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Date of Graduation
8-9-2024
Document Type
Dissertation
Degree Name
Doctor of Philosophy (PhD)
Department
Communication Sciences and Disorders
Advisor(s)
Ayasakanta Rout
Yingjiu Nie
Rory DePaolis
Lincoln Gray
Abstract
The affordability of hearing aids (HA) is a significant barrier to ownership in low-and middle-income countries (WHO, 2021). Crowded living conditions in developing countries intensify the complexity of listening environments compared to developed nations. No existing literature compares the listening environment and HA outcomes using real-world measures across these regions. This study aims to 1) compare HA outcomes and listening environments between India and the USA, and 2) evaluate the benefit of premium HAs over basic HAs in both locations. In an observational, multi-location, single-blinded study, nineteen hearing aid users (mean age 69.6 years) participated. Ecological momentary assessments (EMA) were conducted using premium and basic HAs over one week in each location. Listening environment exposure was objectively captured via HA data logging. Retrospective assessments at the end of each week were used to compare effectiveness in evaluating HA outcomes against EMA. A linear mixed-effects model in R, assessed the effects of location, HA technology, listening environment, and their interactions. Proportions of listening environments from EMA and data logging were compared, and a paired t-test compared HA outcomes from retrospective assessments using both HA technologies in each location. Correlation between EMA and retrospective assessments was analyzed using Pearson’s product-moment correlation. The highest exposure to speech-in-noise was recorded by EMA and data logging in India, while in the USA, EMA indicated speech-in-quiet and data logging showed speech-in-noise. Results of three-way interactions were significantly robust. HA outcomes were better with premium HAs in the USA during speech-in-noise. Conversely, basic HAs outperformed premium HAs in speech-in-noise in India. HA outcomes were generally better in the USA than in India, with statistical significance noted in one HA outcome variable. A moderate to high association was found between HA outcomes from EMA and retrospective assessments. The findings suggest that premium HAs may not be universally superior, particularly in developing countries with challenging listening environments. Clinically, this implies that basic HAs could be a more cost-effective solution in such regions, potentially improving access to HAs for individuals in economically constrained areas. Further research is needed to explore these relationships in other developing countries to generalize the findings.
Recommended Citation
Pandey, Preeti, "Are Hearing Aids Designed for All Parts of the World? An Ecological Momentary Assessment Study" (2024). Dissertations, 2020-current. 160.
https://commons.lib.jmu.edu/diss202029/160
