Preset Hearing Aid Program Selection in Low-Income Communities: A Longitudinal Study.

Area of Science:

• Audiology
• Public Health
• Global Health

Background:

• Decentralized hearing care models utilizing community health workers (CHWs) show promise for improving access in low-income settings.
• Preset hearing aids offer user-selectable programs, potentially supporting these models, but their real-world effectiveness and adherence to clinical guidelines are not well understood.

Purpose of the Study:

• To evaluate the real-world use and clinical alignment of preset hearing aids within a CHW-facilitated, decentralized hearing care model in South Africa.
• To assess participant selection of amplification programs and changes over time in relation to hearing loss configuration.

Main Methods:

• A longitudinal feasibility study involving 36 adults with moderate-to-severe bilateral hearing loss in South Africa.
• Participants were fitted with preset hearing aids by trained CHWs, with program selections recorded at baseline and at 2 weeks, 2 months, and 6 months post-fitting.

Main Results:

• Over half of participants had high-frequency hearing loss, yet only 34% initially selected the corresponding program.
• Most participants (80.6%) changed their selected program at least once within six months.
• Agreement with clinically recommended programs decreased from 42% at baseline to 28% at six months.

Conclusions:

• CHW-delivered hearing aid services empower user autonomy in resource-limited environments.
• Frequent program adjustments suggest reliance on trial-and-error rather than audiometric fitting, potentially limiting long-term benefits.
• Effective utilization of preset hearing aids necessitates continuous, person-centered support and guidance.