A Simplified Patient-Centered Educational Tool for Improved Hearing-Aid Outcomes

NCT ID: NCT01940705

Last Updated: 2019-02-21

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 269 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2014-01-01
• Study Completion Date: 2016-09-30

Brief Summary

Hearing loss is the second most prevalent service-connected disability among Veterans. Hearing aids are the most common technological intervention for hearing loss. The VA, therefore, spends a considerable amount of money on them. Despite these expenditures, there are some Veterans who do not use their hearing aids successfully. Research has demonstrated that this inconsistent use may be related to a patient's inability to effectively take care of, and use, hearing aids. The proposed investigation will compare the effectiveness of three different tools for enhancing the educational efforts (hearing-aid orientation) typically provided by clinical audiologists when dispensing hearing aids. Each of these educational tools were developed using established methods for improving patient-provider communication. The investigators hypothesize that the use of these tools will result in better hearing-aid outcomes for Veteran patients than using the current standard-of-care procedures.

Detailed Description

Objectives: Reasons for non-use of hearing aids are varied, but many studies have suggested that a lack of knowledge about how to use and/or take care of the hearing aids is a major factor. This is not surprising given that other healthcare fields have reported that between 40-80% of information provided during a clinical appointment is forgotten by the patient immediately after the appointment and almost half of what is remembered is not correct. The long-term goal of this project is to improve the delivery of information during the hearing-aid orientation, as better delivery of information will result in better hearing-aid handling skills and thus better overall hearing-aid outcomes. To accomplish this goal, the investigators propose to refine and evaluate the effectiveness of three forms of supplemental hearing-aid-orientation tools, each of which was developed using established guidelines for good patient-provider communication.

Plan: The purpose of the proposed application is to evaluate the relative effectiveness of four forms of hearing-aid orientation provided to first time hearing-aid users, three of which use some of the aforementioned strategies to enhance the standard of care. The four forms of orientation will be: (1) the standard-of-care hearing-aid orientation; (2) the standard of care plus provision a hearing-aid information guide (HAIG) (3) the standard of care supplemented by an explanation of its content using the talk-back technique to confirm patient understanding; and (4) the standard of care plus provision of a take-home hearing-aid orientation DVD (HAO DVD). The content of the HAIG will be field tested and finalized following input obtained via focus groups with clinical audiologists and first-time hearing aid users.

Methods: For the field testing up to 16 clinical audiologists and 10 new hearing aid user Veterans will be recruited to participate in focus groups during which they will view and then be asked questions about the content of the HAIG. Information learned during these focus groups will then be incorporated into the HAIG, at which time they will be ready for use in the study. For the comparative effectiveness study, up to 468 hearing-impaired Veterans who are about to become first-time hearing-aid users will be enrolled to participate in this investigation. These individuals will be recruited from the VA Portland Health Care System's Audiology and Speech Pathology Service (ASPS). Prior to receiving their hearing aids, subjects will be enrolled in the study at the National Center for Rehabilitative Auditory Research (NCRAR), and will conduct health literacy, manual dexterity and hepatic sensitivity, visual acuity, and learning and memory assessments. They will then attend their hearing aid fitting in the ASPS and will receive standard-of-care hearing-aid orientation. At the end of that appointment, they will receive one of the four study interventions. Subjects will return to the NCRAR 4-6 weeks after the hearing-aid-fitting appointment to complete the following outcome measures: a knowledge and practical test regarding hearing-aid use and care, a measure of self-efficacy, and a measure of hearing-aid outcomes. They also will be interviewed so that the investigators can learn their opinions about the intervention. A subset of the initial 50 participants enrolled into each study arm will attend a second follow-up appointment 6 months after the fitting appointment so the investigators can examine longer-term impacts of the hearing aid orientation interventions.

Conditions

Hearing Loss

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: SINGLE

Study Groups

Standard of care (SoC)

standard of care hearing-aid orientation as provided by clinical audiologist

Group Type: ACTIVE_COMPARATOR

Standard of Care

Intervention Type: OTHER

standard of care hearing-aid orientation as provided by clinical audiologist

SoC plus hearing-aid informational guide

standard of care hearing-aid orientation as provided by clinical audiologist plus a take-home informational guide regarding their hearing aids

Group Type: EXPERIMENTAL

Hearing-Aid Informational Guide

Intervention Type: OTHER

Printed take-home guide on hearing aids

Standard of Care

Intervention Type: OTHER

standard of care hearing-aid orientation as provided by clinical audiologist

SoC plus hearing aid DVD

SoC hearing-aid orientation as provided by clinical audiologist plus a take-home hearing aid digital video disc

Group Type: EXPERIMENTAL

Hearing-Aid DVD

Intervention Type: OTHER

Take-home DVD about hearing aids

Standard of Care

Intervention Type: OTHER

standard of care hearing-aid orientation as provided by clinical audiologist

Soc plus teach-back technique

standard of care hearing-aid orientation as provided by clinical audiologist plus a teach-back technique session reviewing information on the hearing aids

Group Type: EXPERIMENTAL

Teach-back Technique

Intervention Type: BEHAVIORAL

Counseling/Educational session using the teach-back technique to review information about their hearing aids

Standard of Care

Intervention Type: OTHER

standard of care hearing-aid orientation as provided by clinical audiologist

Interventions

Hearing-Aid Informational Guide

Printed take-home guide on hearing aids

Intervention Type: OTHER

Hearing-Aid DVD

Take-home DVD about hearing aids

Intervention Type: OTHER

Teach-back Technique

Counseling/Educational session using the teach-back technique to review information about their hearing aids

Intervention Type: BEHAVIORAL

Standard of Care

standard of care hearing-aid orientation as provided by clinical audiologist

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

Participants will be Veterans who are receiving hearing aids from the Audiology Clinic at the VA Portland Health Care System and who have had no prior experience using hearing aids. To be included in the study, participants will:

• Be approved and have plans to get bilateral hearing aid fitting at the VA Portland Health Care System .
• Be able to read and converse in English.

Exclusion Criteria

• Be younger than 50 years or older than 89 years of age.
• Have a documented diagnosis of neurological, cognitive, visual, or other mental disorder, such as Alzheimer's disease, schizophrenia, current alcohol or substance abuse, as determined by chart review that would interfere with study completion.

• Minimum Eligible Age: 50 Years
• Maximum Eligible Age: 89 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

VA Office of Research and Development

FED

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

M. Samantha Lewis, PhD

Role: PRINCIPAL_INVESTIGATOR

VA Portland Health Care System, Portland, OR

Gabrielle H Saunders

Role: PRINCIPAL_INVESTIGATOR

VA Portland Health Care System, Portland, OR

Locations

VA Portland Health Care System, Portland, OR

Portland, Oregon, United States

Countries

United States

Other Identifiers

1I01RX001260-01

Identifier Type: NIH

Identifier Source: secondary_id

View Link

3224

Identifier Type: OTHER

Identifier Source: secondary_id

C1260-R

Identifier Type: -

Identifier Source: org_study_id