The development of a self-report outcome measure to assess social participation restrictions in adults with hearing loss

Hearing loss is a widespread condition that can substantially affect not only auditory functioning but also social functioning. Therefore, it is essential to demonstrate that auditory rehabilitation can improve social participation in individuals with hearing loss. However, currently, there is a lack of agreed-upon, gold-standard, hearing-specific outcome measures. Consequently, the primary aim of this research was to develop a high quality measure of hearing-related social participation restrictions for use in research and practice. To achieve this aim, four consecutive studies were carried out using best practice questionnaire design techniques. Study 1 generated content for the Social Participation Restrictions Questionnaire (SPaRQ) through semi-structured interviews with 25 adults with hearing loss and nine hearing healthcare professionals. Study 2 evaluated the content of the measure through a subject matter expert panel with 20 hearing healthcare professionals and cognitive interviews with 14 adults with hearing loss. Study 3 assessed the psychometric properties of the SPaRQ by applying Rasch analysis to data collected from 279 adults with hearing loss. Finally, Study 4 further assessed the psychometric properties of the SPaRQ by applying traditional psychometric analysis to data collected from a further 102 adults with hearing loss. This research led to the development of a 19-item questionnaire that measured two key elements: social behaviours (e.g. difficulties with social interactions) and social perceptions (e.g. feelings of isolation). There was strong evidence to support the measurement properties of SPaRQ, including construct validity, person separation reliability, and internal consistency. Furthermore, the response scale was statistically justified and respondent burden was minimal. Future research should examine additional measurement properties, such as responsiveness and cross-cultural validity. Also, the best practice techniques used in this research should be applied to other new and existing hearing-specific questionnaires to ensure that they meet the requisite standards for use in clinical trials and clinical practice