Identifying barriers and facilitators to implementing family-centred care in adult audiology practices: a COM-B interview study exploring staff perspectives

Ekberg, Katie; Schuetz, Simone; Timmer, Barbra H B; Hickson, Louise

doi:10.1080/14992027.2020.1745305

Cited by 21 publications

(12 citation statements)

References 38 publications

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“…Caregivers may be highly motivated to ensure their babies are wearing functioning hearing aids, but may require specific strategies to develop capabilities and provide opportunities for good hearing aid management and maintenance skills. Behavior change approaches based on the Capability-Opportunity-Motivation-Behavior (COM-B) model have been shown to be potentially useful in adult audiology ( Barker et al 2016 ; Ekberg et al 2020 ). The COM-B model identifies three “sources of behavior” (“capability,” “opportunity,” and “motivation”) around which a “behavior change wheel” has been developed ( Michie et al 2011 ).…”

Section: Introductionmentioning

confidence: 99%

Longitudinal Changes in Hearing Aid Use and Hearing Aid Management Challenges in Infants

et al. 2020

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Section: Introductionmentioning

confidence: 99%

Longitudinal Changes in Hearing Aid Use and Hearing Aid Management Challenges in Infants

et al. 2020

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“…Authors drew on clinical experience (R. G., A. H., and M. A. F.) and research in supporting hearing health behavior change (D. M. and M. A. F.). Although use of the full BCW in hearing aid care is emerging (Barker et al 2016a, 2018; Edwards & Ferguson 2020; Ekberg et al 2020), there is no guarantee the BCTs are effective or acceptable to audiologists. Of note, a systematic review and meta-analysis of BCTs across health behaviors (Webb et al 2010) has identified that utilizing multiple BCTs tend to be more successful at changing behaviors than those with fewer BCTs.…”

Section: Discussionmentioning

confidence: 99%

Smartphone-Connected Hearing Aids Enable and Empower Self-Management of Hearing Loss: A Qualitative Interview Study Underpinned by the Behavior Change Wheel

et al. 2021

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Objectives: To identify patient-reported barriers and facilitators to using smartphone-connected hearing aids, using the Behavior Change Wheel (BCW) to understand experiences and how these can be addressed.Design: A single-center, prospective, observational study. Eight hearing aid users (new = 1, existing = 7; mean age = 71.75 years, SD = 5.23, range = 65 to 81 years) were identified through convenience sampling from 44 participants who took part in a 7-week evaluation of smartphone-connected hearing aids controlled by a prototype app. The app allowed users to manually control settings such as gain, noise reduction, and microphone directionality, preset, and customized programmes. Participants were assigned to one of two focus groups following trial of the app.Results: Focus group transcripts were thematically analyzed and underpinned by the COM-B (Capability, Opportunity, Motivation-Behavior) model and Theoretical Domains Framework to identify barriers and facilitators to using smartphone-connected hearing aids (the target behavior). Mapping of themes to the BCW allowed use of the Behavior Change Technique Taxonomy (version 1) to identify behavior change techniques that audiologists could implement in clinical practice to address the barriers and facilitators. Capability: The app increased participants' knowledge of hearing aid controls, encouraging use of the app for improved hearing loss self-management. However, barriers to using the app included perception of insufficient digital literacy skills for smartphone-connected hearing aid use and an increased cognitive load caused by decisions over which controls to use. Opportunity: Perceived smartphone norms (i.e., acceptable occasions to use smartphones) and differing listening contexts acted as both facilitators and barriers. Motivation: The ability to control hearing aid settings in any listening situation (e.g., to reduce noise) empowered users to successfully self-manage their hearing loss, leading to greater confidence and participation in everyday life. The app also reduced hearing aid-related and self-stigma, and the ability to selfadjust hearing aids benefitted both participants and communication partners. It was the adjustability and interaction afforded by the app that empowered users, rather than the hearing aid technology itself. Perceived beliefs and knowledge about digital literacy skills, and specifically abilities to use a smartphone, were perceived to be barriers in this typically older population, particularly when they compared themselves to younger generations. Using the Behavior Change Technique Taxonomy (version 1), behavior change techniques that could be used by audiologists to address these barriers included enablement, goal setting, reframing perceptions toward technology, and addressing patient educational needs.Conclusions: Smartphone-connected hearing aids, when used in their everyday lives, were viewed positively by participants across a range of domains, empowering them and enabling hearing loss self-management. Audiologists shoul...

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“…When a child or adolescent is troubled or distressed by their tinnitus, it is likely that their parents and caregivers will be also and that the impact of tinnitus may have implications for the family as a whole [ 12 , 43 ]. FCC acknowledges that when one member of a family is affected by a health condition, other members of the family may be affected also and that they play an integral role in supporting that family member in their health care [ 44 ]. Enquiring into parents' and primary caregivers' experience of tinnitus prior to tinnitus counselling and education is also important as parents or primary caregivers who have experienced tinnitus themselves may be more aware of the potential impact of tinnitus and the benefit of counselling and may be more supportive of their child's experience of tinnitus than parents who have not experienced it [ 13 , 43 , 45 ].…”

Section: Discussionmentioning

confidence: 99%

Reducing the Impact of Tinnitus on Children and Adolescents’ Lives: A Mixed-Methods Concept Mapping Study

Tegg-Quinn

Eikelboom

Brennan‐Jones

et al. 2021

International Journal of Pediatrics

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Objectives. To generate a conceptual framework describing what is done to reduce the impact of chronic tinnitus on the lives of children and adolescents. Design. Views and experiences of 32 adults from two participant groups informed this concept mapping study: (i) a tinnitus group (adults who experienced tinnitus during childhood/adolescence, and primary carers of children/adolescents with tinnitus) and (ii) a clinicians’ group (clinicians who provided care for children/adolescents with tinnitus). Participants produced statements describing what is done to reduce the impact of chronic tinnitus on the lives of children and adolescents who experience it. Through grouping and rating processes, they identified key concepts and inferred their associated benefit. Results. The participants generated 102 unique statements across four concepts: (1) Education, Support, and Counselling; (2) Support from Parents and Teachers; (3) Clinical Assessments and Management; and (4) Self-Management Techniques. Many statements highlighted the need for child-friendly and patient-centred care. Adults with personal experience of childhood tinnitus tended to perceive many of the statements as more beneficial than did the clinician group. Conclusions. Although many children will develop management strategies to assist them with their tinnitus, both the adults who experienced tinnitus as children and their parents valued strategies involving clinical care, knowledge, and expertise. Participants from the tinnitus group perceived a greater degree of benefit associated with strategies from all four clusters than the clinicians’ group. However, both groups perceived the greatest degree of benefit as being associated with activities and strategies within the Education, Support, and Counselling and the Clinical Assessments and Management clusters. Both groups identified that recognising the occurrence of tinnitus for children and adolescents, acknowledging the potential for associated distress, and initiating clinical care provide the nexus of effective management. Addressing the concerns and needs of parents was also perceived as valuable; hence, approaching the management of tinnitus during childhood and adolescence from a family-centred care framework is recommended.

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Identifying barriers and facilitators to implementing family-centred care in adult audiology practices: a COM-B interview study exploring staff perspectives

Cited by 21 publications

References 38 publications

Longitudinal Changes in Hearing Aid Use and Hearing Aid Management Challenges in Infants

Longitudinal Changes in Hearing Aid Use and Hearing Aid Management Challenges in Infants

Smartphone-Connected Hearing Aids Enable and Empower Self-Management of Hearing Loss: A Qualitative Interview Study Underpinned by the Behavior Change Wheel

Reducing the Impact of Tinnitus on Children and Adolescents’ Lives: A Mixed-Methods Concept Mapping Study

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