Characteristics and help-seeking behaviour of persons failing a national hearing screening test

Abstract

A digits-in-noise test was launched as the smartphone hearing screening of South Africa (hearZA™) in 2016. This study investigated characteristics, help-seeking behaviour, and follow-up actions of individuals who failed the hearing screening, considering their stage of behavioural change. The study had two phases; phase one was a retrospective, cross-sectional intervention readiness (stage of change) analysis of 3092 listeners who failed the test. Phase two was a prospective survey of 59 participants to investigate follow-up actions after a failed test. In the retrospective study, the majority of listeners were in the precontemplation stage (75.5%), while the remaining were in contemplation (9.7%), preparation (8.2%), and action (6.6%) stages. Age and stage of change were significant predictors of the digits-in-noise speech recognition threshold (DIN SRT) (p < .05). SRTs deteriorated significantly (p < .05) with increasing age, and listeners in the precontemplation stage were significantly younger than in other stages (p < .05). In the prospective study, 1007 potential participants were contacted through electronic mail or short message services to complete the survey; however, only 59 did so. Of those, most (82.4%) did not think they have a hearing loss. Only, 13.6% followed up with an audiologist. Older individuals presented with poorer DIN SRTs and were in a more advanced stage of change. The majority that did not follow up after failing the screening test did not believe they had a hearing problem. A combination of factors, including poor DIN SRT, older age, and more advanced stage of change predisposed participants to follow up with audiological care.