Health Literacy and Over-the-Counter Hearing Aid Messaging

Background: On October 17, 2022, the U.S. Food and Drug Administration (FDA) formally established a new category of hearing aids (HAs), now available over the counter (OTC). This new self-delivery model bypasses licensed practitioners, meaning consumers may rely more on manufacturer advertising to learn about OTC HA devices.Purpose: This study aimed to (1) document the (a) hearing-health literacy educational content strategies and (b) persuasive messaging strategies present in online advertisements from OTC manufacturers; and (2) analyze how the hearing-related advertising content changed before and after the October 17, 2022, final FDA ruling on OTC devices.Research Design: Pre-post content analysis.Study Sample: A total of 295 branded social media posts from three prominent OTC HA brands were analyzed. All posts from each manufacturer 6 months before and 6 months after the OTC HA final rule on October 17, 2022 (1 year in total) were queried and included in the sample.Data Collection and Analysis: A coding team systematically analyzed the content of the OTC posts. Pearson's χ² tests assessed differences in educational and persuasive messaging content present in the OTC posts before and after the FDA ruling.Results: The results revealed the majority of OTC posts simply urged consumers to visit the brand's website, encouraged immediate product purchase, or detailed features of their OTC HAs, such as the size and discreetness of the devices. Conversely, content vital for effective health communication such as hearing-health information, hearing loss statistics, and usage guidelines were not emphasized. Examination of health literacy content before and after the FDA announcement found that posts featuring hearing-health information significantly increased after the announcement. However, overall, the number of posts containing educational or consumer-informing details about OTC HAs remained low.Conclusions: The findings of this study suggest OTC HA advertisements lack important hearing-health literacy content. Despite FDA approval, the observed promotional orientation of OTC HA advertisements indicates an existing gap in educational content and highlights the need to better incorporate health literacy content into OTC HA marketing to promote informed choices for adult consumers with hearing loss.