Clinical Trial of the "Living Well With Hearing Loss Workshop"
Condition: Hearing Loss; Stress
MeSH terms: Hearing Loss; Deafness
Study type: Interventional
Phase: Phase 2

Summary: 
      This study evaluates whether a 2 hour group session, "The Living Well with Hearing Loss
      Workshop," can successfully teach hard of hearing people how to best use hearing aids and a
      variety of personal skills to compensate for the limitations of their impaired ears.
    

Detailed description: 
      Hearing aids are essential to the rehabilitation of veterans who have acquired hearing loss.
      However, as with most prosthetic devices, the use of hearing aids does not result in fully
      normal functioning, and research shows that residual handicapping effects of hearing loss
      recur for many veterans. Hearing loss now affects 31 million Americans and is increasing in
      prevalence due to the "graying of America" and the noise-traumas of modern life, including
      modern warfare. VA spent over $119,000,000 on hearing aid technology for eligible veterans in
      FY 2004.Therefore, evidence-based rehabilitation treatments to alleviate avoidable hearing
      handicaps is a priority for VA and non-VA audiology. VA audiology clinics, however, are
      forced by high work loads to follow tight schedules for fitting hearing aids, with little
      time available to counsel veterans on skills for dealing effectively with the auditory and
      psychosocial challenges specific to their personal life style.

      The proposed study will present and evaluate a single session, two hour long rehabilitation
      treatment model, "The Living Well with Hearing Loss Workshop." This cost-effective group
      intervention draws from research in psychology and behavioral medicine, as well as audiology,
      to teach specific skills that empower veterans to self-manage the adverse consequences of
      their hearing loss. The workshops will use multi-media presentations to train participating
      veterans in cognitive, behavioral and affective coping skills, while the patient-centered
      process focuses on collaborative problem-solving of hearing-loss-challenges participants
      present to their groups as personally important.

      This is a dual site, randomized clinical trial, conducted by Co-PIs Dr. Turbin, a
      psychologist and Investigator at the NCRAR in the Portland, Oregon VAMC; and Dr. Abrams, a
      rehabilitative audiologist and Chief of Audiology Services at the Bay Pines, Florida VAMC. We
      will recruit a total of 310 veterans, all patients at the VAMC audiology clinics in Portland
      or Bay Pines, who are: 1) recipients of their first hearing aids, 2) have a mild to
      moderately-severe hearing loss in their better ear, and 3) present no other condition that
      would preclude their participation in age-appropriate interpersonal activities. Half of these
      veterans will be randomized to each of our two treatments: the Control condition of routine
      VA hearing-aid-rehabilitation-alone, and our Experimental Treatment condition of routine
      audiology services plus our workshop intervention. All subjects will complete three
      questionnaires as Pre-test measures before hearing aid fitting, eight weeks after hearing aid
      fitting as Re-tests and then four months later as Post-tests. An additional personality
      inventory will be administered only at baseline, yielding co-variates for interpreting
      possible within-group variance. Workshop participants will attend their session within one
      month of hearing aid fitting. The workshops will be facilitated by audiologists we will train
      in our empowering, patient-centered, coping-skills based model.

      We hypothesize that our Workshop participants will show enhanced personal adjustment and use
      of communication strategies when compared to both baseline and to Control subjects, and
      further hypothesize that our Workshop participants will exceed our Controls in self reported
      hearing aid benefit at Re-test, and retain these differential treatment benefits at
      Post-test. The outcome data will enhance our understanding about the coping processes by
      which people respond to their hearing disability and its treatment by hearing-aids-alone, and
      about how well Workshop participants learn and utilize the skills taught in our treatment
      model. The findings from this research can foster continued development and implementation of
      evidence-based rehabilitation treatments and, if shown to be effective, our model can be
      replicated at audiology clinics, adapted for video or online training, or used by other
      health care professionals or even lay mentors to enhance the quality of life of people who
      are hard of hearing.
    

Intervention name(s): The Living Well with Hearing Loss Workshop; hearing aid services
Intervention type(s): Behavioral; Device
Intervention description(s): Interactive group session modeled on Patient-Centered medicine and Adult Learning principles; the participants are partners with the Group Facilitator who is a hearing rehabilitation professional; Standard VA audiological hearing aid dispensing services
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Audiology; Coping behaviors; Counseling; Hearing aids; Hearing impairment; Patient-centered care; Psychological adaptation; Psychological adjustment; Rehabilitation; Social adjustment; Aural Rehabilitation