Association Between Unaided Speech Perception in Noise and Hearing Aid Use Mediated by Perceived Benefit

<b>Background/Objectives</b>: The conventional strategy for addressing age-related hearing loss is hearing aid (HA) use, yet many individuals underutilize their devices. Despite the positive effects of HA use, adherence remains low, highlighting the importance of studying associated vari...

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Main Authors: Anthony Marcotti, Catherine Silva-Letelier, Javier Galaz-Mella, Alejandro Ianiszewski, Nicole B. Vargas, Eduardo Fuentes-López
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Audiology Research
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Online Access:https://www.mdpi.com/2039-4349/15/3/50
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author Anthony Marcotti
Catherine Silva-Letelier
Javier Galaz-Mella
Alejandro Ianiszewski
Nicole B. Vargas
Eduardo Fuentes-López
author_facet Anthony Marcotti
Catherine Silva-Letelier
Javier Galaz-Mella
Alejandro Ianiszewski
Nicole B. Vargas
Eduardo Fuentes-López
author_sort Anthony Marcotti
collection DOAJ
description <b>Background/Objectives</b>: The conventional strategy for addressing age-related hearing loss is hearing aid (HA) use, yet many individuals underutilize their devices. Despite the positive effects of HA use, adherence remains low, highlighting the importance of studying associated variables. We hypothesize that better unaided speech perception in noise (SPiN) would be associated with greater perceived benefit from HAs, which, in turn, would be linked to increased HA use. <b>Methods</b>: A cross-sectional study design was used, including 114 older adults (≥65 years) who were HA users. HA use and perceived benefit were assessed using questions 1 and 2 of the International Outcome Inventory for Hearing Aids (IOI-HAs), while unaided SPiN performance was measured monaurally with a speech-in-noise test. In the mediation analysis, SPiN performance was the predictor, perceived benefit the mediator, and HA use the outcome. Direct and indirect effects were evaluated using generalized structural equation modeling. <b>Results</b>: No significant total effect was found for the right ear. For the left ear, there was a significant indirect effect of SPiN performance on HA use through perceived benefit (OR = 1.26, 95% CI 1.06–1.57, <i>p</i> = 0.019) but no direct effect (<i>p</i> = 0.563). In addition, a significant total effect of left ear SPiN performance on HA use was observed (<i>p</i> = 0.041). <b>Conclusions</b>: The findings suggest that unaided SPiN performance—particularly in the left ear—may be indirectly associated with HA use through its effect on perceived benefit. These results underscore the potential value of including SPiN assessments in the HA fitting process and counseling strategies for older adults.
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spelling doaj-art-b6cbdb8754d4426a937fe34c9538c97d2025-08-20T03:26:53ZengMDPI AGAudiology Research2039-43492025-05-011535010.3390/audiolres15030050Association Between Unaided Speech Perception in Noise and Hearing Aid Use Mediated by Perceived BenefitAnthony Marcotti0Catherine Silva-Letelier1Javier Galaz-Mella2Alejandro Ianiszewski3Nicole B. Vargas4Eduardo Fuentes-López5Escuela de Fonoaudiología, Facultad de Ciencias de la Rehabilitación y Calidad de Vida, Universidad San Sebastián, Santiago 7510157, ChileMagister en Epidemiología, Escuela de Salud Pública, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago 8330023, ChileFaculty of Rehabilitation Sciences, School of Speech Therapy, Exercise and Rehabilitation Sciences Institute, Universidad Andres Bello, Santiago 7591538, ChileEscuela de Fonoaudiología, Facultad de Ciencias de la Rehabilitación y Calidad de Vida, Universidad San Sebastián, Santiago 7510157, ChileFacultad de Salud y Ciencias Sociales, Universidad de Las Américas, Viña del Mar 2531098, ChileDepartamento de Fonoaudiología, Escuela de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago 7820436, Chile<b>Background/Objectives</b>: The conventional strategy for addressing age-related hearing loss is hearing aid (HA) use, yet many individuals underutilize their devices. Despite the positive effects of HA use, adherence remains low, highlighting the importance of studying associated variables. We hypothesize that better unaided speech perception in noise (SPiN) would be associated with greater perceived benefit from HAs, which, in turn, would be linked to increased HA use. <b>Methods</b>: A cross-sectional study design was used, including 114 older adults (≥65 years) who were HA users. HA use and perceived benefit were assessed using questions 1 and 2 of the International Outcome Inventory for Hearing Aids (IOI-HAs), while unaided SPiN performance was measured monaurally with a speech-in-noise test. In the mediation analysis, SPiN performance was the predictor, perceived benefit the mediator, and HA use the outcome. Direct and indirect effects were evaluated using generalized structural equation modeling. <b>Results</b>: No significant total effect was found for the right ear. For the left ear, there was a significant indirect effect of SPiN performance on HA use through perceived benefit (OR = 1.26, 95% CI 1.06–1.57, <i>p</i> = 0.019) but no direct effect (<i>p</i> = 0.563). In addition, a significant total effect of left ear SPiN performance on HA use was observed (<i>p</i> = 0.041). <b>Conclusions</b>: The findings suggest that unaided SPiN performance—particularly in the left ear—may be indirectly associated with HA use through its effect on perceived benefit. These results underscore the potential value of including SPiN assessments in the HA fitting process and counseling strategies for older adults.https://www.mdpi.com/2039-4349/15/3/50hearing aidsspeech perception in noiseperceived benefitolder adultsauditory rehabilitationmediation analysis
spellingShingle Anthony Marcotti
Catherine Silva-Letelier
Javier Galaz-Mella
Alejandro Ianiszewski
Nicole B. Vargas
Eduardo Fuentes-López
Association Between Unaided Speech Perception in Noise and Hearing Aid Use Mediated by Perceived Benefit
Audiology Research
hearing aids
speech perception in noise
perceived benefit
older adults
auditory rehabilitation
mediation analysis
title Association Between Unaided Speech Perception in Noise and Hearing Aid Use Mediated by Perceived Benefit
title_full Association Between Unaided Speech Perception in Noise and Hearing Aid Use Mediated by Perceived Benefit
title_fullStr Association Between Unaided Speech Perception in Noise and Hearing Aid Use Mediated by Perceived Benefit
title_full_unstemmed Association Between Unaided Speech Perception in Noise and Hearing Aid Use Mediated by Perceived Benefit
title_short Association Between Unaided Speech Perception in Noise and Hearing Aid Use Mediated by Perceived Benefit
title_sort association between unaided speech perception in noise and hearing aid use mediated by perceived benefit
topic hearing aids
speech perception in noise
perceived benefit
older adults
auditory rehabilitation
mediation analysis
url https://www.mdpi.com/2039-4349/15/3/50
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