title: Short- and long-term effects of the modified swedish version of the Active Communication Education (ACE) program for adults with hearing loss.
abstract: BACKGROUND
  In Sweden, there is a lack of evidence-based rehabilitation programs for hearing loss. The Active Communication Education program (ACE) has successfully been used in Australia and was translated and evaluated in a Swedish pilot study. The pilot study included 23 participants (age 87 yr). No statistically significant effects were found, but the qualitative assessments indicated that this population found the program to be beneficial. The participants requested more focus on the psychosocial consequences of hearing loss, and the modules in the original ACE program were modified.
  
  
  OBJECTIVE
  The aim of this study was to explore the effects of a modified Swedish version of the ACE program in a population aged 39-82 yr old.
  
  
  METHODS
  Design was a between-group and within-group intervention study.
  
  
  METHODS
  The participants were recruited from the hearing health clinic in Linköping during 2010 and 2012. A total of 73 participants agreed to undergo the ACE, and 67 (92%) completed three or more sessions.
  
  
  METHODS
  The ACE program consists of five weekly 2 hr group sessions with 6 to 10 participants per group.
  
  
  METHODS
  The outcomes were measured before initiation of the program, 3 wk after program completion, and 6 mo after program completion and included communication strategy use, activity and participation, health-related quality of life, and anxiety and depression. In addition, outcomes were measured after program completion using the International Outcome Inventory-Alternative Interventions, a modified version of the Client Oriented Scale of Improvement, and qualitative feedback was obtained about the response to the program and actions taken as a result of participation. The treatment effects were examined using repeated-measures analyses of variance.
  
  
  RESULTS
  Statistically significant effects were found for communication strategy use, activity and participation, and psychosocial well-being. Statistically significant effects were found for gender and degree of hearing loss, indicating that women and those with mild hearing loss significantly improved communication strategies.
  
  
  CONCLUSIONS
  It is suggested that the program be implemented as part of regular audiological rehabilitation and offered in an early stage of rehabilitation.
authors.affiliation: Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden; Department of ENT-Head Neck Surgery, County Council of Östergötland, Linköping, Sweden.
authors.forename: Marie
authors.initials: M
authors.lastname: Oberg
authors.affiliation: Hearing Clinic, County Council of Östergötland, Linköping, Sweden.
authors.forename: Therese
authors.initials: T
authors.lastname: Bohn
authors.affiliation: Hearing Clinic, County Council of Östergötland, Linköping, Sweden; Department of ENT-Auditory Implants, Uppsala University hospital, Uppsala, Sweden.
authors.forename: Ulrika
authors.initials: U
authors.lastname: Larsson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003142:Communication; D012048:Correction of Hearing Impairment; D004493:Education; D005260:Female; D034381:Hearing Loss / Q000534:rehabilitation*; D006320:Hearing Tests; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011788:Quality of Life; D013548:Sweden; D013997:Time Factors