A preliminary evaluation of the active communication education program in a sample of 87-year-old hearing impaired individuals.

Background: Previous research suggests that audiological rehabilitation for older adults could include group communication programs in addition to hearing aid fitting or as an alternative to hearing aid fitting for those people who do not wish to proceed with hearing aids. This pilot study was a first attempt to evaluate a Swedish version of such a program, Active Communication Education (ACE), which had been developed and previously evaluated in Australia (Hickson et al, 2007a).

Purpose: The aim of the study was to explore the use of the ACE program in an older-old population of people aged 87 yr in Sweden.

Research Design: A within-subject intervention study.

Study Sample: The participants were recruited from the Elderly in Linköping Screening Assessment (ELSA), a population-based study of the functional abilities of all inhabitants of the city of Linkoping aged 85 yr in 2007. Participants who responded to the hearing related items in the ELSA study were approached for this study; 29 people agreed to undertake ACE, and 23 (79%) completed three or more sessions.

Intervention: The ACE program consists of five weekly 2 hr group sessions with six to ten participants per group.

Data Collection And Analysis: Self-report measures of communication strategy use, activity and participation, health-related quality of life, and depression were obtained preprogram, 3 wk postprogram, and 6 mo postprogram. Within-group changes and effect sizes were calculated. In addition, outcomes were measured postprogram using the International Outcome Inventory-Alternative Interventions (IOI-AI; Noble, 2002) and a modified version of the Client Oriented Scale of Improvement (COSI; Dillon et al, 1997; Hickson et al, 2007b), and qualitative feedback was obtained.

Results: The effect size of ACE was small (0.03-0.27), and, in the sample of 23 included in this pilot study, differences in pre- and postprogram assessments were not statistically significant. Results from the IOI-AI and the modified COSI indicated that these elderly participants found the program to be beneficial, and 90% stated that the course had increased their ability to deal with hearing loss and the problems it creates.

Conclusions: This preliminary investigation indicates the potential benefits of ACE for older adults, and further research is needed with larger numbers of participants in different age groups to draw conclusions about the effectiveness of the ACE program for a general Swedish population.