Self-efficacy-based Auditory Rehabilitation With Over-the-Counter Hearing Aids

The Measure of Audiologic Rehabilitation Self-Efficacy for Hearing Aids (MARS-HA), referred to as MARSHA, is a 24-item, validated, self-report questionnaire used to assess an individual's confidence (self-efficacy) in their ability to use and manage hearing aids. Participants rated their confidence for each item (0 - 100%) and the average percentage across all items was calculated as the percentage of total confidence. Scores between pre- and post-conditions were compared and reported here.

Participants' readiness to adopt HAs was assessed using the 32-item modified University of Rhode Island Change Assessment (URICA). Each item presents a statement that asks about how ready a person is to move along in their hearing-health journey and adopt a treatment such as HAs. Participants respond to each item using a 5-point scale ranging from strongly disagree (1 point) to strongly agree (5 points). Items represent the stages of change (precontemplation, contemplation, preparation, action). Total readiness score (Readiness for change) is calculated by adding the scores representing the stages contemplation, preparation, action and subtracting this from scores on the items representing the precontemplation stage. The range of total readiness for change score is -2 to 14. Higher score represents higher readiness to adopt HAs, with scores of 11 or more is considered appropriate for someone to have the readiness to taken action to get hearing aids.

The Satisfaction with Amplification in Daily Life (SADL) Scale is a standardized, self-report instrument used to assess patient satisfaction with hearing aid use, including perceived benefit, usability, and psychosocial impact. It has 15 items in 4 subscales (Positive Effect, Service and Cost, Negative Features, Personal Image). For this study, only average score across all items was calculated. For each item participants respond the frequency (how frequently the said outcome in the item happens with them or true for them). Average frequency score (ranging from 1-5) across all items is used for analysis. The range of possible score is 1 to 7. Higher scores indicate greater satisfaction with hearing aids (better outcome). Lower scores indicate lower satisfaction or greater perceived difficulty with hearing aids (poorer outcomes).

Participants' change in emotional state will be assessed using the, 20-item, Positive and Negative Affect Schedule-Short Form (PANAS-SF). Participants respond to each item on a 5-point Likert scale ranging from "very slightly or not at all" to "extremely." Participants are asked to read each word and indicate the extent (intensity) to which they feel that way before/after wearing HAs. Positive and negative affective scores will be computed by calculating the sum of the items included for each of these two subscales. For this study, the final emotional state average score was calculated by subtracting the negative state score from the positive state score for each participant. Total possible range of scores would be -40 to +40. A positive emotional state total score indicated that the participant reported greater positive emotional states than negative emotional states.

A one-item hearing-related quality of life question wase used. The question asked about participants' current quality of life compared to before. The scale ranges from "a very great deal worse" (-7) to "a very great deal better" (7). An absolute change of 2 or more is considered clinically relevant in audiology. Higher positive values indicate improvements in hearing- related QOL and higher negative values indicate reduced hearing related QOL.