PP318 - Ecological Momentary Listening Assessment for Middle-Age Adults

Most middle aged adults with mild hearing loss do not seek audiology services. One approach to improve our understanding of their reluctance to address hearing loss is to learn more about perceived listening effort in a range of listening environments and their thoughts regarding amplification. In this study, we use ecological momentary assessment (EMA) surveys to capture data about real world listening experiences in the moment. Our study also includes the Hearing Handicap Inventory for Adults (Screening Version), pure tone audiometry, digits-in-noise, and the Montreal Cognitive Assessment (MoCA). Participants are sent the EMA survey 5 random times per day for 14 days. Following completion of the surveys an exit interview is completed to learn more about the participants thoughts and feelings regarding the experience. 

Adults from 45-65 years olds were recruited to complete an EMA survey over the course of two-weeks. At the first session all baseline questionnaires and screeners were completed. Then, participants downloaded the mEMA application on their smartphone. At the second session a follow up interview was conducted. 

To date, we have completed testing with 26 participants ranging in age from 45-63 years (mean = 57.36 years; SD = 7.22). HHIA-S scores range from 0-18 (mean = 8; SD = 5.8), suggesting that on average, this sample of middle-aged adults did not perceive a hearing handicap.  MoCA scores range from 20-30 (mean = 25.9; SD = 3). Better ear pure tone average (.5-4 kHz) ranges from 10-28.75 dBHL (mean = 16 dB HL; SD = 5.7dB HL). Speech-in-noise via antiphasic digits-in-noise provided in the hearX tablet audiometer screening options ranges from -11.8 to -7.1 dB SNR (mean = -10.06; SD = 1.04), with lower values indicative of better performance. Per HearX normative values, these results fall in the ‘hearing problem’ category for their hearing screening protocol. Data from 26 individuals responding to survey questions for two weeks yielded a total of 1146  responses. Of the total survey responses 15% indicated at least some listening effort during a listening event; yet only 9% indicated at least a little communication difficulty. Further only 3% of total responses said they would use amplification during the listening event. This data will be further explored for specific analyses based on individual characteristics, such as PTA and HHIA-S scores.

While many of the participants denied hearing loss, they noted that the most common listening challenge is the presence of background noise. When participants were asked how they would feel about using amplification we received a range of responses. For instance one participant stated “I would be fine with it” while another stated “Well, I mean, I don't need one right now”. Both of these participants had a PTA in the slight hearing loss range and no perceived hearing handicap on the HHIA.

Preliminary results suggest middle aged adults experience listening effort throughout their day. Some middle aged adults are open to the idea of exploring traditional hearing aids and other types of listening devices. Potential clinical implications include using an EMA procedure to help individuals recognize the need for amplification.