Computer skills and internet use in adults aged 50-74 years: influence of hearing difficulties

BACKGROUND The use of personal computers (PCs) and the Internet to provide health care information and interventions has increased substantially over the past decade. Yet the effectiveness of such an approach is highly dependent upon whether the target population has both access and the skill set required to use this technology. This is particularly relevant in the delivery of hearing health care because most people with hearing loss are over 50 years (average age for initial hearing aid fitting is 74 years). Although PC skill and Internet use by demographic factors have been examined previously, data do not currently exist that examine the effects of hearing difficulties on PC skill or Internet use in older adults. OBJECTIVE To explore the effect that hearing difficulty has on PC skill and Internet use in an opportunistic sample of adults aged 50-74 years. METHODS Postal questionnaires about hearing difficulty, PC skill, and Internet use (n=3629) were distributed to adults aged 50-74 years through three family physician practices in Nottingham, United Kingdom. A subsample of 84 respondents completed a second detailed questionnaire on confidence in using a keyboard, mouse, and track pad. Summed scores were termed the "PC confidence index." The PC confidence index was used to verify the PC skill categories in the postal questionnaire (ie, never used a computer, beginner, and competent). RESULTS The postal questionnaire response rate was 36.78% (1298/3529) and 95.15% (1235/1298) of these contained complete information. There was a significant between-category difference for PC skill by PC confidence index (P<.001), thus verifying the three-category PC skill scale. PC and Internet use was greater in the younger respondents (50-62 years) than in the older respondents (63-74 years). The younger group's PC and Internet use was 81.0% and 60.9%, respectively; the older group's PC and Internet use was 54.0% and 29.8%, respectively. Those with slight hearing difficulties in the older group had significantly greater odds of PC use compared to those with no hearing difficulties (odds ratio [OR]=1.57, 95% confidence interval [CI] 1.06-2.30, P=.02). Those with moderate+ hearing difficulties had lower odds of PC use compared with those with no hearing difficulties, both overall (OR=0.58, 95% CI 0.39-0.87, P=.008) and in the younger group (OR=0.49, 95% CI 0.26-0.86, P=.008). Similar results were demonstrated for Internet use by age group (older: OR=1.57, 95% CI 0.99-2.47, P=.05; younger: OR=0.32, 95% CI 0.16-0.62, P=.001). CONCLUSIONS Hearing health care is of particular relevance to older adults because of the prevalence of age-related hearing loss. Our data show that older adults experiencing slight hearing difficulty have increased odds of greater PC skill and Internet use than those reporting no difficulty. These findings suggest that PC and Internet delivery of hearing screening, information, and intervention is feasible for people between 50-74 years who have hearing loss, but who would not typically present to an audiologist

Gameplay as a source of intrinsic motivation in a randomized controlled trial of auditory training

Background: Previous studies of frequency discrimination training (FDT) for tinnitus used repetitive task-based training programmes relying on extrinsic factors to motivate participation. Studies reported limited improvement in tinnitus symptoms. Purpose: To evaluate FDT exploiting intrinsic motivations by integrating training with computer-gameplay. Methods: Sixty participants were randomly assigned to train on a conventional taskbased training, or one of two interactive game-based training platforms over six weeks. Outcomes included assessment of motivation, tinnitus handicap, and performance on tests of attention. Results: Participants reported greater intrinsic motivation to train on the interactive game-based platforms, yet compliance of all three groups was similar (~70%) and changes in self-reported tinnitus severity were not significant. There was no difference between groups in terms of change in tinnitus severity or performance on measures of attention. Conclusion: FDT can be integrated within an intrinsically motivating game. Whilst this may improve participant experience, in this instance it did not translate to additional compliance or therapeutic benefit

A eficácia do treinamento auditivo formal em indivíduos com transtorno de processamento auditivo Formal auditory training efficacy in individuals with auditory processing disorder

OBJETIVO: Verificar a eficácia de um programa de Treinamento Auditivo comparando o desempenho inicial, nos testes comportamentais, com o desempenho após o treinamento auditivo aplicado em indivíduos com Transtorno de Processamento Auditivo. MÉTODOS: Participaram do estudo 30 sujeitos com idades entre oito e 16 anos, que passaram por uma avaliação comportamental inicial do processamento auditivo em que foram utilizados dois testes monóticos e dois dicóticos. Posteriormente foram submetidos a um programa de treinamento de auditivo durante oito semanas, a fim de reabilitar as habilidades auditivas encontradas alteradas na avaliação inicial do processamento auditivo e por fim passaram por uma nova avaliação comportamental do processamento auditivo. RESULTADOS: Após o treinamento auditivo houve melhora em todos os testes aplicados. No teste PSI, pré-treinamento auditivo, as crianças, as crianças tinham uma média de acerto de 66,8% que passou para 86,2% após o treinamento auditivo. No teste de fala com ruído, as crianças tinham uma média de acerto de 69,3% pré-treinamento auditivo que passou a ser 80,5% pós-treinamento auditivo. No teste DNV, a média de acerto pré-treinamento auditivo era de 72,6% e passou a ser 91,4%. Finalmente, no teste SSW a treinamento auditivo média de acerto era de 42,2% pré-treinamento auditivo e passou a ser 88,9% pós. CONCLUSÃO: O programa de treinamento auditivo utilizado foi eficaz na reabilitação das habilidades auditivas encontradas alteradas nas crianças com Transtorno de Processamento Auditivo.<br>PURPOSE: To assess the effectiveness of the Auditory Training comparing the performance in the behavioral tests before and after auditory training in individuals with Auditory Processing Disorders. METHODS: Thirty individuals with ages ranging from eight to 16 years were submitted to an auditory processing evaluation, which consisted of two monotic and two dichotic tests. After that, the individuals were enrolled in an auditory training program composed by 8 sessions, to rehabilitate the auditory abilities and afterwards were submitted to a re-evaluation of the auditory processing. RESULTS: After the Auditory Training we observed an improvement in the results of all behavioral tests. On the PSI test the performance before auditory training was 66,8% and after, 86,2%. On the speech in noise test, before auditory training, the results were 69,3% and after auditory training, 80,5%. On the Nonverbal Dichotic test, before auditory training, the performance of the individuals was 72,6% and after training the performance was 91,4%. Finally, in the SSW test before auditory training, the results were 42,2% and after auditory training, 88,9%. CONCLUSION: Auditory training program was considered effective for rehabilitation of auditory abilities in individuals with auditory processing disorders