Abstract
Exploring Differences in Self-Reported and Objective Hearing Loss Using a Digital Hearing Tool
Jessie West, PhD, MPH
Hearing loss affects nearly 40 million adults in the U.S. and is associated with adverse outcomes including social isolation, depression, and cognitive decline. Despite its prevalence, hearing loss remains underdiagnosed and undertreated, particularly in cases of mild hearing loss. The 2017 Over-the-Counter (OTC) Hearing Aid Act was designed to improve access to hearing healthcare by allowing adults to purchase hearing aids without a prescription. However, this policy relies on individuals recognizing their own hearing difficulties and seeking treatment—an assumption that may not hold due to discrepancies between self-reported and objectively measured hearing loss and the influence of hearing loss-related stigma. This pilot study aims to: (1) evaluate the relationship between self-reported and objective hearing loss, and (2) examine how hearing loss stigma contributes to discrepancies between subjective and objective hearing loss assessments. The study will use the World Health Organization’s hearWHO app to collect objective hearing loss data and randomly assign participants to 1 of 3 validated subjective hearing loss measures: the Revised Hearing Handicap Inventory–Screening (RHHI-S), the Speech, Spatial, and Qualities of Hearing Scale (SSQ-12), or a single-item self-assessment. Hearing loss stigma will be measured using tools developed by the Lancet Commission on Hearing Loss. Participants will be adults aged ≥18 years recruited from the Duke University Health System and via social media platforms. Data will be collected remotely using REDCap and analyzed to assess the associations and discrepancies between objective and subjective hearing loss measures. This project aligns with the Duke Center for Population Health and Aging (CPHA) Development Core’s mission to support innovative, interdisciplinary aging research and the development of early-career investigators. By integrating mobile health technology and novel stigma measures, this study will generate preliminary data to inform future interventions aimed at improving hearing loss awareness, reducing stigma, and enhancing adoption of OTC hearing aids among different populations.