Factors Associated With Self-Reported Hearing Difficulty on the Revised Hearing Handicap Inventory and Its Relationship With Hearing Aid Use: Findings From the Population-Based Survey of the Health of Wisconsin
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Updated: May 11, 2026

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Published on: August 8, 2011
Lauren K Dillard1, Judy R Dubno1, Erin R Nelson-Bakkum2
1Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston.
Purpose:
This study aims to determine the (a) factors associated with self-reported hearing difficulty and (b) relationship of self-reported hearing difficulty with hearing aid use.
Method:
This cross-sectional study was conducted among participants of the population-based Survey of the Health of Wisconsin cohort who self-reported hearing loss. Among those participants, self-reported hearing difficulty was measured using the Revised Hearing Handicap Inventory, screening version (RHHI-S). We used age- and sex-adjusted linear and logistic regression models, respectively, to evaluate associations of (a) demographic, hearing- and health-related factors with RHHI-S scores, and (b) RHHI-S scores with self-reported hearing aid use. Results are presented as regression coefficients or odds ratios (ORs) with 95% confidence intervals (CIs).
Results:
This study included 137 participants, with a mean age of 63.7 (SD = 12.1) years, 48.2% male, and 24.3% Black race. Participants' mean RHHI-S score was 11.0 (SD = 10.9) points. Factors associated with higher RHHI-S scores included male sex (among participants ≥ 65 years), younger age of self-reported hearing loss onset, high school/GED education or less (among participants < 65 years), marital status (never married), tinnitus, history of dizziness or balance problems, and occupational noise exposure. The prevalence of hearing aid use was 23.2%. Every +2-point increase on the RHHI-S was associated with approximately 25% higher odds (OR = 1.25, 95% CI [1.12, 1.39]) of hearing aid use.
Conclusions:
Demographic, hearing-, and health-related factors were associated with RHHI-S scores, and higher RHHI-S scores were strongly associated with hearing aid use. Findings could inform the implementation of self-reported hearing difficulty tools in clinical and research settings.
Supplemental Material:
https://doi.org/10.23641/asha.30140890.
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