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A Randomized Controlled Trial to Evaluate the Benefits of a Multimedia Educational Program for First-Time Hearing Aid Users

Ferguson, Melanie; Brandreth, Marian; Brassington, William; Leighton, Paul; Wharrad, Heather

doi: 10.1097/AUD.0000000000000237
Research Articles

Objectives: The aims of this study were to (1) develop a series of short interactive videos (or reusable learning objects [RLOs]) covering a broad range of practical and psychosocial issues relevant to the auditory rehabilitation for first-time hearing aid users; (2) establish the accessibility, take-up, acceptability and adherence of the RLOs; and (3) assess the benefits and cost-effectiveness of the RLOs.

Design: The study was a single-center, prospective, randomized controlled trial with two arms. The intervention group (RLO+, n = 103) received the RLOs plus standard clinical service including hearing aid(s) and counseling, and the waitlist control group (RLO−, n = 100) received standard clinical service only. The effectiveness of the RLOs was assessed 6-weeks posthearing aid fitting. Seven RLOs (total duration 1 hr) were developed using a participatory, community of practice approach involving hearing aid users and audiologists. RLOs included video clips, illustrations, animations, photos, sounds and testimonials, and all were subtitled. RLOs were delivered through DVD for TV (50.6%) and PC (15.2%), or via the internet (32.9%).

Results: RLO take-up was 78%. Adherence overall was at least 67%, and 97% in those who attended the 6-week follow-up. Half the participants watched the RLOs two or more times, suggesting self-management of their hearing loss, hearing aids, and communication. The RLOs were rated as highly useful and the majority of participants agreed the RLOs were enjoyable, improved their confidence and were preferable to written information. Postfitting, there was no significant between-group difference in the primary outcome measure, overall hearing aid use. However, there was significantly greater hearing aid use in the RLO+ group for suboptimal users. Furthermore, the RLO+ group had significantly better knowledge of practical and psychosocial issues, and significantly better practical hearing aid skills than the RLO− group.

Conclusions: The RLOs were shown to be beneficial to first-time hearing aid users across a range of quantitative and qualitative measures. This study provides evidence to suggest that the RLOs may provide valuable learning and educational support for first-time hearing aid users and could be used to supplement clinical rehabilitation practice.

A series of seven multimedia interactive videos (or reusable learning objects [RLOs]) covering a range of practical and psychosocial information were developed for first-time hearing aid users. A prospective randomized controlled trial of 203 patients showed that the intervention group that received the RLOs had better knowledge of hearing-related issues, better practical hearing aid skills, and greater hearing aid use in suboptimal hearing aid users, compared with the control group at 6 weeks post-fitting. RLOs were rated as highly useful, and user feedback on the RLOs was very positive. Take-up was high and adherence was at least 67%. RLOs provide valuable educational support.Supplemental Digital Content is available in the text.

1NIHR Nottingham Hearing Biomedical Research Unit, Otology and Hearing Group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom; 2Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; 3School of Medicine, and 4School of Health Sciences, University of Nottingham, Nottingham, United Kingdom.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and text of this article on the journal’s Web site (

Clinical Trials Registration (registered retrospectively): ISRCTN11486888 Biomed Central

The Nottingham University Hospitals NHS Trust and University of Nottingham will receive a small proportion of any royalties from the sale of the RLOs in DVD format. This paper presents independent research funded by the National Institute for Health Research (NIHR) under its Research for Patient Benefit (RfPB) Program (Grant Reference Number PB-PG-0909-20294). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. The authors have no other conflicts of interest to disclose.

Received October 22, 2014; accepted August 27, 2015.

Address for correspondence: Melanie Ferguson, NIHR Nottingham Hearing Biomedical Research Unit, 113 The Ropewalk, Nottingham NG1 5DU, United Kingdom. E-mail:

This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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