Hearing Rehabilitation Strategies for Hearing Loss

Overseen By Kristin Montella

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: NYU Langone Health

Disqualifiers: Hearing aids, Cochlear implants

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 1

Duration: 4 weeks

120 Participants Needed

Trial Summary

What is the purpose of this trial?

During a primary care visit, investigators will screen and identify participants with hearing loss and then randomize to a) counseling on accessible assistive listening devices or b) referral to traditional audiology care pathway alone.

Do I need to stop my current medications for this trial?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment Counseling on accessible assistive listening devices for hearing loss?

Research suggests that counseling plays a crucial role in helping patients effectively use hearing aids and other assistive listening devices, which can improve communication and reduce feelings of isolation. Effective counseling involves building a strong patient-provider relationship and using techniques like Motivational Interviewing to enhance treatment adherence. ^{1 2 3 4 5}

Is hearing rehabilitation generally safe for humans?

The research does not provide specific safety data for hearing rehabilitation strategies, but these treatments, including counseling and assistive listening devices, are generally considered safe as they are non-invasive and focus on improving communication and hearing aid use. ^{1 2 6 7 8}

How is the treatment 'Counseling on accessible assistive listening devices' different from other hearing loss treatments?

This treatment is unique because it combines counseling on assistive listening devices with traditional audiology care, focusing on building a patient-centered relationship to improve adherence to hearing aid use, unlike treatments that rely solely on technology. ^{1 7 9 10 11}

Research Team

David Friedmann, MD

Principal Investigator

NYU Langone Health

Eligibility Criteria

This trial is for English or Spanish speakers who can consent to research and have hearing loss. It's not for those who already use hearing aids or cochlear implants.

Inclusion Criteria

I speak English or Spanish.

I am able to understand and agree to participate in research.

Exclusion Criteria

Has or uses hearing aids or cochlear implants

Timeline

Screening

Participants are screened for eligibility to participate in the trial

1 day

1 visit (in-person)

Treatment

Participants are randomized to either counseling on accessible assistive listening devices or referral to traditional audiology care pathway

4 weeks

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

Treatment Details

Interventions

• Counseling on accessible assistive listening devices
• Referral to traditional audiology care pathway alone

Trial Overview The study tests two ways to help with hearing loss in a primary care setting: one group gets counseling on assistive listening devices, while the other follows standard audiology care.

Participant Groups

Group I: Alternative Rehabilitation Strategies Experimental Treatment 1 Intervention

Patients who screened positive for hearing loss and were randomized into the counselling on alternative rehabilitation strategies intervention arm.

Group II: Usual Care Active Control 1 Intervention

Patients who screened positive for hearing loss and were randomized into the usual care audiology pathway control arm alone.

Who Is Running the Clinical Trial?

NYU Langone Health

Lead Sponsor

Trials

1,431

Recruited

838,000+

Findings from Research

Building a strong, patient-centered relationship during the initial evaluation is crucial for encouraging patients with hearing loss to use hearing aids effectively.

Training healthcare professionals in specific counseling skills, such as Motivational Interviewing and the Teach-Back Method, can significantly improve patient adherence to hearing aid recommendations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Developing Foundational Counseling Skills for Addressing Adherence Issues in Auditory Rehabilitation. Johnson, CE., Jilla, AM., Danhauer, JL.[2020]

Assistive listening devices can significantly improve communication for elderly patients with hearing loss, helping to reduce feelings of isolation and enhance their quality of life.

Patients and families are encouraged to seek information and support from local audiologists and the American Speech-Language-Hearing Association to find suitable hearing aids and assistive devices.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Nontraditional 'aids' to hearing: assistive listening devices. Rupp, RR., Vaughn, GR., Lightfoot, RK.[2004]

A randomized controlled trial will assess the effectiveness of an internet-based counseling program using a 'patient journey' model for 158 participants with self-reported hearing disability, focusing on outcomes like hearing disability, depression, and anxiety.

If successful, this counseling approach could provide a cost-effective and time-efficient method for managing hearing disabilities, enhancing the support for individuals navigating their hearing loss journey.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Use of the 'patient journey' model in the internet-based pre-fitting counseling of a person with hearing disability: study protocol for a randomized controlled trial. Manchaiah, VK., Stephens, D., Andersson, G., et al.[2021]

A survey of 205 clinical supervisors in audiology graduate programs revealed that while 88% of programs require a counseling course, there is variability in how counseling skills are taught and assessed, indicating a need for more standardized training methods.

Supervisors with more experience reported greater confidence in teaching counseling skills, particularly in discussing emotional topics with clients, suggesting that mentorship and experience play a crucial role in developing effective counseling instruction for audiology students.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Teaching Counseling Skills in Audiology Graduate Programs: Clinical Supervisors' Perceptions and Practices. Muñoz, K., Landon, T., Corbin-Lewis, K.[2020]

Many adults who could benefit from hearing aids do not use them, and those who do often stop using them shortly after, indicating that simply providing hearing aids is not enough for effective treatment of hearing loss.

The Audiology Practice Standards Organization has introduced evidence-based standards for hearing aid selection and fitting, emphasizing the need for thorough assessments of patients' amplification needs and measuring outcomes to improve adoption and success rates.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

APSO Standards: Implementing Hearing Aid Needs Assessments and Measuring Related Outcomes. Arnold, ML., Sanchez, VA.[2023]

A study involving 33 audiology professionals from 5 countries identified 64 key competencies necessary for effective audiologic counseling, emphasizing the importance of knowledge, skills, and attitudes in this field.

The findings highlight a gap in current practice guidelines for audiology education, suggesting that these competencies should be integrated into graduate training programs to enhance counseling practices for patients with ear-related disorders.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Counseling Competencies in Audiology: A Modified Delphi Study. Meibos, A., Muñoz, K., Twohig, M.[2019]

A survey of audiology faculty from 40 ASHA-accredited colleges revealed gaps in the aural rehabilitation training provided to graduate students, particularly in areas like cochlear implants and vestibular disorders.

The findings aim to highlight deficiencies in current training programs, which could help improve the education and preparedness of future audiologists working with hearing-impaired patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Aural rehabilitation and graduate audiology programs. Sykes, S., Tucker, D., Herr, D.[2020]

A survey of 209 clinical audiologists revealed that many frequently encounter normal-hearing patients who experience significant communication difficulties, yet few have established protocols for managing these cases.

Counseling is the most common rehabilitation method used, but audiologists are also beginning to fit these patients with mild-gain hearing aids, despite a lack of research supporting the efficacy of such interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Questionnaire Survey of Current Rehabilitation Practices for Adults With Normal Hearing Sensitivity Who Experience Auditory Difficulties. Koerner, TK., A Papesh, M., Gallun, FJ.[2022]

A study involving 106 veterans showed that while hearing aids significantly improved self-perception of communication performance in both short- and long-term, there were no additional benefits from a counseling-oriented audiological rehabilitation (AR) program in the long run.

However, the AR program did provide short-term benefits in communication strategy usage, leading to better interaction and reaction scores, suggesting that it may help users adjust to hearing aids initially.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Short- and long-term outcomes of adult audiological rehabilitation. Chisolm, TH., Abrams, HB., McArdle, R.[2019]

In 2011, the Israeli government significantly increased subsidies for adult hearing aids, which led to a reduction in prices and increased demand, making hearing aids more accessible to the public.

However, this shift towards affordability risks diminishing the role of professional audiologists in the rehabilitation process, highlighting the need for a balance between cost reduction and the importance of professional care in hearing rehabilitation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Price reductions in hearing aids and access to audiologists, Israel. Lavie, L., Bar-Moshe, T.[2022]

Participation in counseling and communication strategy-oriented group aural rehabilitation programs significantly reduces self-perception of hearing handicap in adults with hearing impairment, based on a systematic review of 12 studies.

While these programs may enhance the use of communication strategies and hearing aids in the short term, it remains uncertain if these benefits last longer than the initial period after the program.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness of counseling-based adult group aural rehabilitation programs: a systematic review of the evidence. Hawkins, DB.[2020]

References

1. United States pubmed.ncbi.nlm.nih.gov

Developing Foundational Counseling Skills for Addressing Adherence Issues in Auditory Rehabilitation. [2020]

2. United States pubmed.ncbi.nlm.nih.gov

Nontraditional 'aids' to hearing: assistive listening devices. [2004]

3. England pubmed.ncbi.nlm.nih.gov

Use of the 'patient journey' model in the internet-based pre-fitting counseling of a person with hearing disability: study protocol for a randomized controlled trial. [2021]

4. United States pubmed.ncbi.nlm.nih.gov

Teaching Counseling Skills in Audiology Graduate Programs: Clinical Supervisors' Perceptions and Practices. [2020]

5. United States pubmed.ncbi.nlm.nih.gov

APSO Standards: Implementing Hearing Aid Needs Assessments and Measuring Related Outcomes. [2023]

6. United States pubmed.ncbi.nlm.nih.gov

Counseling Competencies in Audiology: A Modified Delphi Study. [2019]

7. United States pubmed.ncbi.nlm.nih.gov

Aural rehabilitation and graduate audiology programs. [2020]

8. United States pubmed.ncbi.nlm.nih.gov

A Questionnaire Survey of Current Rehabilitation Practices for Adults With Normal Hearing Sensitivity Who Experience Auditory Difficulties. [2022]

9. United States pubmed.ncbi.nlm.nih.gov

Short- and long-term outcomes of adult audiological rehabilitation. [2019]

10. Switzerland pubmed.ncbi.nlm.nih.gov

Price reductions in hearing aids and access to audiologists, Israel. [2022]

11. United States pubmed.ncbi.nlm.nih.gov

Effectiveness of counseling-based adult group aural rehabilitation programs: a systematic review of the evidence. [2020]