Consumer preferences for hearing health care information and services as described by older adults surveyed in Australia, Canada, England, and the United States

BACKGROUND: Age-related hearing loss is a global public health concern and yet hearing health care (HHC) services remain underutilized. Understanding the HHC experiences of older adults is essential to addressing why existing systems are underutilized. Therefore, we surveyed older adults to determine their preferences for HHC service delivery. In this cross-sectional survey study, we report where they preferred to obtain HHC information, undergo hearing tests, and acquire hearing devices. We also examined whether these preferences varied by degree of hearing loss, help-seeking experience, survey mode (online or in person), age, or country. METHODS: Using survey questions that were co-created with consumers, responses were collected online and in person prior to the pandemic (2016-2018) in the United States (USA), Canada (CAN), Australia (AUS), and England (EN). Third-party firms recruited convenience samples from each region. Participants, aged 60 + and proficient in English, responded to three questions: "Where would you prefer to get information about HHC?" (8,151 respondents, 14 response options), "Where would you most like to get your hearing tested?" (8,035 respondents, 8 options), and "From which of the following places would you MOST like to get hearing aids (or other types of hearing devices) if you needed them?" (8,151 respondents, 11 options). Participants could select multiple options. Hearing thresholds were obtained from in-person respondents and used to impute hearing loss estimates for online respondents. RESULTS: Across all questions, respondents consistently preferred traditional medical over nonmedical locations when seeking HHC information, hearing tests, and hearing devices. Respondents consistently reported a preference for seeking HHC in-person, at provider-mediated medical settings (e.g., doctors' and audiologists' offices and hospitals) rather than through non-medical channels such as radio, internet advertisements, or retail stores. Preferences were consistent across degrees of hearing loss, survey modes, age bands, and countries. CONCLUSIONS: Our survey results indicate that older adults preferred to seek and receive HHC through traditional medical settings. These data were collected prior to the pandemic and before some of the recent OTC policy changes; nonetheless, they align with more recent findings and capture the attitudes of individuals who are likely still making HHC decisions today. These findings, therefore, provide contextual evidence about older adults' reported preferences against which future studies of hearing healthcare preferences may be compared.