sample t-test). Conclusions: Internet-based CBT can help individuals with tinnitus to think more positively by changing unhelpful thought patterns. Open-ended questions can supplement structured questionnaires to measure treatment outcomes. [ABSTRACT FROM AUTHOR]

Professionals have expressed concerns about the quality of autism-related information available from Internet-based sources. The purpose of this study was to examine the source, content, usability, and actionability of autism spectrum disorder--related information contained in 100 different videos directed to families of children with autism spectrum disorder uploaded to YouTube. Upload sources were identified, and video content was coded. Understandability and actionability of the videos were examined using Patient Education Materials Assessment Tool for Audiovisual Materials. The collective number of views of the videos was almost 100 million. The length of videos was 691.17 min (i.e. 11.5 h) with the shortest video being 30 s and the longest video being 37.36 min. The YouTube videos related to autism spectrum disorder covered a range of issues, although much of the content was focused on signs and symptoms. No difference in content reporting was noted based on sources for most categories, although differences were noted in some categories (e.g. professionals mentioned diagnosis and resources more frequently). Poor understandability and actionability scores (i.e. below 70%) were reported for all videos regardless of video source. However, the videos generated by the professionals were superior in terms of understandability. Study implications and recommendations for further research are discussed.

Purpose: The current study was aimed at understanding the benefits and shortcomings of direct-to-consumer hearing devices (DCHDs) by analyzing the large text corpus of secondary data generated from Amazon customer reviews. Method: Secondary data were generated manually by gathering user feedback for 62 different DCHDs (cost range: $9.95-$635) on the Amazon.com website, which included 11,258 unique Amazon-verified customer reviews. The data were analyzed using both quantitative and qualitative analyses methods. Results: The cluster analysis of large data corpus resulted in 7 unique clusters, which were labeled as (a) Issues related to fit and comfort (15%), (b) Friends and family recommendations (11.8%), (c) Issues related to sound quality (11.9%), (d) Listening and conversation (16.1%), (e) Positive customer service (12.1%), (f) General usage and customer service (14.7%), and (g) Cost and affordability (17.3%). Exploratory analysis also revealed an association between customer ratings and cost in relation to these clusters (i.e., customer reviews). For example, customer reviews about cheaper DCHDs are related to issues about sound quality, whereas reviews about expensive DCHDs are related to cost and affordability of the device. The qualitative content analysis resulted in 8 main themes, which include (a) intrinsic factors, (b) extrinsic factors, (c) supplemental items, (d) ease of use, (e) interaction with support services, (f) reasons for purchase, (g) experiences, and (h) general information. Conclusions: The study using the text mining techniques highlights the benefits and shortcomings of DCHDs that are currently available in the U.S. market. Our findings relate well to the published study results of electroacoustic analysis on similar products, which provide clinicians with knowledge related to DCHDs that they can convey to consumers during clinical consultations. The findings may also be of interest to the hearing instrument industry from the perspective of developing products based on user feedback.

Purpose: The aim of the current study was to explore the construct validity and internal consistency reliability of the International Classification of Functioning, Disability and Health (ICF)--based original English version of the Hearing and Functioning in Everyday Life Questionnaire (HFEQ) and to revise the HFEQ based on the results. Method: This study used a cross-sectional survey design. The data were collected using an online survey. Adults with self-reported hearing disability (n = 513) from the United States were included. The ICF components of body functions, activity and participation, and environmental factors were tested as the underlying structure of the HFEQ using confirmatory factor analysis and then adjusted by triangulation with previous content validation. Results: The results of the current study confirmed the ICF components of body functions, activity and participation, and environmental factors as underlying constructs of the HFEQ. However, after triangulation with previous content validation, fine adjustments were made. The revised version of the HFEQ includes two removed items and a fine-tuned factor structure. Conclusion: The results confirm that the structure of the HFEQ aligns with the ICF, and the overall results indicate that HFEQ has acceptable construct validity and internal consistency. [ABSTRACT FROM AUTHOR]

The aim of the current study was to examine the presence of positive experiences reported by individuals with tinnitus in the United States. The study used a cross-sectional survey design. The data were analysed using qualitative (content analysis) and quantitative (t-test or Chi-square test) analyses. Study participants were individuals participating in clinical trials involving Internet-based cognitive behavioural therapy (ICBT) for tinnitus. A total of 439 respondents, 211 (48.1%) male and 228 (51.9%) female responded, and data were collected via an online questionnaire. Of the 439 participants, 164 (i.e. 37.4%) reported at least one positive experience. Younger participants and those with lower hearing disability were more likely to report positive experiences. The responses were categorised into six categories: Outlook (n = 139), Personal development (n = 42), Treatment-related (n = 42), Coping (n = 29), Support (n = 19), and Disease-specific (n = 19). The ability of individuals with chronic tinnitus to identify positive experiences may give insights regarding acceptance and coping with tinnitus as well as the temperament of individuals reporting positive experiences. Considering these variables may help when planning individualised rehabilitation programs. [ABSTRACT FROM AUTHOR]

Problem: Although many young adults with Autism Spectrum Disorder (ASD) are intellectually capable of pursuing college degrees, a high percentage either do not enroll in or do not graduate from two-year or four-year institutions. Online student support services may uniquely support the higher education goals of this population. Understanding current accessibility of Internet-based information will help institutions develop targeted resources. Method: This study assessed the quantity, quality, and readability of such Internet-based information. Quantity of websites was determined using the search strategy provided by Laplante-Lévesque and colleagues (2012). An 11-item criteria checklist (Hasan & Abuelrub, 2011) was used for content quality evaluation. Readability of the website text was assessed using Oleander Software (http://www.oleandersolutions.com/). Descriptive statistics were reported. Results: Of 116 identified websites, only 12 included information directed to young adults with ASD. Most websites stated clear, relevant aims. However, information related to unique areas of needs of college students with ASD were minimal. Readability levels were high, which is indicative of complex, abstract language. Conclusions: Results suggest increased attention to the quantity, quality, and readability of online information for college students with ASD seeking student support services is needed. Specific recommendations for online student support service programming are included.

Purpose: The current study was aimed at understanding the benefits and shortcomings of direct-to-consumer hearing devices (DCHDs) by analyzing the large text corpus of secondary data generated from Amazon customer reviews. Method: Secondary data were generated manually by gathering user feedback for 62 different DCHDs (cost range: $9.95-$635) on the Amazon.com website, which included 11,258 unique Amazon-verified customer reviews. The data were analyzed using both quantitative and qualitative analyses methods. Results: The cluster analysis of large data corpus resulted in 7 unique clusters, which were labeled as (a) Issues related to fit and comfort (15%), (b) Friends and family recommendations (11.8%), (c) Issues related to sound quality (11.9%), (d) Listening and conversation (16.1 %), (e) Positive customer service (12.1%), (f) General usage and customer service (14.7%), and (g) Cost and affordability (17.3%). Exploratory analysis also revealed an association between customer ratings and cost in relation to these clusters (i.e., customer reviews). For example, customer reviews about cheaper DCHDs are related to issues about sound quality, whereas reviews about expensive DCHDs are related to cost and affordability of the device. The qualitative content analysis resulted in 8 main themes, which include (a) intrinsic factors, (b) extrinsic factors, (c) supplemental items, (d) ease of use, (e) interaction with support services, (f) reasons for purchase, (g) experiences, and (h) general information. Conclusions: The study using the text mining techniques highlights the benefits and shortcomings of DCHDs that are currently available in the U.S. market. Our findings relate well to the published study results of electro-acoustic analysis on similar products, which provide clinicians with knowledge related to DCHDs that they can convey to consumers during clinical consultations. The findings may also be of interest to the hearing instrument industry from the perspective of developing products based on user feedback., It is estimated that, globally, there are 466 million people with disabling hearing loss (World Health Organization, 2018). Untreated hearing loss can have physical, mental, and social consequences for people [...]