Feasibility of Ecological Momentary Assessment of Hearing Difficulties Encountered by Hearing Aid Users

Abstract

Objectives Measurement of outcomes has become increasingly important to assess the benefit of audiologic rehabilitation, including hearing aids, in adults. Data from questionnaires, however, are based on retrospective recall of events and experiences, and often can be inaccurate. Questionnaires also do not capture the daily variation that typically occurs in relevant events and experiences. Clinical researchers in a variety of fields have turned to a methodology known as ecological momentary assessment (EMA) to assess quotidian experiences associated with health problems. The objective of this study was to determine the feasibility of using EMA to obtain real-time responses from hearing aid users describing their experiences with challenging hearing situations. Design This study required three phases: (1) develop EMA methodology to assess hearing difficulties experienced by hearing aid users; (2) utilize focus groups to refine the methodology; and (3) test the methodology with 24 hearing aid users. Phase 3 participants carried a personal digital assistant (PDA) 12 hr per day for 2 wk. The PDA alerted participants to respond to questions four times a day. Each assessment started with a question to determine if a hearing problem was experienced since the last alert. If “yes,” then up to 23 questions (depending on contingent response branching) obtained details about the situation. If “no,” then up to 11 questions obtained information that would help to explain why hearing was not a problem. Each participant completed the Hearing Handicap Inventory for the Elderly (HHIE) both before and after the 2-wk EMA testing period to evaluate for “reactivity” (exacerbation of self-perceived hearing problems that could result from the repeated assessments). Results Participants responded to the alerts with a 77% compliance rate, providing a total of 991 completed momentary assessments (mean = 43.1 per participant). A substantial amount of data was obtained with the methodology. Notably, participants reported a “hearing problem situation since the last alert” 37.6% of the time (372 responses). The most common problem situation involved “face-to-face conversation” (53.8% of the time). The next most common problem situation was “telephone conversation” (17.2%) followed by “TV, radio, iPod, etc.” (15.3%), “environmental sounds” (9.7%), and “movies, lecture, etc.” (4.0%). Comparison of pre- and post-EMA mean HHIE scores revealed no significant difference (p>.05), indicating that reactivity did not occur for this group. It should be noted, however, that 37.5% of participants reported a greater sense of awareness regarding their hearing loss and use of hearing aids. Conclusions Results showed participants were compliant, gave positive feedback, and did not demonstrate reactivity based on pre- and post-HHIE scores. We conclude that EMA methodology is feasible with patients who use hearing aids and could potentially inform hearing healthcare (HHC) services. The next step is to develop and evaluate EMA protocols that provide deta...

Construct Validity of the Ecological Momentary Assessment in Audiology Research

“…In total, 991 assessments were completed. Because the participants showed high compliance (77% response rate to the PDA alarm) and reported positive feedback, the study by Galvez et al (2012) supported the feasibility of computerized EMA. Due to the recent advancement of smartphone technology, applications/software that allow researchers to implement the EMA methodology using smartphones in outcome research has been developed (Hasan et al, 2013).…”

“…It would be beneficial to establish and validate a set of standardized questions that can be used in EMA. Finally, it has been suggested that EMA data could be useful for clinicians to understand patients’ specific communication needs, optimize hearing aid fitting, and provide individualized aural rehabilitation training (Galvez et al, 2012). However, the current format of EMA is not suitable for clinical use due to its high levels of respondent load (Kahneman et al, 2004).…”

“…EMA can also be realized using “high-tech” portable computers (Galvez et al, 2012; Henry et al, 2012). For example, Galvez et al (2012) used personal digital assistants (PDAs) to characterize listening difficulty encountered by hearing aid users.…”

“…For example, Galvez et al (2012) used personal digital assistants (PDAs) to characterize listening difficulty encountered by hearing aid users. Twenty-four hearing aid users were asked to carry PDAs for 2 weeks.…”

Privacy-Aware Acoustic Assessments of Everyday Life

“…In order to reduce the time between a given situation and the questionnaire, the method of ecological momentary assessment (EMA) was introduced. EMA allows to get ongoing data through self-reports, often implemented as the expe- * Supported by governmental funding initiative "Niedersächsisches Vorab" of the Lower Saxony Ministry for Science and Culture, research focus "Hören im Alltag Oldenburg (HALLO)" rience sampling method (ESM) [8], e.g., for hearing aid users [4]. The results are still on subjective scales.…”