Exploring real-world listening motivation in hearing aid users: associations between heart rate, ambient acoustics, and self-reported importance to hear well

According to the Framework for Understanding Effortful Listening (FUEL), motivation is a key component of successful listening. So far, little is known about physiological and context-dependent correlates of listening motivation in real-world settings. Physiological measures such as heart rate can index arousal, while ecological momentary assessments (EMAs) can provide context-related information about real-world listening. This study explored associations between heart rate and listening motivation in different real-world listening situations. During a 2-week field trial, participants used a smartphone-based EMA-app to report their listening intents in the situations they encountered using a dropdown menu. As a proxy for listening motivation, they also rated the importance to hear well on a continuous visual analogue scale. Simultaneously, they wore hearing aids (HAs) and wristbands that collected ambient acoustic and heart rate data. 25 experienced HA users aged 53-83 years with symmetrical mild-to-moderate sensorineural hearing losses. Linear mixed-effects models showed that higher heart rate was associated with a higher importance to hear well during conversations with one person in relatively quiet environments, and during group conversations in relatively loud environments. These results suggest that heart rate can index real-world listening motivation during speech-related listening in different acoustic environments.