Usability and Performance of Self-Fitting Over-the-Counter Hearing Aids.

Purpose: Over-the-counter (OTC) hearing aids can potentially improve access to hearing-health careand enable individuals with mild-to-moderate hearing loss to self-manage their condition. This study com-pared the usability and performance of a range of self-fitting over-the-counter (OTC-SF) hearing aids.

Research Design: This cross-sectional study evaluated six OTC-SF hearing aids.

Study Sample: Forty-three adults with self-perceived mild-to-moderate hearing difficulties participatedin this study.

Data Collection And Analysis: Participants were randomly assigned to two of six OTC-SF hearingaids and used the manufacturer-provided instructions and smartphone applications. These hearingaids included HP Hearing PRO, Jabra Enhance Plus, Lexie B2 Powered by Bose, Lexie Lumen,Soundwave Sontro, and Sony CRE-C10. Usability was assessed based on the fitting time, hearing aidskills and knowledge (HASK), self-reported ease of the SF process, and Post-Study System UsabilityQuestionnaire (PSSUQ) results. Performance was evaluated using the judgment of sound quality (JSQ)test and speech-in-noise benefit using the digits-in-noise and quick speech-in-noise tests.

Results: Fitting time ranged from 14.4 to 27.1 min, with Lexie Lumen requiring the longest time (27.1 min;standard deviation [SD], 5.9 min) and HP Hearing PRO requiring the shortest time (14.4 min; SD = 1.9 min).The HASK scores varied, with Soundwave Sontro achieving the highest score (8.9/10) and HP Hear-ing PRO achieving the lowest score (6.8/10). Self-reported ease of SF and PSSUQ scores did notdiffer significantly between the OTC-SF hearing aids. Overall sound quality and clarity ratings signifi-cantly differed, with Lexie B2 receiving the highest rating (8.1/10 and 7.5/10) and HP Hearing PROreceiving the lowest rating (6.3/10 and 5.1/10). Speech-in-noise benefit did not differ significantlybetween devices. A thematic analysis identified seven themes of the participants' SF experiencesand six themes of the researcher's field notes. Participants generally considered OTC-SF hearing aidsuser-friendly, although issues with Bluetooth connectivity, handling and insertion, and sound quality werenoted by the researcher as common challenges.

Conclusions: Usability and performance of OTC-SF hearing aids were similar across devices in termsof useability and speech-in-noise benefits. However, the devices exhibited variations in fitting time,HASK, and sound quality, including the overall impression and clarity. These findings can support thedecisions of consumers and recommendations of health-care professionals. Further research of thelong-term usability and selection processes of OTC-SF hearing aids is necessary.