Effectiveness of a web-based SUpport PRogramme (SUPR) for communication partners of persons with hearing loss: results of a two-arm, cluster randomised controlled trial and process evaluation

Figures & data

Table 1. cRCT outcome measures (ranges) and time points.

	t0	t1	t2	t3
Third-party disability (SOS-HEAR)
Communication changes (0–4)	X	X	X	X
Communicative burden (0–4)	X	X	X	X
Relationship changes (0–4)	X	X	X	X
Going out and socialising (0–4)	X	X	X	X
Emotional reactions (0–4)	X	X	X	X
Concern for partner (0–4)	X	X	X	X
Total SOS–HEAR score (0–4)	X	X	X	X
HA rehabilitation outcomes (IOI–HA–SO) (1–5) – administered in the control and SUPR groups
Proxy report: HA use (1–5)		X	X	X
Third–party disability: satisfaction (1–5)		X	X	X
Third–party disability: quality of life (1–5)		X	X	X
HA rehabilitation outcomes (IOI–HA–SO) administered in the control group; and SUPR rehabilitation outcomes (IOI–AI–SO) administered in the SUPR group*
Use (1–5)		X	X	X
Benefit (1–5)		X	X	X
Residual activity limitations (1–5)		X	X	X
Satisfaction (1–5)		X	X	X
Residual participation restrictions (1–5)		X	X	X
Impact on others (1–5)		X	X	X
Quality of life (1–5)		X	X	X

Abbreviations: SOS-HEAR: significant other scale for hearing disability; HA: hearing aid; IOI-HA-SO: international outcome inventory for hearing aids – significant other; IOI-AI-SO: international outcome inventory for alternative interventions – significant other.

*These outcomes were not compared between the SUPR and control group as part of the ITT analysis; distributions are only provided for descriptive purposes (see Supplemental material 1).

Figure 1. Flow of CP participants through the study.

Table 2. Characteristics of CPs and their PHLs included in the ITT analysis (n = 128), and CPs included in the PE analysis (n = 41).

	CPs SUPR group	CPs control group	CPs PE group	PHLs SUPR group	PHLs Control group
Female	50 (69)	40 (71)	23 (58)	28 (38)	22 (39)
Age in years, mean (SD)	61.9 (10.0)	62.3 (12.8)	63 (9.5)	67 (7.4)	67.9 (8.6)
Marital status
Married	61 (85)	45 (80)	33 (83)	58 (79)	45 (79)
Cohabiting	4 (6)	6 (11)	3 (8)	4 (6)	3 (5)
Widowed	3 (4)	2 (4)	1 (3)	8 (11)	3 (5)
Divorced	2 (3)	2 (4)	1 (3)	1 (1)	6 (11)
Single, never married	2 (3)	1 (2)	2 (5)	2 (3)	0
Living situation
Living together with other people	66 (92)	53 (95)	37 (93)	63 (88)	49 (86)
Living alone	6 (8)	3 (5)	3 (8)	9 (12)	8 (14)
Educational level
Low	12 (17)	6 (11)	8 (20)	16 (22)	8 (14)
Middle	50 (69)	42 (75)	27 (68)	52 (71)	39 (68)
High	10 (14)	8 (14)	5 (13)	5 (7)	10 (18)
Paid job
Yes	27 (38)	21 (38)	15 (38)	16 (23)	16 (28)
No	45 (63)	35 (63)	25 (63)	56 (78)	41 (72)
Country of birth
The Netherlands	69 (96)	55 (98)	39 (98)	68 (93)	55 (97)
Other	3 (4)	1 (2)	1 (3)	5 (7)	2 (4)
Relationship with PHL*
Spouse/partner	59 (82)	48 (86)	34 (85)	–	–
Brother/sister	1 (1)	0	0	–	–
Father/mother	7 (10)	6 (11)	2 (5)	–	–
Friend	2 (3)	2 (4)	2 (5)	–	–
Neighbour	1 (1)	0	1 (3)	–	–
Family in law	2 (3)	0	1 (3)	–	–
Better ear average hearing loss in dB HL, mean (SD)	–	–	–	43 (11.6)	44 (9.8)
AIADH sum score** (range 0–84), mean (SD)	–	–	–	38.7 (14.8)	38.9 (13.9)

Abbreviations: CPs: communication partners; PE: process evaluation; PHL: person with hearing loss; SD: standard deviation; dB HL: decibels hearing level averaged across 1, 2, and 4 kilohertz; AIADH: Amsterdam inventory for auditory disability and handicap.

*He or she is my…

**Higher scores indicate higher levels of hearing disability.

Values indicate numbers (%) of participants unless stated otherwise.

Table 3. Descriptive statistics and results of linear mixed models on third-party disability (mean or median SOS-HEAR domain- and total scores).

		t0		t1		t2		t3		LMM
	Group	n	Med (IQR)	n	Med (IQR)	n	Med (IQR)	n	Med (IQR)	p*
Communication changes	S	72	0.7 (1.0)	53	0.7 (1.2)	43	0.5 (1.2)	42	0.3 (0.9)	0.21
	C	56	0.8 (1.0)	52	0.7 (1.3)	50	0.5 (1.4)	42	0.5 (1.2)
Communicative burden	S	72	0.2 (0.5)	53	0.0 (0.7)	43	0.0 (0.2)	42	0.0 (0.3)	0.14
	C	56	0.2 (0.5)	52	0.1 (0.5)	50	0.0 (0.5)	42	0.0 (0.4)
Relationship changes	S	72	0.0 (0.3)	40	0.0 (0.3)	37	0.0 (0.0)	31	0.0 (0.3)	0.30
	C	55	0.0 (0.3)	42	0.0 (0.0)	43	0.0 (0.3)	38	0.0 (0.1)
Going out and socialising	S	72	0.3 (0.5)	53	0.0 (0.5)	43	0.0 (0.3)	42	0.0 (0.3)	0.94
	C	56	0.3 (0.5)	52	0.0 (0.5)	50	0.0 (0.3)	42	0.0 (0.5)
Emotional reactions	S	72	0.2 (0.6)	53	0.0 (0.6)	43	0.0 (0.2)	42	0.0 (0.3)	0.56
	C	56	0.3 (0.6)	52	0.0 (0.4)	50	0.0 (0.5)	42	0.0 (0.4)
Concern for partner	S	72	0.0 (0.7)	53	0.0 (0.0)	43	0.0 (0.0)	42	0.0 (0.0)	0.71
	C	56	0.3 (0.7)	52	0.0 (0.3)	50	0.0 (0.3)	42	0.0 (0.3)
Total score	S	72	0.3 (0.6)	40	0.3 (0.7)	37	0.1 (0.7)	31	0.1 (0.4)	0.40
	C	55	0.4 (0.6)	42	0.3 (0.5)	43	0.2 (0.7)	38	0.3 (0.5)

Abbreviations: Med: median; IQR: Interquartile range; LMM: linear mixed models; S: SUPR group; C: control group.

*Indicates a difference in the course of the outcomes between groups (interaction term time*group). A p-value of <0.05 was considered statistically significant.

Scores could range between 0 and 4; higher scores indicate greater disability.

Table 4. Descriptive statistics and results of the linear mixed models on rehabilitation outcomes (IOI-HA-SO).

		t1			t2		t3		LMM
	Group	n	Mean (SD)	p*	n	Mean (SD)	n	Mean (SD)	p**
Item 1. Proxy report: HA use – Hours of HA worn by PHL	S	55	4.6 (0.8)	0.84	43	4.5 (0.9)	42	4.4 (1.1)	0.68
	C	52	4.5 (0.9)		51	4.5 (0.9)	43	4.3 (1.1)
Item 4. Third-party disability: satisfaction with HA – Were the HAs “worth the trouble”?	S	55	3.8 (1.0)	0.73	43	3.8 (1.0)	42	3.8 (1.0)	0.62
	C	52	3.7 (0.9)		51	3.5 (1.0)	43	3.7 (1.0)
Item 7. Third-party disability Quality of life with HA – Did HAs change CP’s enjoyment of life?	S	55	3.8 (0.9)	0.76	43	3.4 (1.2)	42	3.5 (1.1)	0.31
	C	52	3.7 (0.8)		51	3.5 (0.9)	43	3.6 (1.0)

Abbreviations: SD: standard deviation; MD: mean difference; CI: confidence interval; LMM: linear mixed models; HA: hearing aid; S: SUPR group; C: control group; CP: communication partner; PHL: person with hearing loss.

*p value for difference between mean values in SUPR and control group immediately post-intervention (t1). A p value of <0.05 was considered statistically significant.

**Indicates a difference in the course of the outcomes between groups (interaction time*group). A p-value of <0.05 was considered statistically significant.

Scores could range between 1 and 5; higher scores indicate better outcomes.

Figure 2. Mean post-intervention and CP and PHL scores on the IOI-HA-SO (CPs) and IOI-HA (PHLs) items “use”, “satisfaction”, and “quality of life”.

Table 5. Intervention dose-received: The extent to which CPs (n = 41) watched the educational videos.

	Did you watch the videos?
	None	One or two	Three or four	All	Do not know (anymore)
	n (%)	n (%)	n (%)	n (%)	n (%)
Instruction videos	33 (81)	0	N.a.	6 (15)	2 (5)
Videos on communication strategies and personal adjustment	31 (76)	3 (7)	3 (7)	3 (7)	1 (2)
Testimonials	32 (78)	6 (15)	N.a.	3 (7)	0

Abbreviation: N.a.: not applicable.

Table 6. Satisfaction with SUPR: the extent to which CPs thought the particular SUPR element was useful for themselves and their PHL.

	Element useful for CP?			Element useful for PHL?
	Disagree	Neutral	Agree	Disagree	Neutral	Agree
	n (%)	n (%)	n (%)	n (%)	n (%)	n (%)
Practical Support Booklet (n = 15*)	2 (13)	5 (33)	8 (53)	2 (13)	4 (27)	3 (60)
Instruction videos (n = 6*)	0	3 (50)	3 (50)	0	3 (50)	3 (50)
Videos on communication strategies and personal adjustment (n = 9*)	1 (11)	5 (56)	3 (33)	0	3 (33)	6 (67)
Testimonials (n = 9*)	2 (22)	6 (67)	1 (11)	0	5 (56)	4 (44)

Abbreviations: CP: communication partner; PHL: person with hearing loss.

*Only includes participants who indicated to have used the particular SUPR element.