Climbing up the hearing rehabilitation ladder

Abstract: Hearing impairment is a major public health problem, affecting communication and participation, and is associated with a range of health problems. Most individuals with perceived hearing impairment do not seek help, do not opt for rehabilitation (hearing aids), and do not use prescribed hearing aids adequately. Reducing the impact of hearing impairment and supporting healthy aging are important public health goals. Motivation, access to hearing health care, and poor societal awareness about hearing impairment, consequences, and rehabilitation options influence help-seeking. Offering online hearing screening has been proposed to improve hearing help-seeking, access to hearing health care, and to increase public knowledge about hearing and hearing impairment. Applying theories from health psychology (i.e. the Stages of change model) could help audiologists and other hearing health care professionals understand the psychological barriers that prevent people with hearing problems to seek help and take up rehabilitation. The overarching aim of this thesis was to investigate behaviors related to hearing rehabilitation (help-seeking, hearing aid uptake, and hearing aid use) in adults who fail an online hearing screening. A second aim was to explore the usefulness of the Stages of change model in predicting hearing rehabilitation related behavior in a self-selected online hearing screening sample. Studies I–IV show tentative support for offering online hearing screening and for supplementary interventions for increasing help-seeking and provide tentative support for Stages of change as a useful classification tool to indicate individual needs for further information and guidance. Future studies should contemplate integrating screening for multiple health-related factors associated with hearing impairment and to provide a clear and tailored pathway for each participant (e.g. referral to adequate health care or equivalent online intervention).