Short- and long-term effects of the modified swedish version of the Active Communication Education (ACE) program for adults with hearing loss.

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.

Purpose: 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.

Research Design: Design was a between-group and within-group intervention study.

Study Sample: 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.

Intervention: The ACE program consists of five weekly 2 hr group sessions with 6 to 10 participants per group.

Data Collection And Analysis: 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.