title: Factors influencing pursuit of hearing evaluation: Enhancing the health belief model with perceived burden from hearing loss on communication partners.
abstract: There is limited application of health behavior-based theoretical models in hearing healthcare, yet other fields utilizing these models have shown their value in affecting behavior change. The health belief model (HBM) has demonstrated appropriateness for hearing research. This study assessed factors that influence an individual with suspected hearing loss to pursue clinical evaluation, with a focus on perceived burden of hearing loss on communication partners, using the HBM as a framework.
  
  
  
  Cross-sectional design collecting demographics along with three validated hearing-loss related questionnaires.
  
  
  
  Patients from Duke University Medical Center Otolaryngology Clinic aged 55-75 years who indicated a communication partner had expressed concern about their hearing. A final sample of 413 completed questionnaire sets was achieved.
  
  
  
  The HBM model construct 'cues to action' was a significant (p <0.001) predictor of pursuing hearing evaluation. Perceived burden of hearing loss on communication partners was a significant (p <0.001) predictor of pursuing hearing evaluation and improves the model fit when added to the HBM: 72.0% correct prediction when burden is added versus 66.6% when not (p <0.0001).
  
  
  
  Hearing healthcare initiatives that incorporate these factors may improve hearing help-seeking behavior. More research using sound theoretical models in hearing healthcare is warranted.
authors.affiliation: a Head and Neck Surgery & Communication Sciences, Duke University Medical Center , Durham , North Carolina , USA .
authors.forename: Kristine A
authors.initials: KA
authors.lastname: Schulz
authors.affiliation: b Center for Nutrition, Healthy Lifestyle, and Disease Prevention, Loma Linda University , Loma Linda , California , USA .
authors.forename: Naomi
authors.initials: N
authors.lastname: Modeste
authors.affiliation: b Center for Nutrition, Healthy Lifestyle, and Disease Prevention, Loma Linda University , Loma Linda , California , USA .
authors.forename: Jerry
authors.initials: J
authors.lastname: Lee
authors.affiliation: c Duke Clinical Research Institute , Durham , North Carolina , USA .
authors.forename: Rhonda
authors.initials: R
authors.lastname: Roberts
authors.affiliation: d National Center for Rehabilitative Auditory Research, Portland VA Healthcare System , Portland , Oregon , USA.
authors.forename: Gabrielle H
authors.initials: GH
authors.lastname: Saunders
authors.affiliation: a Head and Neck Surgery & Communication Sciences, Duke University Medical Center , Durham , North Carolina , USA .
authors.forename: David L
authors.initials: DL
authors.lastname: Witsell
mesh_terms: D000368:Aged; D001307:Auditory Perception; D003142:Communication; D012048:Correction of Hearing Impairment / Q000523:psychology; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006311:Hearing Disorders / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D006320:Hearing Tests; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D009657:North Carolina; D010342:Patient Acceptance of Health Care; D019986:Persons with Hearing Disabilities / Q000523:psychology* / Q000534:rehabilitation; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
keywords: HBQ; HHIE-S; Perceptions about hearing loss; SOS-HEAR; health behavior; health-care seeking behavior; hearing impaired