Does research indicate group support programs have greater success rates than one-on-one counseling regarding new hearing aid fittings?
In recent years, there have been two studies that have addressed this question. The first was a study published in the British Journal of Audiology (Brickley, Cleaver, & Bailey, 1996) in which group follow-up programs were compared to individual follow-up programs for 98 new hearing aid users. The investigators concluded that participants in the group programs were generally more positive about their hearing aids, required fewer follow-up appointments, and reported more benefit in various listening situations. The self-rated hearing aid performance of the group attendees was significantly better than for individual attendees, although the two groups did not differ in hours of hearing aid use and satisfaction. Attendance rates were significantly poorer, however, for group attendees. The investigators concluded that the group follow-up program made efficient use of staff time, cost less to run than the individual program, and would be even more cost effective if attendance rates could be improved.
The second study was reported in The Hearing Journal (Taylor & Jurma, 1999). The benefits of group support programs compared to individual post-fitting counseling included significantly lower handicap perception scores and increased perception of audiologist effectiveness. The authors reported that elderly patients who attended the group sessions benefited in a number of ways from affiliating with others who were living with hearing loss. Their conclusions parallel those of health education researchers such as Lorig and her co-authors (Lorig, 2000; Lorig, Gonzalez, Laurent, Morgan, & Laris, 1998) who have analyzed the benefits of group support programs for patients with arthritis. These investigators found that among the strongest perceived benefits from group support and education programs for individuals with arthritis were the sharing of coping strategies and support among patients, as well as an increase in the self-efficacy of the patients.
Most of us who offer AR support groups for new hearing aid users will probably relate to the concern expressed by Brickley et al. (1996) regarding less than perfect attendance rates by group participants. Dahl and her coauthors (1998) interviewed 102 hearing aid users and found that age was a major factor affecting patient interest in post-fitting education and counseling. Their subjects who were less than 70 years of age showed significantly more interest in obtaining follow-up education and counseling than subjects above 70 years of age. This finding is of concern given that the older adult population makes up a substantial portion of the dispensing audiologist's caseload. Dr. Alice Holmes and I are currently overseeing an investigation at the University of Florida of the variables that affect a new hearing aid user's decision whether or not to attend a post-fitting AR support group. We are hopeful that our data will offer insights into this decision so that AR support programs can be made more appealing to new hearing aid users.
Rather than wait for additional efficacy data regarding group support programs for new hearing aid users, dispensing audiologists would be wise to heed the studies that have clearly demonstrated the benefits of post-fitting counseling for both group and individual programs. Although there is limited research at this time regarding whether group programs are superior to individual counseling, AR support groups are an efficient way to provide information to new HA users and their significant others, and not only that, they are fun and richly rewarding to the practitioner!
Brickley, G.J., Cleaver, V.C.G., & Bailey, S. (1996). An evaluation of a group follow-up scheme for new NHS hearing aid users. British Journal of Audiology, 30:307-312.
Dahl, B., Vesterager, V., Sibelle, P., & Boisen, G. (1998). Self-reported need of information, counselling and educational: Needs and interests of re-applicants. Scandinavian Audiology, 27:143-51.
Lorig, K. (2000). The promise and pitfalls of outcomes measurement: Meeting the challenges of service delivery in the new millenium. Symposium presented at the 46th Annual Meeting of the American Society on Aging, March 26, 2000, San Diego, CA.
Lorig, K., Gonzalez, V.M., Laurent, D.D., Morgan, L., & Laris, B.A. (1998). Arthritis self-management program variations: Three studies. Arthritis Care and Research, 11(6):448-54.
Taylor, K.S., & Jurma, W.E. (1999). Study suggests that group rehabilitation increases benefit of hearing aid fittings. The Hearing Journal, 52(9):48-54.
Patricia B. Kricos, Ph.D., is Director of Audiology and Professor at the University of Florida. She has provided group support programs for new hearing aid users and their families and friends for 25 years. Dr. Kricos has authored a number of articles on audiologic rehabilitation for adults, and was co-editor of a book on hearing care for older adults entitled Hearing Care for the Older Adult: Audiologic Rehabilitation (Butterworth-Heinemann, 1995).