Sherri L. Smith

Purpose: This exploratory study examined if hearing handicap in older adults affected listening-related fatigue during health care interactions and explored whether different face mask types worn during the coronavirus disease 2019 (COVID-19) pandemic influenced this association. Method: A cross-sectional observational study among community-dwelling adults aged 60 years and older receiving care at an academic health care system outpatient audiology or otolaryngology clinics was conducted. Eligible participants completed and returned a mail-in self-reported packet including the Hearing Handicap Inventory for the Elderly (Screener Version; HHIE-S) and the 10-item Vanderbilt Fatigue Scale for Adults (VFS-A-10). Face masks were institutionally required during the COVID-19 pandemic, with options including (a) standard surgical face mask, (b) clear face mask, or (c) standard surgical face mask with face shield. General linear models assessed differences in VFS-A-10 by HHIE-S score. Results: Among the 104 participants, the HHIE-S mean was 15.3 ( SD = 10.4); 34.3% experienced no hearing handicap, 45.5% experienced mild to moderate handicap, and 20.2% experienced severe handicap. Higher hearing handicap scores correlated with increased listening-related fatigue (β = 0.66, SE = 0.06, p ≤ .0001). Clear masks were linked to less listening-related fatigue, especially for individuals with higher degrees of hearing handicap, compared to standard surgical masks (β = −0.30, SE = 0.10, p ≤ .01). Conclusions: Findings from this exploratory study underscore the need for tailored communication strategies and accommodations to enhance the health care experience for individuals with hearing handicap. Future research could explore listening-related fatigue in other health care settings.

Purpose: The association between working memory and the self-perception of hearing difficulties in older adults is not well understood. Therefore, the purpose of the study was to investigate the relation between auditory working memory and self-reported hearing difficulties in older adults with varying degrees of pure-tone hearing loss. Method: Twenty-four older adults with varying degrees of sensorineural hearing loss participated. Self-reported hearing difficulties were assessed using the Adult Auditory Performance Scale (AAPS). Auditory working memory was measured using the Word Auditory Recognition and Recall Measure (WARRM). Results: Results revealed significant negative correlations between the WARRM recall score and the AAPS global, easy listening, noise, and complex listening scores. Pure-tone hearing was significantly correlated with self-reported hearing difficulty in easy listening environments (e.g., quiet and ideal listening) but was not for noise or complex listening. Regression analyses revealed that pure-tone hearing accounted for a significant amount of variability associated with the AAPS easy listening, whereas WARRM recall scores accounted for a significant amount of variability associated with AAPS noise and complex listening scores. Conclusions: Findings suggest that cognitive factors, such as auditory working memory, contribute to the self-perception of hearing difficulty among older adults. Routine clinical measurement of self-reported hearing difficulties and auditory working memory may provide a more global assessment of the hearing challenges faced by older adults with pure-tone hearing loss.

Background: The Glasgow Hearing Aid Benefit Profile (GHABP) is a patient-reported outcome measure (PROM) that was developed for the assessment of hearing aid efficacy using standard goals and user-nominated goals. The objective of this study was to describe user-nominated hearing goals to determine themes that are not currently being captured by the standard goals and that could improve comprehensive assessment of hearing quality of life with the GHABP for use in clinical trials. Methodology: We conducted a secondary analysis of a clinical trial at two tertiary care institutions. Adults ≥ 50 years of age with hearing loss completed the GHABP before treatment, including the portion where they provided up to two user-nominated goals for situations where hearing was personally challenging to them. We then categorized these goals into themes. Results: A total of 262 participants completed the standard GHABP and provided a total of 501 user-nominated goals. Common themes were having a conversation with several people in a group (80/501, 16.0%), hearing in background noise (73/501, 14.6%), and listening when unable to see the speaker’s mouth (57/501, 11.4%). Conclusions: Themes of listening in background noise and listening when unable to see the speaker’s mouth are very important to many individuals with hearing loss. Expanding PROMs to include these goals may improve patient-centeredness of clinical trial and clinical care outcomes tracking.

Objectives: The prevalence of hearing loss increases with age. Untreated hearing loss is associated with poorer communication abilities and negative health consequences, such as increased risk of dementia, increased odds of falling, and depression. Nonetheless, evidence is insufficient to support the benefits of universal hearing screening in asymptomatic older adults. The primary goal of the present study was to compare three hearing screening protocols that differed in their level of support by the primary care (PC) clinic and provider. The protocols varied in setting (in-clinic versus at-home screening) and in primary care provider (PCP) encouragement for hearing screening (yes versus no). Design: We conducted a multisite, pragmatic clinical trial. A total of 660 adults aged 65 to 75 years; 64.1% female; 35.3% African American/Black completed the trial. Three hearing screening protocols were studied, with 220 patients enrolled in each protocol. All protocols included written educational materials about hearing loss and instructions on how to complete the self-administered telephone-based hearing screening but varied in the level of support provided in the clinic setting and by the provider. The protocols were as follows: (1) no provider encouragement to complete the hearing screening at home, (2) provider encouragement to complete the hearing screening at home, and (3) provider encouragement and clinical support to complete the hearing screening after the provider visit while in the clinic. Our primary outcome was the percentage of patients who completed the hearing screening within 60 days of a routine PC visit. Secondary outcomes following patient access of hearing healthcare were also considered and consisted of the percentage of patients who completed and failed the screening and who (1) scheduled, and (2) completed a diagnostic evaluation. For patients who completed the diagnostic evaluation, we also examined the percentage of those who received a hearing loss intervention plan by a hearing healthcare provider. Results: All patients who had provider encouragement and support to complete the screening in the clinic completed the screening (100%) versus 26.8% with encouragement to complete the screening at home. For patients who were offered hearing screening at home, completion rates were similar regardless of provider encouragement (26.8% with encouragement versus 22.7% without encouragement); adjusted odds ratio of 1.25 (95% confidence interval 0.80–1.94). Regarding the secondary outcomes, roughly half (38.9–57.1% depending on group) of all patients who failed the hearing screening scheduled and completed a formal diagnostic evaluation. The percentage of patients who completed a diagnostic evaluation and received a hearing loss intervention plan was 35.0% to 50.0% depending on the group. Rates of a hearing loss intervention plan by audiologists ranged from 28.6% to 47.5% and were higher compared with those by otolaryngology providers, which ranged from 15.0% to 20.8% among the groups. Conclusions: The results of the pragmatic clinical trial showed that offering provider encouragement and screening facilities in the PC clinic led to a significantly higher rate of adherence with hearing screening associated with a single encounter. However, provider encouragement did not improve the significantly lower rate of adherence with home-based hearing screening.

Purpose: The purpose of this study was to evaluate the association between self-reported hearing handicap and life-space mobility utilizing the Life-Space Questionnaire (LSQ). Life-space mobility reflects how an individual moves through their daily physical and social environment, and the role of hearing loss in life-space mobility is not fully understood. We hypothesized that those with higher self-reported hearing handicap would be more likely to demonstrate restricted life-space mobility. Method: A total of 189 older adults (Mage = 75.76 years, SD = 5.81) completed a mail-in survey packet including the LSQ and Hearing Handicap Inventory for the Elderly (HHIE). Participants were categorized into one of three groups ("no/ none," "mild/moderate," or "severe" hearing handicap) according to HHIE total score. LSQ responses were dichotomized to either "nonrestricted/typical" or "restricted" life-space mobility groups. Logistic regression models were per-formed to analyze life-space mobility differences among the groups. Results: Logistic regression results demonstrated no statistically significant association between hearing handicap and LSQ. Conclusions: The results of this study indicate that there is no association between self-reported hearing handicap and life-space mobility as evaluated using a mail-in version of the LSQ. This counters other studies that have dem-onstrated that life space is associated with chronic illness, cognitive functioning, and social and health integration.

Objective: To determine adherence to the 2017 American Academy of Otolaryngology‐Head and Neck Surgery (AAO‐HNS) guidelines for the management and treatment of benign paroxysmal positional vertigo (BPPV) in primary care (PC) and compare whether key recommendations differed by sex, race, or insurance status.Study Design: Retrospective chart review.Setting: Twenty‐six clinic locations within a single healthcare system.Methods: Charts of 458 patients diagnosed with BPPV in PC between 2018 and 2022 were reviewed. Encounters where the diagnosis of BPPV was made were identified. From the clinical encounter note, demographics, symptomatology, management, and treatment were extracted. Nonparametric analyses were used to identify whether AAO‐HNS guidelines differed regarding sex, race, or insurance status.Results: Of 458 patients, 249 (54.4%) did not receive a diagnostic exam, and only 4 (0.9%) patients received imaging. Regarding treatment, only 51 (11.1%) received the Epley maneuver, with 263 (57.4%) receiving vestibular suppressant medication and 12.4% receiving a referral to a specialist. In regard to sex, race, or insurance status, there was no significant difference in receiving a Dix‐Hallpike diagnostic maneuver, Epley maneuver, vestibular suppressant medication, imaging, or referral to a specialist.Conclusion: Our data suggest that there continue to be gaps in the adherence to AAO‐HNS guidelines; however, these gaps did not differ by sex, race, or insurance status. Care should be taken to increase the use of diagnostic and treatment maneuvers but decrease the use of vestibular‐suppressant medications for the treatment of BPPV in PC.

Purpose: The purpose of this article was to provide a brief tutorial about impact metrics and how to use these metrics to document scientific impact. In addition, examples are provided that describe possible ways to document clinical impact of research. Method: We briefly introduce traditional bibliometrics for journals (e.g., impact factor), articles (e.g., citation counts), and authors (e.g., h index). We describe alternative metrics (i.e., altmetrics) that focus on other types of dissemination metrics such as usage (e.g., downloads, reads, and views), engagement (e.g., comments, shares, and replies), and attention (e.g., Altmetric Attention Score). We also discuss how these metrics are used by others to make decisions about employment, tenure and promotion, funding, and the like. We detail six steps to documenting the scientific and clinical impact of your research. Steps include establishing an ORCID (Open Researcher and Contributor ID) account, creating research profiles on academic platforms, engaging in broad dissemination activities, harvesting bibliometric and altmetric data, adding bibliometric and altmetric information to your curriculum vitae (CV), and submitting your promotion and tenure portfolio with confidence. Examples for ways in which scientific impact and clinical impact of research can be documented on your CV are provided. Results: Readers will have an introductory understanding of bibliometrics and altmetrics and how these data may be used in the evaluation of their research impact and reach. Some strategies are offered as means to increase scientific and clinical impact of research using research profiles on academic platforms. Others are suggestions for documenting scholarly activity aimed to increase clinical impact of research. Conclusions: Creating profiles with organizations that document scientific impact and engaging in the research community using less traditional methods may allow researchers to achieve a broader reach and greater clinical impact for their research. Documenting such research outputs should facilitate a researcher's career advancement.

Objectives: To support governments' efforts at neonatal mortality reduction, UNICEF and the American Academy of Pediatrics launched a telementoring project in Kenya, Pakistan and Tanzania.Methods: In Fall 2019, an individualised 12‐session telementoring curriculum was created for East Africa and Pakistan after site visits that included care assessment, patient data review and discussion with faculty and staff. After the programme, participants, administrators and UNICEF staff were surveyed and participated in focus group discussions.Results: Participants felt the programme improved knowledge and newborn care. Qualitative analysis found three common themes of successful telementoring: local buy‐in, use of existing training or clinical improvement structures, and consideration of technology needs.Conclusions: Telementoring has potential as a powerful tool in newborn education. It offers more flexibility and easier access than in‐person sessions. This project has the potential for scale‐up, particularly when physical distancing and travel restrictions are the norm.

Purpose: The purpose of this study was to determine the test–retest reliability and the minimum detectable change (MDC) scores of the Listening Self-Efficacy Questionnaire (LSEQ). Method: A total of 77 older adults who were experienced hearing aid users were administered the LSEQ in pen–paper format on two separate occasions. They were provided the first copy of the LSEQ in the clinic to take home to complete. Those participants who completed and returned the first copy of the questionnaire were then mailed a second copy of the LSEQ to complete and return approximately 2 weeks later. The mean subscale and total scale scores from the two administrations were compared using intraclass correlation coefficients (ICCs) to determine test–retest reliability of the measure. The MDC scores, or the minimum difference between scores to demonstrate a real change in self-efficacy levels, were also calculated for each subscale and the total scale. Results: The ICCs ranged from 0.786 to 0.920 for the subscale and total scale scores. The MDC scores for the subscale and total scale ranged from 14.3% to 19.1%. Conclusions: The results of this study indicate that the LSEQ has moderate to excellent test–retest reliability. The MDC scores demonstrate that the LSEQ has the potential to detect true changes in listening self-efficacy in older patients with hearing loss who use hearing aids. The LSEQ may aid clinicians in understanding listening self-efficacy in their patients and how their self-efficacy levels change with amplification.