Knowledge is power: improving outcomes for patients, partners, and professionals in the digital age

Purpose The aim of this research was to develop and evaluate methods to address poor knowledge of hearing aids, hearing loss, and communication in patients, partners, and nonaudiologic health and social care professionals. Method An interactive multimedia educational program (C2Hear) has been co-produced with hearing aid users and audiologists to provide high-quality information and demonstrate complex concepts relating to hearing aids and communication. Results A randomized controlled trial showed numerous benefits for first-time hearing aid users that included better knowledge and skill, and increased hearing aid use and satisfaction. Patients reported that C2Hear was highly useful, enjoyable, and preferable to written information. C2Hear Online is now freely available on YouTube and has global reach, well in excess of 150,000 views. Further developments include a version for communication partners, which showed that joint-working between hearing aid users and their communication partners resulted in joint responsibility for communication that facilitated communication behaviors. In addition, a behavior theory-driven version for use with mobile technologies (m2Hear) has been designed to be tailored to the needs of individual hearing aid users. m2Hear includes more activities/interaction to maximize user engagement and learning. Finally, C2Hear has been used to improve hearing-related knowledge in other health and social care professionals, such as carehome assistants. Conclusion This range of educational programs and tools aims to improve knowledge and skills, leading to better outcomes for patients, partners, and health care professionals

Improvements in untrained measures of speech intelligibility by participant type.

<p>Significant improvement <b>Y</b> = yes, N = no. (Q) stimuli presented in quiet; (SSN) stimuli presented in speech-shaped noise; (ICRA 6) stimuli presented in ICRA (track 6) two-talker noise-vocoded competition; (MSB) stimuli presented in multi-speaker babble.</p

PICOS criteria for inclusion.

<p>PICOS criteria for inclusion.</p

Level of evidence by study quality score (Adapted from the GRADE Working Group, 2004 [35]).

<p>Level of evidence by study quality score (Adapted from the GRADE Working Group, 2004 <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0062836#pone.0062836-Group1" target="_blank">[35]</a>).</p

Flow diagram of the study identification, eligibility, and inclusion process.

<p>Flow diagram of the study identification, eligibility, and inclusion process.</p

Descriptive summary of extracted data from the 13 included articles.

<p>Data for normally hearing participants are omitted from this table <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0062836#pone.0062836-Humes1" target="_blank">[42]</a>.</p><p>− = no data reported, *p<.05, **p<.01, ***p<.001. MSB = multi-speaker babble, SNHL = sensorineural hearing loss; SNR = signal to noise ratio, SRT = speech reception threshold, RAU = rationalised arcsine unit <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0062836#pone.0062836-Studebaker1" target="_blank">[49]</a>; Adaptive spondee words in babble test <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0062836#pone.0062836-Turner1" target="_blank">[50]</a>; Adaptive 12-choice spondee words with multiple jammers test <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0062836#pone.0062836-Tyler2" target="_blank">[51]</a>; AzBio sentences <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0062836#pone.0062836-Spahr1" target="_blank">[52]</a>; BKB = Bamford-Kowal-Bench sentence lists <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0062836#pone.0062836-Bench1" target="_blank">[53]</a>; Build-a-sentence test <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0062836#pone.0062836-TyeMurray1" target="_blank">[54]</a>; CID Everyday Sentences = Central Institute for the Deaf everyday sentences <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0062836#pone.0062836-Davis3" target="_blank">[55]</a>; CID W22 = Central Institute for the Deaf word lists <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0062836#pone.0062836-Hirsh1" target="_blank">[56]</a>; CNC = consonant-vowel nucleus-consonant monosyllables <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0062836#pone.0062836-Tillman1" target="_blank">[57]</a>; CNC words <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0062836#pone.0062836-Peterson1" target="_blank">[58]</a>; Consonant recognition <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0062836#pone.0062836-Shannon1" target="_blank">[59]</a>; CSOA = Communication Scale for Older Adults <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0062836#pone.0062836-Kaplan1" target="_blank">[60]</a>; CST-A = Connected Speech [audio] test <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0062836#pone.0062836-Cox1" target="_blank">[61]</a>; CST-AV = Connected Speech [audio-visual] test <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0062836#pone.0062836-Cox1" target="_blank">[61]</a>; CUNY = City University of New York sentences <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0062836#pone.0062836-Boothroyd1" target="_blank">[62]</a>; Everyday sounds localization test <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0062836#pone.0062836-Dunn1" target="_blank">[63]</a>; IEEE Sentences <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0062836#pone.0062836-IEEE1" target="_blank">[64]</a> Four-choice discrimination test <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0062836#pone.0062836-Barcroft1" target="_blank">[46]</a>; GBI = Glasgow benefit inventory <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0062836#pone.0062836-Robinson1" target="_blank">[65]</a>; HHIA = Hearing handicap inventory for adults <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0062836#pone.0062836-Newman1" target="_blank">[66]</a>; HHIE = Hearing handicap inventory for the elderly <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0062836#pone.0062836-Ventry1" target="_blank">[67]</a>; HINT = Hearing in noise test <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0062836#pone.0062836-Nilsson1" target="_blank">[68]</a>; Iowa consonant test <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0062836#pone.0062836-Dubno1" target="_blank">[69]</a>; LACE = Listening and Communication Enhancement, <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0062836#pone.0062836-Sweetow2" target="_blank">[39]</a>; Listening span test <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0062836#pone.0062836-PichoraFuller1" target="_blank">[11]</a>; NST = Nonsense syllable test <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0062836#pone.0062836-Killion1" target="_blank">[70]</a>; QuickSIN <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0062836#pone.0062836-Killion1" target="_blank">[70]</a>; R-SPIN = Revised speech perception noise test <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0062836#pone.0062836-Wilson1" target="_blank">[71]</a>; SPATS = <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0062836#pone.0062836-Miller2" target="_blank">[72]</a>; SPIN = Speech perception in noise test <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0062836#pone.0062836-Kalikow1" target="_blank">[73]</a>; SSQ = Speech, Spatial and Qualities of Hearing Scale <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0062836#pone.0062836-Gatehouse1" target="_blank">[74]</a>; Stroop Color Word test <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0062836#pone.0062836-Uttl1" target="_blank">[75]</a>; TIMIT sentences <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0062836#pone.0062836-Garofolo1" target="_blank">[76]</a>; VAST = Verb and sentence test <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0062836#pone.0062836-Bastiaanse1" target="_blank">[77]</a>; Vowel recognition <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0062836#pone.0062836-Hillenbrand1" target="_blank">[78]</a>.</p