Health Behaviour Theory and Hearing Aid Use (V1.0)
Research type
Research Study
Full title
Assessing the construct and predictive validity of COM-B for the use of hearing amplification by adults with hearing loss
IRAS ID
286583
Contact name
Helen Henshaw
Contact email
Sponsor organisation
University of Nottingham
Clinicaltrials.gov Identifier
NA, NA
Duration of Study in the UK
0 years, 6 months, 0 days
Research summary
Research Summary:
Health psychology is increasingly applied to audiology and hearing healthcare. Nevertheless, we don't yet have evidence as to how useful specific behaviour theories are for predicting hearing health behaviours (such as hearing aid use). The COM-B system is a psychological model of behaviour change that identifies three components that interact and need to be present for any behaviour change to occur: Capability, Opportunity and Motivation. Capability refers to an persons psychological and physical ability to engage in a behaviour, for example having the necessary skills or knowledge. Motivation refers to the processes that direct behaviour such as making decisions or setting goals. Opportunity refers to factors outside of the person that make the behaviour possible, for example, having access to resources.
This study will explore whether the three component domains of the COM-B system can be represented as latent variables using scores from hearing- and health-specific questionnaire measures specifically chosen to align with the three COM-B components, in a sample of 200 owners of hearing amplification devices (e.g. hearing aids or alternatives). A statistical analysis method (Structural Equation Modelling) will be used to assess whether these latent variables can reliably predict hearing device use, measured 7 days later. Finally, participants will be invited to repeat of all study outcomes at a 3-month follow-up assessment, which will allow us examine the variability in responses to the questionnaires over time. This will enable us to be able to select reliable questionnaires for our future research.
The results of this study will inform the validity of COM-B as a useful theoretical framework to examine the use of hearing amplification use by adults with hearing loss, both immediately and over time. It will also enable us to determine whether this model is appropriate to underpin the future development of targeted behaviour change interventions for this population.
Summary of Research:
Health behaviour theories are increasingly used in hearing health research to inform new interventions and to guide care. It is not clear, however, how useful these theories are in predicting hearing health behaviours, such as hearing aid use, benefit, and satisfaction. The COM-B model is an overarching theory of health behaviour with three interacting parts: Capability, Opportunity, and Motivation. According to the theory, all three parts need to be present for a behaviour to occur.
We invited adults with hearing aid(s) to complete self-report questionnaires of hearing and lifestyle behaviours via an online survey. Each questionnaire was selected to theoretically measure one or more aspects of Capability, Opportunity, or Motivation. Behaviour measures that completed seven days later were: self-reported hearing aid use, benefit, and satisfaction.
Participants, recruited from UK audiology clinics and via social media, were 226 hearing aid users aged 21-92 years (median = 68 years), of which 189 provided full data and were included within the analyses. A total of 102 of the initial 226 participants recruited also completed the same measures 12 weeks later.Principal component analyses did not confirm the a priori COM-B categorisation of questionnaires. Exploratory factor analyses were used to examine data-driven grouping of responses and to generate latent variables reflecting different profiles. Finally, the predictive validity of latent variables for hearing aid use, benefit, and satisfaction was investigated using partial-least squares (variance based) structural equation modelling. Results will inform how aided outcomes are influenced by social, psychological, and physical factors and provide insights into the relationships between constructs measured by a variety of self-report questionnaires. Future analyses will examine test-retest reliability of questionnaires between baseline 12 weeks, for those participants who completed questionnaires at follow-up.
REC name
North East - Tyne & Wear South Research Ethics Committee
REC reference
20/NE/0254
Date of REC Opinion
3 Dec 2020
REC opinion
Further Information Favourable Opinion