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Exploring barriers to hearing help-seeking using behavioral economics: a qualitative study
Simon Alperstein1, Gurjit Singh2,3,4, David Joseph Dunn5
1Public Trust Research and Economics Team, People Insights Branch, Australian Public Service Commission, Australia.
Objective:
This study examines how concepts from Behavioural Economics (BE) can provide insights into the factors influencing decisions to seek help for hearing difficulties from a hearing health professional.
Design:
A qualitative approach was used, involving semi-structured interviews with individuals experiencing hearing difficulties who had not yet sought help from a hearing health professional. Thematic analysis was conducted, and responses were interpreted using the Organisation for Economic Co-operation and Development (OECD) Attention, Belief formation, Choice, Determination (ABCD) framework in conjunction with BE principles to explore cognitive and contextual influences to getting hearing help.
Study Sample:
Fifteen participants (aged 57-81, mean age 68 years) were recruited through targeted advertisements. All participants reported noticing hearing difficulties but had not undergone formal hearing assessments or used hearing aids.
Results:
Participants often minimised the importance of their hearing difficulties, attributing them to ageing or external factors, and described reliance on coping strategies as sufficient for managing daily communication. Perceptions of stigma, uncertainty about the help-seeking process, and beliefs about the thresholds for needing professional help appeared to influence delays in action. While participants expressed intentions to seek help in the future, their responses reflected a tendency to defer action. Many of these barriers are representative of cognitive biases, including the attribution of personal deficiencies to external factors, and the desire to minimise losses over gains.
Conclusions:
Applying a BE perspective to hearing health help-seeking decisions offers a nuanced understanding of the psychological and contextual barriers to help-seeking. Interventions that raise awareness of hearing difficulties and reframe help-seeking in ways that address cognitive biases may support earlier engagement with hearing services.
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