Application of Health Behavior Models to Predict Hearing Healthcare Outcomes

描述（由申请人提供）：80%的听力受损成年人在发现听力损失后的最初5-10年内未能治疗听力损失，尽管不这样做会带来许多负面后果。这并不是听力学所独有的-许多其他慢性健康状况也存在类似的数据。此外，影响听力保健（HHC）行为的因素与影响其他慢性病健康行为的因素相似。因此，在健康行为理论的框架内研究HHC行为是恰当的。在这项调查中，三个既定的健康行为理论将被用来确定的关键态度和信念的基础HHC行为，以便在未来的理论为基础的行为改变干预措施可以开发。这种方法很有前途，因为虽然影响HHC行为的一些变量无法改变（例如听力损失的严重程度，年龄，收入水平），但可以通过教育和咨询来改变态度和信念。因此，本研究将为开发基于理论的教育和咨询行为改变干预措施提供基础，以增加轻度至中度听力损失成年人的HHC行为。本研究将（1）确定哪些HHC态度和信念最能解释听力损失成年人寻求帮助和接受干预的HHC行为。(2)确定寻求帮助的态度和信念是否与接受干预的态度和信念不同。(3)确定短期健康行为评估是否能有效预测HHC行为，短期健康行为评估是否能在临床上实用，长期健康行为评估是否能为制定教育和咨询行为改变计划提供必要的细节。将进行一项混合方法的纵向研究，其中HHC的态度和信念将使用长式和短式健康行为评估进行评估，这些评估衡量了跨理论模型、健康信念模型和计划行为理论的结构。参与者将是587名未通过社区听力筛查的人。他们将每6个月联系一次，以确定他们是否寻求过帮助，如果是，他们是否遵循了听力学家关于康复的建议。将在研究开始和结束时完成健康行为评估。还将检查其他解释变量（测量和自评听力，健康素养，一般健康状况和听觉生活方式），参与者将参加结构化访谈，以便我们了解HHC行为的人际和心理社会影响。这项研究将是第一个前瞻性地研究HHC行为的框架内的多种健康行为理论。通过了解HHC行为的基础，可以制定行为改变策略，增加听力损失患者寻求帮助和干预的机会，从而改善言语理解和沟通，并改善听力损失的继发性负面影响。

DESCRIPTION (provided by applicant): Eighty percent of hearing-impaired adults fail to treat their hearing loss in the initial 5-10 years after its detection, despite the many negative consequences of not doing so. This is not unique to audiology - similar data exist for many other chronic health conditions. Further, the factors that influence hearing health care (HHC) behaviors are similar to those that affect health behaviors for other chronic conditions. It is thu appropriate to examine HHC behaviors within the framework of health behavior theory. In this investigation three established health behavior theories will be used to identify the critical attitudes and beliefs underlying HHC behaviors, so that in the future theory-based behavior change interventions can be developed. This approach is promising because while some variables that influence HHC behaviors cannot be changed (e.g. severity of hearing loss, age, income level), it is possible to modify attitudes and beliefs through education and counseling. This study will therefore provide the foundation for the development of theory-based education and counseling behavior change interventions to increase HHC behaviors among adults with mild-to-moderate hearing loss. This study will (1) Determine which HHC attitudes and beliefs best explain the HHC behaviors of help seeking and intervention uptake in adults with hearing loss. (2) Determine whether attitudes and beliefs underlying help seeking differ from those underlying intervention uptake. (3) Determine whether short form health behavior assessments that would be practical for use in the clinic are as effective at predicting HHC behaviors as long form assessments that will provide the necessary detail for developing an education and counseling behavior change program. A mixed methods longitudinal study will be conducted in which HHC attitudes and beliefs will be evaluated using long form and short form health behavior assessments that measure constructs of the Transtheoretical Model, Health Belief Model and Theory of Planned Behavior. Participants will be 587 individuals who fail a community-based hearing screening. They will be contacted at 6-monthly intervals to determine whether they have sought help, and if so, whether they have followed the audiologist's recommendations regarding rehabilitation. Health behavior assessments will be completed at the start and end of the study. Additional explanatory variables (measured and self-rated hearing, health literacy, general health, and auditory lifestyle) will also be examined, and participants will take part in a structured interview so we can learn about interpersonal and psychosocial influences on HHC behaviors. This study will be the first to prospectively examine HHC behaviors within the framework of multiple health behavior theories. By understanding the underpinnings of HHC behaviors, behavior change strategies can be developed that will increase help seeking and intervention uptake by people with hearing loss thus, improving speech understanding and communication, and ameliorating the secondary negative effects of hearing loss.