Measuring empowerment with the EmpAQ-15 and EmpAQ-5: test-retest reliability and responsiveness in a clinical population

OBJECTIVE: To evaluate the test-retest reliability and responsiveness of the 15-item and 5-item forms of the Empowerment in Audiology Questionnaire (EmpAQ measures). DESIGN: In Study A, participants completed the EmpAQ-15 and the Revised Hearing Handicap Inventory-Screening version (RHHI-S) twice, 3-4 weeks apart. Reliability was assessed using intraclass correlation coefficients (ICCs) and Bland-Altman plots. In Study B, participants completed the EmpAQ-15 and RHHI-S at baseline (pre-hearing aid fitting) and three and six months post-hearing aid fitting. Responsiveness was assessed using distribution-based, anchor-based, and measurement error-based approaches. We derived EmpAQ-5 from the EmpAQ-15 dataset and analysed it similarly. STUDY SAMPLE: = 51 hearing aid-naïve adults with hearing difficulties. RESULTS: EmpAQ-15 and EmpAQ-5 demonstrated moderate test-retest reliability (ICC = 0.72 and 0.74 respectively), comparable to the RHHI-S (ICC = 0.77). Following hearing aid fitting, EmpAQ scores increased significantly at 3 months (mean change +9.29 and +10.60; SRM = 0.50 and 0.53). Approximately 21-23% exceeded MDC95 thresholds, indicating individual-level change beyond measurement error. Improvements were maintained at 6 months. CONCLUSIONS: The EmpAQ-15 and EmpAQ-5 are reliable and responsive measures that capture empowerment changes following hearing aid fitting and complement traditional evaluation tools in contemporary audiological care.