Health behavior theories as predictors of hearing-aid uptake and outcomes

Figures & data

Table 1. Baseline participant audiometric and demographic data.

Variable	Mean (SD), Range
4F-PTA (dB HL) Left ear	35.5 (14.0), 5–72.5
Right ear	36.3 (13.7), 7.5–76.3
Baseline HHI Total score	35.3 (24.3), 0–100
Baseline PIHL Total score	−0.44 (0.77), −3.0–2.92
	n (%)
Work status n (%)
Full-time	13 (7.1)
Part-time	32 (17.6)
Volunteer	39 (21.4)
None	98 (53.8)
Prompted hearing test
Self	115 (63.2)
Family/friends	37 (20.3)
Doctor	17 (9.3)
Other	13 (7.1)
Duration of hearing difficulty
No difficulties	15 (8.2)
<1 year	10 (5.5)
1–5 years	49 (26.9)
>5 years	108 (59.3)

Figure 1. Adapted University of Rhode Island change assessment scores with ±1 standard error bars by group. Dark bars are the scores of participants who did not take up hearing aids, light bars are scores of participants who took up hearing aids.

Table 2. Percentage and number of participants who did and did not take up hearing aids (HAs) as a function of their baseline URICA stage of change, along with the result of a Pearson chi-square analysis.

Stage at baseline	Participants % (n)	Took up HAs % (n)	Did not take up HAs % (n)	Pearson χ^2
URICA precontemplation	4.2 (7)	14.3 (1)	85.7 (6)	23.0 p < 0.001
URICA contemplation	16.2 (27)	51.9 (14)	48.1 (13)
URICA action	79.6 (133)	79.7 (106)	20.3 (27)

Figure 2. HBQ scores with ±1 standard error bars by group. Dark bars are the scores of participants who did not take up hearing aids, light bars are scores of participants who took up hearing aids.

Figure 3. Histogram of the predicted probability of hearing-aid uptake (lower panel) and no hearing-aid uptake (upper panel) using age, four frequency better-ear average, reported duration of hearing difficulty and baseline scores on the hearing handicap inventory, University of Rhode Island change assessment, and hearing beliefs questionnaire as predictors.

Table 3. Results of binary logistic regression modeling hearing-aid uptake from age, duration of hearing difficulty, 4F-BEA, HHI, URICA (precontemplation, contemplation, and action scales) and HBQ (susceptibility, severity, benefits, barriers, self-efficacy, and cues to action scales) scores. The significant predictors (p < 0.05) are in bold font.

Predictor	β	Wald χ^2	p values	Odds ratio
Age	0.066	0.741	0.389	1.068
Duration hearing difficulty	0.077	0.038	0.845	1.080
4F-BEA	0.166	6.631	0.010	1.181
HHI total score	0.040	2.162	0.141	1.041
URICA precontemplation	0.249	2.277	0.131	1.283
URICA contemplation	−0.001	0.000	0.993	0.999
URICA action	0.787	12.433	<0.001	2.198
HBQ susceptibility	−0.078	0.083	0.773	0.930
HBQ severity	0.232	1.206	0.272	1.262
HBQ benefits	−0.534	2.593	0.107	0.586
HBQ barriers	0.242	0.735	0.391	1.274
HBQ self-efficacy	−0.534	3.188	0.074	0.586
HBQ cues to action	0.261	0.910	0.340	1.298
Constant	−35.863	10.336	0.001	0.000

Table 4. Pearson correlations between attitudes and beliefs (URICA and HBQ scores) at baseline and follow up, and hearing-aid outcomes (IOI-HA and PIADS). To adjust for multiple analyses only correlations with an associated p < 0.001 were considered to be statistically significant. Statistically significant correlations are indicated in bold font.

Variable	Baseline correlation with IOI-HA (r-value)	Follow-up correlation with IOI-HA (r-value)	Baseline correlation with PIADS (r-value)	Follow-up correlation with PIADS (r-value)
URICA precontemplation	−0.252	−0.443	−0.297	−0.396
URICA contemplation	0.166	0.320	0.375	0.393
URICA action	0.240	0.465	0.375	0.363
HBQ susceptibility	−0.035	−0.117	0.127	0.073
HBQ severity	0.015	−0.130	0.319	0.242
HBQ benefits	0.143	0.151	0.344	0.371
HBQ barriers	−0.138	−0.329	−0.140	−0.140
HBQ self-efficacy	0.175	0.363	0.008	0.048
HBQ cues to action	0.125	0.268	0.212	0.260

Table 5. Multiple linear regression analyses modeling hearing-aid outcomes as assessed with the IOI-HA and PIADS.

Predictor variable	β-value	Adjusted r^2	% variance explained	p values
Outcome variable: IOI-HA total score modeled from baseline scores
Baseline URICA precontemplation	−0.252	0.055	6.3	0.006
Total variance explained			6.3
Outcome variable: IOI-HA total score modeled from follow-up scores
Follow-up URICA action	0.270	0.210	21.7	0.011
Follow-up HBQ self-efficacy	0.248	0.278	7.3	0.002
Follow-up HBQ susceptibility	−0.185	0.296	2.4	0.019
Follow-up URICA precontemplation	−0.240	0.321	3.0	0.024
Total variance explained			34.4
Outcome variable: PIADS total score modeled from baseline scores
Baseline URICA action	0.245	0.133	14.1	<0.001
4F-BEA	0.273	0.207	8.0	0.001
Baseline HHI total	0.198	0.233	3.2	0.017
Total variance explained			25.3
Outcome variable: PIADS total score modeled from follow-up scores
Follow-up URICA precontemplation	−0.253	0.151	15.8	0.003
4F-BEA	0.259	0.231	8.6	0.001
Follow-up HHI total	0.214	0.291	6.5	0.012
Follow-up HBQ benefits	0.200	0.320	3.4	0.018
Total variance explained			34.3

Table 6. HBQ scores at baseline and at six-month follow-up separated by whether or not an individual took up hearing aids. Baseline and follow-up scores that differ significantly are shown in bolded font.

	Did not take up hearing aids n = 47		Took up hearing aids n = 120
		Mean (SD)	F-value p values	Mean (SD)	F-value p values
HBQ susceptibility
Baseline	7.1 (1.3)	1.10	7.5 (1.6)	0.01
6-month follow-up	7.3 (1.5)	0.300	7.5 (1.4)	0.988
HBQ severity
Baseline	6.1 (2.2)	0.01	7.2 (2.0)	7.18
6-month follow-up	6.1 (2.1)	0.981	6.7 (2.3)	0.008
HBQ benefits
Baseline	7.0 (1.8)	0.02	7.7 (1.6)	−1.15
6-month follow-up	7.0 (1.6)	0.889	7.6 (1.6)	0.285
HBQ barriers
Baseline	3.1 (1.6)	4.64	3.4 (1.8)	30.27
6-month follow-up	3.5 (1.6)	0.037	2.5 (1.6)	<0.001
HBQ self-efficacy
Baseline	5.8 (1.4)	0.01	5.3 (2.1)	20.0
6-month follow-up	5.8 (1.6)	0.971	6.3 (2.1)	<0.001
HBQ cues to action
Baseline	8.1 (1.3)	0.11	8.7 (1.3)	8.84
6-month follow-up	8.2 (1.6)	0.742	9.0 (1.0)	0.004