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Barriers and facilitators to over-the-counter hearing aids success: A patient journey approach

Award Number: R01DC015997
ORGANIZATION: NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION DISORDERS
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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PROJECT SUMMARY/ABSTRACT Age-related hearing loss is a substantial national problem due to its high prevalence and significant quality- of-life consequences. Although hearing aids (HAs) are the primary choice for the management of age-related hearing loss, the adoption rate of HAs is quite low. A commonly reported barrier to HA uptake is that HAs ob- tained in the traditional healthcare pathway, which requires multiple visits to a licensed professional (e.g., audi- ologists) for hearing loss diagnosis and the month(s) long process of fitting and ﬁne-tuning HAs, are not afford- able or accessible. We refer to this healthcare pathway as the AUD pathway. As an alternative pathway to im- prove affordability and accessibility of hearing healthcare, the over-the-counter (OTC) pathway uses a direct- to-consumer service-delivery model and enables users to self-determine hearing loss, self-fit the HA, and self- manage device without professional support. Although the OTC pathway has become popular, little is known about how potential users determine the right pathway for themselves (OTC vs. AUD) and how the OTC pathway impacts users’ long-term well-being. To guide potential users in their selection of one pathway over the other and to improve well-being of people with hearing loss, our project aims to characterize the entire OTC patient journey and compare that with the AUD journey, from pathway selection, through patient outcomes and consequences of unsuccessful HA expe- riences. Aim 1 seeks to understand the decision-making processes used by individuals to choose between the OTC and AUD pathways (i.e., what factors they consider and what personal characteristics drive the decision). Aim 2 seeks to determine the long-term (12 months) course of OTC outcomes (e.g., HA satisfaction) com- pared with that of the AUD pathway and to establish the individual differences (e.g., finger dexterity) that ex- plain the variance in long-term outcomes of each pathway. Aim 3 seeks to understand what people think and do following unsuccessful OTC experiences and whether this is the same as for the AUD pathway (Aim 3). To achieve our aims, we will conduct a two-site (Iowa and Vanderbilt), mixed-methods, longitudinal study in which participants choose their preferred healthcare pathways (OTC vs. AUD). Participants will purchase HAs up-front, but will be able to return the devices for a refund within the manufacturers’ trial periods. After selecting a pathway (Aim 1), participants will be contacted at 1-, 6- and 12-months post-fitting. At each contact, depend- ing on the status of HA usage we will assess HA outcomes (Aim 2) or the engagement with hearing healthcare behaviors (e.g., adopting new HAs, Aim 3). Our project will generate crucial data that will help us develop tools (e.g., decision aids) that adults with hearing loss can use to make informed decisions regarding hearing healthcare, and help ensure that the OTC pathway has a positive impact on their well-being.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = $0 )
2025	2024	THE UNIVERSITY OF IOWA	105 JESSUP HALL	IOWA CITY	IA	52242	JOHNSON	USA	Research Related to Deafness and Communication Disorders	002	6	11/27/2024	COMPETING CONTINUATION	$15,069
2025	2024	THE UNIVERSITY OF IOWA	105 JESSUP HALL	IOWA CITY	IA	52242	JOHNSON	USA	Research Related to Deafness and Communication Disorders	000	6	11/6/2024	COMPETING CONTINUATION	$0
2025	2022	THE UNIVERSITY OF IOWA	105 JESSUP HALL	IOWA CITY	IA	52242	JOHNSON	USA	Research Related to Deafness and Communication Disorders	001	5	11/27/2024	NON-COMPETING CONTINUATION	-$15,069
														Subtotal = $0

Issue Date FY: 2024 ( Subtotal = $664,611 )
2024	2024	THE UNIVERSITY OF IOWA	105 JESSUP HALL	IOWA CITY	IA	52242	JOHNSON	USA	Research Related to Deafness and Communication Disorders	001	6	7/22/2024	COMPETING CONTINUATION	$664,611
2024	2022	THE UNIVERSITY OF IOWA	105 JESSUP HALL	IOWA CITY	IA	52242	JOHNSON	USA	Research Related to Deafness and Communication Disorders	000	5	5/21/2024	NON-COMPETING CONTINUATION	$0
														Subtotal = $664,611

Issue Date FY: 2022 ( Subtotal = $323,561 )
2022	2022	UNIVERSITY OF IOWA, THE	105 JESSUP HALL	IOWA CITY	IA	52242	JOHNSON	USA	Research Related to Deafness and Communication Disorders	000	5	4/28/2022	NON-COMPETING CONTINUATION	$323,561
														Subtotal = $323,561

Issue Date FY: 2021 ( Subtotal = $323,739 )
2021	2021	UNIVERSITY OF IOWA, THE	105 JESSUP HALL	IOWA CITY	IA	52242	JOHNSON	USA	Research Related to Deafness and Communication Disorders	000	4	4/26/2021	NON-COMPETING CONTINUATION	$323,739
														Subtotal = $323,739

Issue Date FY: 2020 ( Subtotal = $323,904 )
2020	2020	UNIVERSITY OF IOWA, THE	105 JESSUP HALL	IOWA CITY	IA	52242	JOHNSON	USA	Research Related to Deafness and Communication Disorders	001	3	4/14/2020	NON-COMPETING CONTINUATION	$323,904
2020	2019	UNIVERSITY OF IOWA, THE	105 JESSUP HALL	IOWA CITY	IA	52242	JOHNSON	USA	Research Related to Deafness and Communication Disorders	000	2	2/24/2020	SUPPLEMENT FOR EXPANSION	$0
														Subtotal = $323,904

Issue Date FY: 2019 ( Subtotal = $684,086 )
2019	2019	UNIVERSITY OF IOWA, THE	105 JESSUP HALL	IOWA CITY	IA	52242	JOHNSON	USA	Research Related to Deafness and Communication Disorders	001	2	6/17/2019	SUPPLEMENT FOR EXPANSION	$365,807
2019	2019	UNIVERSITY OF IOWA, THE	105 JESSUP HALL	IOWA CITY	IA	52242	JOHNSON	USA	Research Related to Deafness and Communication Disorders	000	2	4/15/2019	NON-COMPETING CONTINUATION	$318,279
														Subtotal = $684,086

Issue Date FY: 2018 ( Subtotal = $328,156 )
2018	2018	UNIVERSITY OF IOWA, THE	105 JESSUP HALL	IOWA CITY	IA	52242	JOHNSON	USA	Research Related to Deafness and Communication Disorders	000	1	5/7/2018	NEW	$328,156
														Subtotal = $328,156

Grand Total All Awards = $2,648,057

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Barriers and facilitators to over-the-counter hearing aids success: A patient journey approach

Award Number: R01DC015997

ORGANIZATION: NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION DISORDERS

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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