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DOI: 10.1055/s-0044-1789598
An Evaluation of a Proposed Direct-to-Consumer (DTC) Model of Hearing-Health Care
Funding This research was funded by the Gerber Fund at Syracuse University.
Abstract
Background The introduction of over-the-counter hearing aids (HA) has resulted in a new hearing-health-care pathway.
Purpose The aim of this study was to assess if individuals could navigate four steps in a direct-to-consumer (DTC) HA delivery model, which include self-identification of hearing difficulties and risk for ear disease, self-selection of device, self-fitting and programming of device, and self-management.
Research Design Fifty-two participants self-reported their degree of hearing loss and risk for ear disease. Participants were provided with three preselected DTC-HA Web sites and asked to select a device. Using the manufacturer's instructions, they then self-fit and programmed the device they chose. Participants' HA use and handling skills were evaluated using the Practical HA Skills Test-Revised (PHAST-R) and the Measure of Audiologic Rehabilitation Self-efficacy for Hearing Aids (MARS-HA). Real-ear verification was completed to determine how closely they programmed their device to NAL-NL2 targets. Agreement between self-reported degree of hearing loss and ear disease was determined from an audiological and ear disease risk assessment, respectively.
Results Seventy-five percent of participants reported that their perceived hearing loss was in the mild-to-moderate range. Ninety-three percent of participants who were identified to be at risk for ear disease did not self-report being at risk. PHAST-R scores ranged from 45 to 100% and were significantly impacted by manufacturer instructions. Only 24% of fittings were within the accepted tolerances for prescriptive targets.
Conclusions No participant was able to successfully navigate all four steps in the proposed DTC-HA model. Participants with hearing thresholds ≤ 25 dB HL and participants who were identified as being at risk for ear disease, but did not self-report the risk, both said they would purchase a DTC-HA as a treatment option. Manufacturer instructional materials can impact setup and programming of a DTC device. DTC models of hearing-health care may require additional consumer support.
Publication History
Received: 18 October 2022
Accepted: 11 April 2023
Article published online:
15 October 2024
© 2023. American Academy of Audiology. This article is published by Thieme.
Thieme Medical Publishers, Inc.
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