Preliminary support for a brief psychological intervention to improve first-time hearing aid use among adults

Christopher J Armitage, Deborah Lees, Kathryn Lewis, Kevin J Munro, Christopher J Armitage, Deborah Lees, Kathryn Lewis, Kevin J Munro

Abstract

Objectives: Suboptimal hearing aid use extorts significant social, health, and economic costs. The aims of this study were to (1) test the novel hypothesis that the threat associated with being diagnosed with hearing loss could be ameliorated with a self-affirmation manipulation and (2) gauge the feasibility of deploying the manipulation in routine clinical practice.

Design: Parallel groups randomized controlled trial with 10-week follow-up.

Method: Fifty people, newly prescribed with a hearing aid, completed either a questionnaire that included a brief self-affirming exercise or an identical questionnaire with no self-affirming exercise. The main outcome measure was derived from data logging automatically stored by the hearing aid. Perceived threat ('anxiety about ageing'), behavioural intention, and self-efficacy were measured as potential mediators.

Results: Objectively measured hours of daily hearing aid use were marginally higher in the intervention group compared with the control group (between-group difference = 1.94 hr, 95%CI = -1.24, 5.12, d = 0.43). At follow-up, participants in the intervention group were significantly less anxious about ageing and more accepting of older people than were participants in the control group (between-group difference = 0.75, 95%CI = 0.26, 1.22, d = 0.87). There was no statistically significant effect of the intervention on behavioural intention or self-efficacy.

Conclusions: Although not statistically significant, the magnitude of the effect of the intervention on hearing aid use (d = 0.43) suggests that it would be worthwhile working towards a fully powered randomized controlled trial. The ability to reduce anxieties about ageing with this brief intervention could have far-reaching benefits for multiple patient and general population groups. Statement of contribution What is already known on this subject? Hearing impairment is more disabling than diabetes, yet hearing aid use is suboptimal. Anxieties about ageing may undermine hearing aid use. What does this study add? The study tests a brief theory-based psychological intervention to reduce anxiety about ageing and promote hearing aid use. Results show that the brief psychological intervention reduced anxiety and marginally increased objective hearing aid use. Further work is required to identify other situations in which anxieties about ageing undermine behaviour change efforts. The very brief, flexible nature of the intervention means it could be adapted and deployed in numerous other health care settings.

Keywords: ageing; audiology; behaviour change; hearing aid prescription; hearing aid use; intervention; self-affirmation.

© 2017 The Authors. British Journal of Health Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society.

Figures

Figure 1
Figure 1
CONSORT diagram showing flow of participants through the trial. [Colour figure can be viewed at wileyonlinelibrary.com]

References

    1. Action on Hearing Loss . (2014). Statistics. Retrieved from
    1. Ajzen, I. (1991). The theory of planned behaviour. Organizational Behavior and Human Decision Processes, 50, 179–211.
    1. Armitage, C. J. (2008). A volitional help sheet to encourage smoking cessation: A randomized exploratory trial. Health Psychology, 27, 557–566.
    1. Armitage, C. J. (2016). A brief psychological intervention to protect subjective well‐being in a community sample. Quality of Life Research, 25, 385–391.
    1. Armitage, C. J. , & Arden, M. A. (2016). Enhancing the effectiveness of alcohol warning labels with a self‐affirming implementation intention. Health Psychology, 35, 1159–1163.
    1. Armitage, C. J. , & Conner, M. (2001). Efficacy of the theory of planned behaviour: A meta‐analytic review. British Journal of Social Psychology, 40, 471–499.
    1. Armitage, C. J. , Harris, P. R. , & Arden, M. A. (2011). Evidence that self‐affirmation reduces alcohol consumption: Randomized exploratory trial with a new, brief means of self‐affirming. Health Psychology, 30, 633–641.
    1. Armitage, C. J. , Norman, P. , Noor, M. , Alganem, S. , & Arden, M. A. (2014). Evidence that a very brief psychological intervention boosts weight loss in a weight loss program. Behavior Therapy, 45, 700–707.
    1. Armitage, C. J. , Rahim, W. A. , Rowe, R. , & O'Connor, R. C. (2016). An exploratory randomised trial of a simple, brief psychological intervention to reduce subsequent suicidal ideation and behaviour in patients admitted to hospital for self‐harm. British Journal of Psychiatry, 208, 470–476.
    1. Armitage, C. J. , Rowe, R. , Arden, M. A. , & Harris, P. R. (2014). A brief psychological intervention that reduces adolescent alcohol consumption. Journal of Consulting and Clinical Psychology, 82, 546–550.
    1. Barker, F. , Mackenzie, E. , Elliott, L. , Jones, S. , & de Lusignan, S. (2016). Interventions to improve hearing aid use in adult auditory rehabilitation. Cochrane Database of Systematic Reviews, 7 Article no. CD010342.
    1. Campbell, D. (2015, January 3). NHS accursed of “cruel” rationing of hearing aids. The Observer Retrieved from
    1. Cohen, J. (1992). A power primer. Psychological Bulletin, 112, 155–159.
    1. Connelly, L. M. (2008). Pilot studies. Medsurg Nursing: Official Journal of the Academy of Medical‐Surgical Nurses, 17, 411–412.
    1. Coulson, N. S. , Ferguson, M. , Henshaw, H. , & Heffernan, E. (2016). Applying theories of health behaviour and change to hearing health research: Time for a new approach. International Journal of Audiology, 55(Suppl. 3), S99–S104.
    1. Cruickshanks, K. J. , Tweed, T. S. , Wiley, T. L. , Klein, B. E. K. , Klein, R. , Chappell, R. , … Dalton, D. S. (2003). The 5‐year incidence and progression of hearing loss – The Epidemiology of Hearing Loss Study. Archives of Otolaryngology‐Head and Neck Surgery, 129, 1041–1046.
    1. Dawes, P. , Maslin, M. , & Munro, K. J. (2014). ‘Getting used to’ hearing aids from the perspective of adult hearing‐aid users. International Journal of Audiology, 53, 861–870.
    1. Epton, T. , Harris, P. R. , Kane, R. , van Koningsbruggen, G. M. , & Sheeran, P. (2015). The impact of self‐affirmation on health behavior change: A meta‐analysis. Health Psychology, 34, 187–196.
    1. Faul, F. , Erdfelder, E. , Lang, A. G. , & Buchner, A. (2007). G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39, 175–191.
    1. Gollwitzer, P. M. (1999). Implementation intentions – Strong effects of simple plans. American Psychologist, 54, 493–503.
    1. Isaac, S. , & Michael, W. B. (1995). Handbook in research and evaluation. San Diego, CA: Educational and Industrial Testing Services.
    1. Julious, S. A. (2005). Sample size of 12 per group rule of thumb for a pilot study. Pharmaceutical Statistics, 4, 287–291.
    1. Lasher, K. P. , & Faulkender, P. J. (1993). Measurement of aging anxiety – development of the anxiety about aging scale. International Journal of Aging and Human Development, 37, 247–259.
    1. McCormack, A. , & Fortnum, H. (2013). Why do people fitted with hearing aids not wear them? International Journal of Audiology, 52, 360–368.
    1. Michie, S. , & Prestwich, A. (2010). Are interventions theory‐based? Development of a theory coding scheme. Health Psychology, 29, 1–8.
    1. Rivera‐Ledesma, A. , Lena, M. M. L. , Rangel, A. L. G. C. , & Sanchez‐Sosa, J. J. (2007). Lasher and Faulkender. Anxiety about ageing scale: Psychometric properties on Mexican elderly. Salud Mental, 30, 55–61.
    1. Steele, C. M. (1988). The psychology of self‐affirmation: Sustaining the integrity of the self In Berkowitz L. (Ed.), Advances in experimental social psychology (Vol. 21, pp. 261–302). New York, NY: Academic Press.
    1. WHO . (2002). Facts about deafness. Retrieved from
    1. Wileman, V. , Farrington, K. , Chilcot, J. , Norton, S. , Wellsted, D. M. , Almond, M. , … Armitage, C. J. (2014). Evidence that self‐affirmation improves phosphate control in hemodialysis patients: A pilot cluster randomized controlled trial. Annals of Behavioral Medicine, 48, 275–281.

Source: PubMed

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