Assess Choose Educate and Learn (ACEL): A Program for Improved Auditory Wellness

About This Grant

Project Summary / Abstract Recent national estimates indicate that there are 31 to 44 million US adults with perceived mild-moderate hearing loss and only about 13% currently use hearing aids. These adults with unmet hearing needs are the primary target for over-the-counter (OTC) hearing aids, a new pathway to hearing help that was created by the Food and Drug Administration (FDA) in October of 2022. For the first time in the 75-year history of wearable electroacoustic hearing aids, tens of millions of US adults with perceived mild-to-moderate hearing difficulties have been empowered to manage their own hearing health. Hearing health is more than the absence of hearing loss; to reflect this, we use the term auditory wellness which includes both the absence of unaddressed impairments in the auditory system and the absence of limitations in auditory activities and restrictions on participation in a largely auditory/oral society. Poor auditory wellness has been shown to negatively impact the performance of daily activities, psychological well-being, social well-being, and cognitive function. OTC hearing aids represent part of the solution to address poor auditory wellness. It is now clear that OTC hearing aids can be self-fit by adults with less-than-optimal auditory wellness and can provide significant benefit to the wearers. The delivery of devices, a first step in the process of improving auditory wellness for many adults, is not the only option available. For some adults with less-than-optimal auditory wellness, communication training may suffice. For others, OTC hearing aids, alone or with training, may be required. Although millions of US adults have recently been empowered to manage their own auditory wellness, they have not been fully equipped to do so. This application proposes the development and evaluation of a broad online educational program supporting the assessment and improvement of auditory wellness, the Assess Choose Educate and Learn (ACEL) program. The efficacy of the ACEL program is evaluated here using an innovative randomized patient-preference trial, which includes a 4-branch randomized clinical trial (RCT) with an active control. The central hypothesis of this proposal is that those with fair to poor auditory wellness can significantly improve their auditory wellness through use of ACEL. The specific aims of this research are: (1) to evaluate the relationship between self-assessed auditory wellness, ear-disease risk, and participants’ interest in pursuing help in a large sample; (2) to demonstrate the efficacy of the subsequent stages of the ACEL intervention to improve the auditory wellness of adults with fair to poor wellness, the target group for OTC hearing aids; and (3) to determine the long-term (6- month) stability of observed improvements in auditory wellness achieved after completion of the 4-6-week ACEL program.