Factors Associated With Successful Setup of a Self-Fitting Hearing Aid and the Need for Personalized Support

Objectives: Self-fitting hearing aids have the potential to increase the accessibility of hearing health care. The aims of this study were to (1) identify factors that are associated with the ability to successfully set up a pair of commercially available self-fitting hearing aids; 2) identify factors that are associated with the need for knowledgeable, personalized support in performing the self-fitting procedure; and (3) evaluate performance of the individual steps in the self-fitting procedure. Design: Sixty adults with hearing loss between the ages of 51 and 85 took part in the study. Half of the participants were current users of bilateral hearing aids; the other half had no previous hearing aid experience. At the first appointment, participants underwent assessments of health locus of control, hearing aid self-efficacy, cognitive status, problem-solving skills, demographic characteristics, and hearing thresholds. At the second appointment, participants followed a set of computer-based instructions accompanied by video clips to self-fit the hearing aids. The self-fitting procedure required participants to customize the physical fit of the hearing aids, insert the hearing aids into the ear, perform self-directed in situ audiometry, and adjust the resultant settings according to their preference. Participants had access to support with the self-fitting procedure from a trained clinical assistant (CA) at all times. Results: Forty-one (68%) of the participants achieved a successful self-fitting. Participants who self-fit successfully were significantly more likely than those who were unsuccessful to have had previous experience with hearing aids and to own a mobile device (when controlling for four potential covariates). Of the 41 successful self-fitters, 15 (37%) performed the procedure independently and 26 (63%) sought support from the CA. The successful self-fitters who sought CA support were more likely than those who self-fit independently to have a health locus of control that is externally oriented toward powerful others. Success rates on the individual steps in the self-fitting procedure were relatively high. No one step was more problematic than any other, nor was there a systematic tendency for particular participants to make more errors than others. Steps that required use of the hearing aids in conjunction with the self-fitting app on the participant’s mobile device had the highest rates of support use. Conclusions: The findings of this study suggest that nonaudiologic factors should be considered when selecting suitable candidates for the self-fitting hearing aids evaluated in this study. Although computer-based instructions and video clips were shown to improve self-fitting skill acquisition relative to past studies in which printed instruction booklets were used, the majority of people are still likely to require access to support from trained personnel while carrying out the self-fitting procedure, especially when this requires the use of an app. ACKNOWLEDGEMENTS: The authors thank Shawn Stahmer and Stavros Basseas of SoundWorld Solutions for providing the hearing aids and app used in this study and for their ongoing support during data collection. The authors additionally thank Mark Seeto, Vivian Fabricatorian, Scott Brewer, and Pamela Jackson of the National Acoustic Laboratories and Jamie Macaulay of Macquarie University for their contributions to this study. Preliminary results were presented at Hearing Across the Lifespan (HeAL), Lake Como, Italy, in June 2016; the International Hearing Aid Research Conference (IHCON), Lake Tahoe, CA, in August 2016; the XXXIII World Congress of Audiology, Vancouver, in September 2016; the 44th Annual American Auditory Society Scientific and Technology Meeting, Scottsdale, AZ, in March 2017; the 21st ENT World Congress, Paris, in June 2017; Cutting-Edge Perspectives in Service Delivery for Older Adults, American Speech-Language-Hearing Association Online Conference, October 2017; the 14th Annual British Academy of Audiology Conference, Bournemouth, UK, in November 2017; and the 23rd Audiology Australia National Conference, Sydney, in May 2018. The authors acknowledge the financial support of the HEARing CRC, established under the Australian Government’s Cooperative Research Centres (CRC) Program. The CRC Program supports industry-led collaborations between industry, researchers, and the community. The first author (E.C.) received financial remuneration from the American Auditory Society for her presentation of these findings at the 44th Annual American Auditory Society Scientific and Technology Meeting, Scottsdale, AZ, in March 2017. Address for correspondence: Elizabeth Convery, National Acoustic Laboratories, Level 4, Australian Hearing Hub, 16 University Avenue, Macquarie University NSW 2109, Australia. E-mail: elizabeth.convery@nal.gov.au Received April 16, 2018; accepted August 4, 2018. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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