Applying the COM-B model to assess the usability of smartphone-connected listening devices in adults with hearing loss

Background: Unlike conventional hearing aids, smartphone-connected listening devices may require limited or no input from a trained audiologist in terms of device programming and adjustment. However, there is a lack of peer-reviewed evidence assessing the real-world perspectives of people living with hearing loss toward such technological innovations. Purpose: This study assessed the everyday experiences of adults living with hearing loss toward a range of smartphone-connected listening devices using the COM-B model as a theoretical framework. Research Design: A qualitative study whereby participants trialled one of the following smartphone-connected listening devices for two-weeks in their everyday lives: made-for-smartphone hearing aids, personal sound amplification product, smartphone ‘hearing aid’ app with wired earphones or wireless hearable. Individual semi-structured interviews were conducted. Study Sample: Twenty adults (13 male, 7 female; mean age = 62.25 years, SD = 11.59) with mild-moderate hearing loss (mean better ear pure-tone average = 30.49 dB HL, SD = 17.51) were recruited using a convenience sampling strategy. All participants owned conventional hearing aids. Results: The data were analysed using an established deductive thematic analysis procedure within the context of the COM-B model. The model stipulates that for individuals to engage in a particular behaviour (B), they must have sufficient capability (C), opportunity (O), and motivation (M). Capability: One of the key advantages facilitating use and adherence of smartphone-connected listening devices was the ability for participants to make fine-tune adjustments in any listening situation. Opportunity: Participants commented that these devices could address issues surrounding stigma, as smartphones are ubiquitous in everyday life. Motivation: Participants consistently reported that the ability to make adjustments via a smartphone provided them with a greater sense of autonomy and empowerment. As a result, they felt more in control of their hearing loss. Conclusions: This study lays the foundation for further high-quality research to explore whether smartphone-connected technologies have the potential to yield optimum benefits for people living with hearing loss.