An examination of clinical uptake factors for remote hearing aid support: a concept mapping study with audiologists

Abstract

Objective: To develop a conceptual framework around the factors that influence audiologists in the clinical uptake of remote follow-up hearing aid support services. Design: A purposive sample of 42 audiologists, stratified according to client-focus of either paediatric or adult, were recruited from professional associations in Ontario, Canada, as members of the six-step, participatory-based concept mapping process. Analyses included multidimensional scaling and hierarchical cluster analysis. Results: Six main themes emerged from this research according to overall level of importance: (1) technology and infrastructure; (2) audiologist-centred considerations; (3) hearing healthcare regulations; (4) client-centred considerations; (5) clinical implementation considerations; and (6) financial considerations. Subthemes were identified at the group-level and by subgroup. These highlight the importance of TECH factors (accessible Technology, Easy to use, robust Connection, and Help available), as well as the multifaceted nature of the perceived attitudes/aptitudes across stakeholders. Conclusion: Findings can be utilised in tailored planning and development efforts to support future research, knowledge dissemination, best-practice protocol/guideline development, and related training to assist in the clinical uptake of remote follow-up hearing aid support services, across variable practice contexts.

Phase 1 of collaborative action around the implementation of virtual hearing aid care: Development of a clinical practice guideline

“…22 The uptake of virtual care in hearing healthcare, and specifically the lack of knowledge tools to support/facilitate implementation, was identified as a current knowledge-to-action (KTA) gap in hearing healthcare at the time of CPG development. 15,23 This aligned with consistent reporting of a need for standardised protocols, procedures, and professional guidelines for care providers delivering virtual hearing healthcare. [24][25][26] Partnerships between clinical and academic settings are frequently cited to benefit the translation of knowledge (scientific knowledge concerning implementation) and improved utilisation (real-life implementation); these partnerships that include pragmatic implementation projects offer unique and collaborative opportunities to bridge research-to-practice gaps and to contribute to implementation science and knowledge translation in health.…”

“…Specifically, providerengaged research explored the factors perceived to influence the use of remote hearing aid support (barriers and facilitators) and the current implementation readiness levels. 15,23 Findings from these preimplementation studies led to the development of a conceptual framework describing the multi-dimensional aspects of virtual hearing healthcare readiness; these included eight factors that are addressed in the CPG: attitude, aptitude, access, client-provider relationship, social capital, professional standards, contextual, and organisational support. When considering Canadian hearing healthcare providers' readiness for virtual care, an average to high level was reported for all factors, with the exception of professional standards, reported to have low readiness scores 23 ; this indicated a strong need for the development of accessible resources to guide professionals in the implementation of virtual care.…”

“…13,14 Despite the current literature suggesting positive attitudes and a strong professional capacity for virtual hearing care, clinical implementation and uptake remain a challenge within hearing healthcare. 13,[15][16][17][18] When systematically developed using evidence-based methods, a clinical practice guideline (CPG) can assist providers, recipients, and others involved in the healthcare journey in making informed decisions around health interventions and public health actions. 19 CPGs can optimise patient care through the synthesis and dissemination of current scientific evidence into a collection of formal advisory statements and expert summaries.…”

“…In the adult literature, virtual care has been found to significantly improve outcomes for communication, hearing aid fitting, and quality of life, as part of follow‐up hearing aid appointments, alongside improvements in timeliness of care and reduced travel needs 13,14 . Despite the current literature suggesting positive attitudes and a strong professional capacity for virtual hearing care, clinical implementation and uptake remain a challenge within hearing healthcare 13,15–18 …”

Implementation Science: Increasing the Public Health Impact of Audiology Research

“…Though not necessarily framed as implementation science research, numerous studies in audiology consider implementation science outcomes. Examples of studies addressing the adoption (e.g., Glista et al, 2020 ), acceptability (e.g., Saunders & Roughley, 2021 ), feasibility (e.g., Amlani et al, 2019 ; Ferguson et al, 2020 ), and costs (e.g., Hatton et al, 2019 ; Manus et al, 2021 ) of specific programs and practices are readily available and illustrate how implementation science can increase understanding of whether and why an evidence-based program, practice, or policy may be implemented. Other implementation outcomes—particularly reach and maintenance—are rarely addressed, even in audiology research addressing health services and public health perspectives.…”