Evaluating a Theoretically Informed and Cocreated Mobile Health Educational Intervention for First-Time Hearing Aid Users: Qualitative Interview Study

David W Maidment, Rachel Heyes, Rachel Gomez, Neil S Coulson, Heather Wharrad, Melanie A Ferguson, David W Maidment, Rachel Heyes, Rachel Gomez, Neil S Coulson, Heather Wharrad, Melanie A Ferguson

Abstract

Background: Adults living with hearing loss have highly variable knowledge of hearing aids, resulting in suboptimal use or nonuse. This issue can be addressed by the provision of high-quality educational resources.

Objective: This study aims to assess the everyday experiences of first-time hearing aid users when using a newly developed, theoretically informed cocreated mobile health (mHealth) educational intervention called m2Hear. This intervention aims to deliver greater opportunities for individualization and interactivity compared with our previously developed multimedia intervention, C2Hear.

Methods: A total of 16 first-time hearing aid users trialed m2Hear for a period of 10-weeks in their everyday lives, after which individual semistructured interviews were completed. The data were analyzed using an established deductive thematic analysis procedure underpinned by the Capability, Opportunity, Motivation-Behavior model. The model stipulates that to engage in a target behavior, an individual must have physical and psychological capability, physical and social opportunity, and automatic and reflective motivation.

Results: Capability-m2Hear was viewed as a concise and comprehensive resource, suitable for a range of digital literacy skills. It was stated that m2Hear could be conveniently reused to provide useful reminders that facilitate knowledge of hearing aids and communication. Opportunity-m2Hear was simple and straightforward to use, enabling greater individualization and independence. The availability of m2Hear via mobile technologies also improved accessibility. Motivation-m2Hear provided greater support and reassurance, improving confidence and empowering users to self-manage their hearing loss.

Conclusions: Overall, this qualitative study suggests that m2Hear supports first-time hearing aid users to successfully self-manage their hearing loss postfitting. Furthermore, this study demonstrates the utility of employing a combined theoretical and ecologically valid approach in the development of mHealth educational resources to meet the individual self-management needs of adults living with hearing loss.

Trial registration: ClinicalTrials.gov NCT03136718; https://ichgcp.net/clinical-trials-registry/NCT03136718.

Keywords: behavioral medicine; hearing aids; hearing loss; mobile phone; qualitative research; telemedicine.

Conflict of interest statement

Conflicts of Interest: None declared.

©David W Maidment, Rachel Heyes, Rachel Gomez, Neil S Coulson, Heather Wharrad, Melanie A Ferguson. Originally published in JMIR mHealth and uHealth (http://mhealth.jmir.org), 05.08.2020.

Figures

Figure 1
Figure 1
Radar chart showing the proportion of time the theoretical domains framework (TDF) factors were included in the communication tactics and adapting to wearing your hearing aids C2Hear reusable learning objects (RLOs). Percentages are plotted for the 14 TDF factors on individual axes. Concentric grid lines connecting axes increase in 20% increments, from 0% (center point) to 100% (outer edge). Each data point has been connected to form the black shaded area.
Figure 2
Figure 2
Screenshots of the m2Hear intervention, which is a freely available web-based intervention.

References

    1. Integrated chronic disease prevention and control. World Health Organization. [2020-01-09].
    1. McGowan PT. Self-management education and support in chronic disease management. Prim Care. 2012 Jun;39(2):307–25. doi: 10.1016/j.pop.2012.03.005.
    1. Taylor SJ, Pinnock H, Epiphaniou E, Pearce G, Parke HL, Schwappach A, Purushotham N, Jacob S, Griffiths CJ, Greenhalgh T, Sheikh A. A rapid synthesis of the evidence on interventions supporting self-management for people with long-term conditions: PRISMS - Practical systematic Review of Self-Management Support for long-term conditions. Southampton (UK): NIHR Journals Library. 2014 Dec;2(53) doi: 10.3310/hsdr02530.
    1. Barker F, Mackenzie E, Elliott L, Jones S, de Lusignan S. Interventions to improve hearing aid use in adult auditory rehabilitation. Cochrane Database Syst Rev. 2016 Aug 18;(8):CD010342. doi: 10.1002/14651858.CD010342.pub3.
    1. Convery E, Meyer C, Keidser G, Hickson L. Assessing hearing loss self-management in older adults. Int J Audiol. 2018 Apr;57(4):313–20. doi: 10.1080/14992027.2017.1390268.
    1. Convery E, Hickson L, Meyer C, Keidser G. Predictors of hearing loss self-management in older adults. Disabil Rehabil. 2019 Aug;41(17):2026–35. doi: 10.1080/09638288.2018.1457091.
    1. Ferguson M, Brandreth M, Brassington W, Wharrad H. Information retention and overload in first-time hearing aid users: an interactive multimedia educational solution. Am J Audiol. 2015 Sep;24(3):329–32. doi: 10.1044/2015_AJA-14-0088.
    1. Reese J, Smith S. Recall of hearing aid orientation content by first-time hearing aid users. Semin Hear. 2006 Nov;27(4):337–44. doi: 10.1055/s-2006-954862.
    1. Desjardins JL, Doherty KA. Do experienced hearing aid users know how to use their hearing AIDS correctly? Am J Audiol. 2009 Jun;18(1):69–76. doi: 10.1044/1059-0889(2009/08-0022).
    1. Ferguson M, Kitterick P, Chong L, Edmondson-Jones M, Barker F, Hoare D. Hearing aids for mild to moderate hearing loss in adults. Cochrane Database Syst Rev. 2017 Sep 25;9:CD012023. doi: 10.1002/14651858.CD012023.pub2.
    1. Heffernan E, Coulson NS, Henshaw H, Barry JG, Ferguson MA. Understanding the psychosocial experiences of adults with mild-moderate hearing loss: an application of Leventhal's self-regulatory model. Int J Audiol. 2016 Jul;55(Suppl 3):S3–12. doi: 10.3109/14992027.2015.1117663.
    1. Barker AB, Leighton P, Ferguson MA. Coping together with hearing loss: a qualitative meta-synthesis of the psychosocial experiences of people with hearing loss and their communication partners. Int J Audiol. 2017 May;56(5):297–305. doi: 10.1080/14992027.2017.1286695.
    1. Kessels RPC. Patients' memory for medical information. J R Soc Med. 2003 May;96(5):219–22. doi: 10.1258/jrsm.96.5.219.
    1. Latorre-Postigo JM, Ros-Segura L, Navarro-Bravo B, Ricarte-Trives JJ, Serrano-Selva JP, López-Torres-Hidalgo J. Older adults' memory for medical information, effect of number and mode of presentation: an experimental study. Patient Educ Couns. 2017 Jan;100(1):160–6. doi: 10.1016/j.pec.2016.08.001.
    1. Nair EL, Cienkowski KM. The impact of health literacy on patient understanding of counseling and education materials. Int J Audiol. 2010 Feb;49(2):71–5. doi: 10.3109/14992020903280161.
    1. Ferguson M, Leighton P, Brandreth M, Wharrad H. Development of a multimedia educational programme for first-time hearing aid users: a participatory design. Int J Audiol. 2018 Aug;57(8):600–9. doi: 10.1080/14992027.2018.1457803.
    1. Ferguson M, Brandreth M, Brassington W, Leighton P, Wharrad H. A randomized controlled trial to evaluate the benefits of a multimedia educational program for first-time hearing aid users. Ear Hear. 2016;37(2):123–36. doi: 10.1097/AUD.0000000000000237.
    1. Gomez R, Ferguson M. Improving self-efficacy for hearing aid self-management: the early delivery of a multimedia-based education programme in first-time hearing aid users. Int J Audiol. 2020 Apr;59(4):272–81. doi: 10.1080/14992027.2019.1677953.
    1. C2Hear Online. YouTube. [2020-07-01]. .
    1. C2Hear Online. [2020-07-01].
    1. Henshaw H, Clark DP, Kang S, Ferguson MA. Computer skills and internet use in adults aged 50-74 years: influence of hearing difficulties. J Med Internet Res. 2012 Aug 24;14(4):e113. doi: 10.2196/jmir.2036.
    1. World Health Organization . Mhealth: New Horizons for Health Through Mobile Technologies: Second Global Survey on Ehealth. Geneva, Switzerland: World Health Organization; 2011. [accessed 2020-01-09]
    1. Wang J, Wang Y, Wei C, Yao NA, Yuan A, Shan Y, Yuan C. Smartphone interventions for long-term health management of chronic diseases: an integrative review. Telemed J E Health. 2014 Jun;20(6):570–83. doi: 10.1089/tmj.2013.0243.
    1. Kim BY, Lee J. Smart devices for older adults managing chronic disease: a scoping review. JMIR Mhealth Uhealth. 2017 May 23;5(5):e69. doi: 10.2196/mhealth.7141.
    1. Ferguson M, Maidment D, Henshaw H, Heffernan E. Evidence-based interventions for adult aural rehabilitation: that was then, this is now. Semin Hear. 2019 Feb;40(1):68–84. doi: 10.1055/s-0038-1676784.
    1. Ferguson M, Maidment D, Henshaw H, Gomez R. Knowledge is power: improving outcomes for patients, partners, and professionals in the digital age. Perspect ASHA SIGs. 2019 Feb 26;4(1):140–8. doi: 10.1044/2018_pers-sig7-2018-0006.
    1. Medical Research Council Developing and evaluating complex interventions: new guidance. London, United Kingdom. 2006. [2020-01-09].
    1. Rosenstock IM. Why people use health services. Milbank Q. 1966 Jul;44(3):94. doi: 10.2307/3348967.
    1. Fishbein M, Ajzen I. Belief, Attitude, Intention, and Behavior: An Introduction to Theory and Research. Reading, MA: Addison-Wesley; 1977.
    1. Prochaska JO, DiClemente CC. Stages and processes of self-change of smoking: toward an integrative model of change. J Consult Clin Psychol. 1983 Jun;51(3):390–5. doi: 10.1037//0022-006x.51.3.390.
    1. Coulson NS, Ferguson MA, Henshaw H, Heffernan E. Applying theories of health behaviour and change to hearing health research: time for a new approach. Int J Audiol. 2016 Jul;55(Suppl 3):S99–104. doi: 10.3109/14992027.2016.1161851.
    1. Atkins L, Francis J, Islam R, O'Connor D, Patey A, Ivers N, Foy R, Duncan EM, Colquhoun H, Grimshaw JM, Lawton R, Michie S. A guide to using the theoretical domains framework of behaviour change to investigate implementation problems. Implement Sci. 2017 Jun 21;12(1):77. doi: 10.1186/s13012-017-0605-9.
    1. Michie S, van Stralen MM, West R. The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implement Sci. 2011 Apr 23;6:42. doi: 10.1186/1748-5908-6-42.
    1. Fonteyn ME, Kuipers B, Grobe SJ. A description of think aloud method and protocol analysis. Qual Health Res. 1993 Nov 1;3(4):430–41. doi: 10.1177/104973239300300403.
    1. Todhunter F. Using concurrent think-aloud and protocol analysis to explore student nurses' social learning information communication technology knowledge and skill development. Nurse Educ Today. 2015 Jun;35(6):815–22. doi: 10.1016/j.nedt.2015.01.010.
    1. Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006 Jan;3(2):77–101. doi: 10.1191/1478088706qp063oa.
    1. m2Hear. University of Nottingham. 2019. [2020-07-01].
    1. mHealth Technologies for Hearing Aid Users (m2Hear) Clinical Trials. [2020-07-01]. .
    1. Yardley L. Demonstrating validity in qualitative psychology. In: Smith JA, editor. Qualitative Psychology: A Practical Guide to Research Methods. London, UK: Sage Publications; 2008.
    1. Cane J, O'Connor D, Michie S. Validation of the theoretical domains framework for use in behaviour change and implementation research. Implement Sci. 2012 Apr 24;7:37. doi: 10.1186/1748-5908-7-37.
    1. Michie S, Atkins L, West R. The Behaviour Change Wheel: A Guide to Designing Interventions. London, UK: Silverback; 2014.
    1. Scariot CA, Heemann A, Padovani S. Understanding the collaborative-participatory design. Work. 2012;41(Suppl 1):2701–5. doi: 10.3233/WOR-2012-0656-2701.
    1. Mobile Consumer Survey 2019: Plateauing at the Peak: the State of the Smartphone. Deloitte UK. 2019. [2020-07-01]. .
    1. Mobile Fact Sheet. Pew Research Center. 2018. [2020-07-01].
    1. Ibrahim M, Antonenko PD, Greenwood CM, Wheeler D. Effects of segmenting, signalling, and weeding on learning from educational video. Learn Media Technol. 2011 Jun 28;37(3):220–35. doi: 10.1080/17439884.2011.585993.
    1. Kamil RJ, Lin FR. The effects of hearing impairment in older adults on communication partners: a systematic review. J Am Acad Audiol. 2015 Feb;26(2):155–82. doi: 10.3766/jaaa.26.2.6.
    1. Scarinci N, Worrall L, Hickson L. Factors associated with third-party disability in spouses of older people with hearing impairment. Ear Hear. 2012;33(6):698–708. doi: 10.1097/AUD.0b013e31825aab39.
    1. Ekberg K, Meyer C, Scarinci N, Grenness C, Hickson L. Family member involvement in audiology appointments with older people with hearing impairment. Int J Audiol. 2015 Feb;54(2):70–6. doi: 10.3109/14992027.2014.948218.
    1. Stark P, Hickson L. Outcomes of hearing aid fitting for older people with hearing impairment and their significant others. Int J Audiol. 2004;43(7):390–8. doi: 10.1080/14992020400050050.
    1. Hearing loss in adults: assessment and management. National Institute for HealthCare Excellence. 2018. Jun 21, [2020-01-09]. .
    1. Kumar S, Nilsen WJ, Abernethy A, Atienza A, Patrick K, Pavel M, Riley WT, Shar A, Spring B, Spruijt-Metz D, Hedeker D, Honavar V, Kravitz R, Lefebvre RC, Mohr DC, Murphy SA, Quinn C, Shusterman V, Swendeman D. Mobile health technology evaluation: the mHealth evidence workshop. Am J Prev Med. 2013 Aug;45(2):228–36. doi: 10.1016/j.amepre.2013.03.017.
    1. Chang C, Yan C, Tseng J. Perceived convenience in an extended technology acceptance model: mobile technology and English learning for college students. Australas J Educ Technol. 2012 Jul 26;28(5):809–26. doi: 10.14742/ajet.818.
    1. Bennett GG, Glasgow RE. The delivery of public health interventions via the internet: actualizing their potential. Annu Rev Public Health. 2009;30:273–92. doi: 10.1146/annurev.publhealth.031308.100235.
    1. Zhang D, Zhou L, Briggs RO, Nunamaker JF. Instructional video in e-learning: assessing the impact of interactive video on learning effectiveness. Inf Manag. 2006 Jan;43(1):15–27. doi: 10.1016/j.im.2005.01.004.
    1. Evans C, Gibbons NJ. The interactivity effect in multimedia learning. Comput Educ. 2007 Dec;49(4):1147–60. doi: 10.1016/j.compedu.2006.01.008.
    1. Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev. 1977;84(2):191–215. doi: 10.1037//0033-295x.84.2.191.
    1. Jennings MB, Cheesman MF, Laplante-Lévesque A. Psychometric properties of the self-efficacy for situational communication management questionnaire (SESMQ) Ear Hear. 2014;35(2):221–9. doi: 10.1097/01.aud.0000441081.64281.b9.
    1. West RL, Smith SL. Development of a hearing aid self-efficacy questionnaire. Int J Audiol. 2007 Dec;46(12):759–71. doi: 10.1080/14992020701545898.
    1. Smith SL, Pichora-Fuller KM, Watts KL, la More C. Development of the listening self-efficacy questionnaire (LSEQ) Int J Audiol. 2011 Jun;50(6):417–25. doi: 10.3109/14992027.2011.553205.
    1. Hickson L, Meyer C, Lovelock K, Lampert M, Khan A. Factors associated with success with hearing aids in older adults. Int J Audiol. 2014 Feb;53(Suppl 1):S18–27. doi: 10.3109/14992027.2013.860488.
    1. Meyer C, Hickson L, Lovelock K, Lampert M, Khan A. An investigation of factors that influence help-seeking for hearing impairment in older adults. Int J Audiol. 2014 Feb;53(Suppl 1):S3–17. doi: 10.3109/14992027.2013.839888.
    1. Meyer C, Hickson L, Fletcher A. Identifying the barriers and facilitators to optimal hearing aid self-efficacy. Int J Audiol. 2014 Feb;53(Suppl 1):S28–37. doi: 10.3109/14992027.2013.832420.
    1. Ferguson MA, Woolley A, Munro KJ. The impact of self-efficacy, expectations, and readiness on hearing aid outcomes. Int J Audiol. 2016 Jul;55(Suppl 3):S34–41. doi: 10.1080/14992027.2016.1177214.
    1. Laplante-Lévesque A, Hickson L, Worrall L. Stages of change in adults with acquired hearing impairment seeking help for the first time: application of the transtheoretical model in audiologic rehabilitation. Ear Hear. 2013;34(4):447–57. doi: 10.1097/AUD.0b013e3182772c49.
    1. Saunders GH, Frederick MT, Silverman S, Papesh M. Application of the health belief model: development of the hearing beliefs questionnaire (HBQ) and its associations with hearing health behaviors. Int J Audiol. 2013 Aug;52(8):558–67. doi: 10.3109/14992027.2013.791030.
    1. Meister H, Grugel L, Meis M. Intention to use hearing aids: a survey based on the theory of planned behavior. Patient Prefer Adherence. 2014;8:1265–75. doi: 10.2147/PPA.S65008. doi: 10.2147/PPA.S65008.
    1. Barker F, Atkins L, de Lusignan S. Applying the COM-B behaviour model and behaviour change wheel to develop an intervention to improve hearing-aid use in adult auditory rehabilitation. Int J Audiol. 2016 Jul;55(Suppl 3):S90–8. doi: 10.3109/14992027.2015.1120894.
    1. Ferguson MA, Coulson NS, Henshaw H, Heffernan E. Application of health behaviour theory to hearing healthcare research: the state of play and beyond. Int J Audiol. 2016 Jul;55(Suppl 3):S1–2. doi: 10.1080/14992027.2016.1206215.
    1. Maidment DW, Ali YH, Ferguson MA. Applying the COM-B model to assess the usability of smartphone-connected listening devices in adults with hearing loss. J Am Acad Audiol. 2019 May;30(5):417–30. doi: 10.3766/jaaa.18061.
    1. Pulvirenti M, McMillan J, Lawn S. Empowerment, patient centred care and self-management. Health Expect. 2014 Jun;17(3):303–10. doi: 10.1111/j.1369-7625.2011.00757.x.
    1. Small N, Bower P, Chew-Graham CA, Whalley D, Protheroe J. Patient empowerment in long-term conditions: development and preliminary testing of a new measure. BMC Health Serv Res. 2013 Jul 8;13:263. doi: 10.1186/1472-6963-13-263.

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