Hearing health care utilization following automated hearing screening

Robert L. Folmer, Gabrielle H. Saunders, Jay J. Vachhani, Robert H. Margolis, George Saly, Bevan Yueh, Rachel A. McArdle, Lawrence L. Feth, Christina M. Roup, M. Patrick Feeney

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Background The study examined follow-up rates for pursuing hearing health care (HHC) 6 to 8 months after participants self-administered one of three hearing screening methods: an automated method for testing of auditory sensitivity (AMTAS), a four-frequency pure-tone screener (FFS), or a digits-in-noise test (DIN), with and without the presentation of a 2-minute educational video about hearing. Purpose The study aims to determine if the type of self-administered hearing screening method (with or without an educational video) affects HHC follow-up rates. Research Design The study is a randomized controlled trial of three automated hearing screening methods, plus control group, with and without an educational video. The control group completed questionnaires and provided follow-up data but did not undergo a hearing screening test. Study Sample The study sample includes 1,665 participants (mean age 50.8 years; 935 males) at two VA Medical Centers and at university and community centers in Portland, OR; Bay Pines, FL; Minneapolis, MN; Mauston, WI; and Columbus, OH. Data Collection and Analysis HHC follow-up data at 6 to 8 months were obtained by contacting participants by phone or mail. Screening methods and participant characteristics were compared in relation to the probability of participants pursuing HHC during the follow-up period. Results The 2-minute educational video did not have a significant effect on HHC follow-up rates. When all participants who provided follow-up data are considered (n ¼ 1012), the FFS was the only test that resulted in a significantly greater percentage of HHC follow-up (24.6%) compared with the control group (16.8%); p ¼ 0.03. However, for participants who failed a hearing screening (n ¼ 467), follow-up results for all screening methods were significantly greater than for controls. The FFS resulted in a greater probability for HHC follow-up overall than the other two screening methods. Moreover, veterans had higher follow-up rates for all screening methods than non-veterans. Conclusion The FFS resulted in a greater HHC follow-up rate compared with the other screening methods. This self-administered test may be more motivational for HHC follow-up because participants who fail the screening are aware of sounds they could not hear which does not occur with adaptive assessments like AMTAS or the DIN test. It is likely that access to and reduced personal cost of audiological services for veterans contributed to higher HHC follow-up rates in this group compared with non-veteran participants.

Original languageEnglish (US)
Pages (from-to)235-245
Number of pages11
JournalJournal of the American Academy of Audiology
Issue number4
StatePublished - Apr 1 2021

Bibliographical note

Funding Information:
This research was supported by grant R33 DC011769 from NIH/NIDCD. Additional support was provided by VA RR&D Center Award C9230C. R.H.M. and G.S. have a commercial interest in the automated method for testing of auditory sensitivity (AMTAS). Preliminary results of this study were presented in March 2019 at the Annual Scientific and Technology Conference of the American Auditory Society in Scottsdale, Arizona.

Publisher Copyright:
© 2021. American Academy of Audiology. All rights reserved.


  • Automated hearing screening
  • Hearing health care
  • Hearing loss


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