HEAR-aware: Development and evaluation of an e-health tool for older adults who are not ready for a hearing aid: Presentation of a study design

The primary objectives of the HEAR-aware project are to 1) develop and 2) evaluate a smartphone-based tailored e-health tool (HEAR-aware app prototype with external microphone) that can serve the individualized needs of adults (aged 50+) with hearing impairment who do not want a hearing aid, but who are willing to be supported in an alternative way to establish better self-management of their hearing problems. Methods: In the developmental stage, potential users, VUmc-researchers, two private partners, and an app-development company will collaborate to develop three successive prototypes (I, II, III) of the HEAR-aware tool. The development of the tool will be grounded on behavior change theory of the Transtheoretical Model of Behavior Change (Stages of Change and Processes of Change). It is firstly explored which elements of an existing support program for hearing aid users (HoorSupport©) and what other intervention elements could be useful for the new target group, and could be combined with the innovative methodology of Ecological Momentary Assessment (EMA). Secondly, a needs assessment among potential users will beis performed via focus groups (Study 1). Thirdly, the development of the tool's successive prototypes (from I to III) will be performed and described (Study 2). Lastly, Prototype III’s effectiveness will be examined via a randomized controlled trial (Study 3). Outcomes will be measured at baseline, directly post, and 3-months post-intervention and amongst others will include: readiness for hearing action, coping (personal adjustment and use of communication strategies), self-reported disability, and self-efficacymanagement of hearing problems. Cost-effectiveness will also be determined. Results and Discussion: The content of HoorSupport has been reviewed for applicability in the tool, and each element has been linked to particular Stages and Processes of Change. Data collection for Study 1 will occur during summer and fall 2019. Results for Study 2 and 3 are expected in 2020 and 2021