Usability and performance of the Apple over-the-counter hearing aid feature

Abstract

PURPOSE : This study provides the first independent evaluation of the Apple Over-the-Counter Hearing Aid Feature (OTC-HAF), examining its usability and laboratory performance among adults with self-perceived mild-to-moderate hearing loss. METHOD : A cross-sectional evaluation was conducted at a university audiology clinic. Digitally literate iPhone users (n = 25, ages 20-72 years) independently used AirPods Pro 2 to complete the Apple Hearing Test Feature and activate the OTC-HAF. The sample size aligns with usability model recommendations for moderately complex systems. Outcomes were assessed immediately after setup. RESULTS : Usability was high, with a mean mHealth App Usability Questionnaire score of 6.7/7 (SD = 0.3) and a mean Hearing Aid Skills and Knowledge Inventory-Clinical score of 93.4% (SD = 9.0%). Study-specific questionnaire responses showed high satisfaction, good sound quality, and ease of use. Qualitative feedback highlighted affordability, convenience, and dual-purpose design, with some noting occlusion and difficulty locating settings. Some participants reported they would only use the device situationally. The audiogram import feature showed limited accuracy: 71% of thresholds were within 5 dB of the reference when both ears were scanned together and 73% when each ear was scanned separately, with 12% and 8% of thresholds missing for these methods, respectively. Objective performance measures showed nonsignificant speech-in-noise benefit (Quick Speech-in-Noise Test mean benefit of 0.1 dB SNR, SD = 1.9), and real-ear measurements showed gain levels generally below National Acoustic Laboratories-Non-Linear 2 targets. CONCLUSIONS : The Apple OTC-HAF showed high usability and satisfaction among digitally literate iPhone users, but nonsignificant speech-in-noise benefit and gain levels generally lower than prescriptive targets. Further research should explore broader applicability, long-term outcomes, and strategies to support uptake and consistent use.