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  • 1.
    Brännström, Jonas K
    et al.
    Linköping University, Faculty of Arts and Sciences. Dept of clinical science, Section of Logopedics, Phoiatrics and audiology, Lund University, Sweden.
    Öberg, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Ingo, Elisabeth
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Månsson, Kristoffer N. T.
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Institute, Sweden.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Eriksholm Research Centre, Oticon A/S, Denmark.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Eriksholm Research Centre, Oticon A/S, Denmark.
    The Process of Developing an Internet-Based Support System for Audiologists and First-Time Hearing Aid Clients2015In: American Journal of Audiology, ISSN 1059-0889, E-ISSN 1558-9137, Vol. 24, no 3, p. 320-324Article in journal (Refereed)
    Abstract [en]

    Background: In audiologic practice, complementary information sources and access to the clinician between appointments improve information retention and facilitate adjustment behaviors. An Internet-based support system is a novel way to support information sharing and clinician access. Purpose: This research forum article describes the process of developing an Internet-based support system for audiologists and their first-time hearing aid clients. Method: The iterative development process, including revisions by 4 research audiologists and 4 clinical audiologists, is described. The final system is exemplified. Conclusion: An Internet-based support system was successfully developed for audiologic practice.

  • 2.
    Brännström, Jonas
    et al.
    Clinical Sciences Lund, Sweden.
    Öberg, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping. Linköping University, Faculty of Medicine and Health Sciences.
    Ingo, Elisabeth
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Månsson, Kristoffer N T
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Institutet, Department of Clinical Neuroscience, Sweden.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Snekkersten, Oticon A/S, Eriksholm Research Centre, Denmark.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Snekkersten, Oticon A/S, Eriksholm Research Centre, Denmark.
    The initial evaluation of an internet-based support system for audiologists and first-time hearing aid clientsThe process of developing an internet-based support system for audiologists and first-time hearing aid clients2016In: Internet Interventions, ISSN 2214-7829, Vol. 4, no 1, p. 82-91Article in journal (Refereed)
  • 3.
    Ingo, Elisabeth
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Climbing up the hearing rehabilitation ladder2019Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Hearing impairment is a major public health problem, affecting communication and participation, and is associated with a range of health problems. Most individuals with perceived hearing impairment do not seek help, do not opt for rehabilitation (hearing aids), and do not use prescribed hearing aids adequately. Reducing the impact of hearing impairment and supporting healthy aging are important public health goals. Motivation, access to hearing health care, and poor societal awareness about hearing impairment, consequences, and rehabilitation options influence help-seeking. Offering online hearing screening has been proposed to improve hearing help-seeking, access to hearing health care, and to increase public knowledge about hearing and hearing impairment. Applying theories from health psychology (i.e. the Stages of change model) could help audiologists and other hearing health care professionals understand the psychological barriers that prevent people with hearing problems to seek help and take up rehabilitation. The overarching aim of this thesis was to investigate behaviors related to hearing rehabilitation (help-seeking, hearing aid uptake, and hearing aid use) in adults who fail an online hearing screening. A second aim was to explore the usefulness of the Stages of change model in predicting hearing rehabilitation related behavior in a self-selected online hearing screening sample. Studies I–IV show tentative support for offering online hearing screening and for supplementary interventions for increasing help-seeking and provide tentative support for Stages of change as a useful classification tool to indicate individual needs for further information and guidance. Future studies should contemplate integrating screening for multiple health-related factors associated with hearing impairment and to provide a clear and tailored pathway for each participant (e.g. referral to adequate health care or equivalent online intervention).

    List of papers
    1. Stages of change in audiology: comparison of three self-assessment measures
    Open this publication in new window or tab >>Stages of change in audiology: comparison of three self-assessment measures
    Show others...
    2017 (English)In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 56, no 7, p. 516-520Article in journal (Refereed) Published
    Abstract [en]

    Objective: In a clinical setting, theories of health behaviour change could help audiologists and other hearing health care professionals understand the barriers that prevent people with hearing problems to seek audiological help. The transtheoretical (stages of change) model of health behaviour change is one of these theories. It describes a persons journey towards health behaviour change (e.g. seeking help or taking up rehabilitation) in separate stages: precontemplation, contemplation, preparation, action, and, finally, maintenance. A short self-assessment measure of stages of change may guide the clinician and facilitate first appointments. This article describes correlations between three stages of change measures of different lengths, one 24-item and two one-item. Design: Participants were recruited through an online hearing screening study. Adults who failed the speech-in-noise recognition screening test and who had never undergone a hearing aid fitting were invited to complete further questionnaires online, including the three stages of change measures. Study sample: In total, 224 adults completed the three measures. Results: A majority of the participants were categorised as being in one of the information- and help-seeking stage of change (contemplation or preparation). The three stages of change measures were significantly correlated. Conclusions Our results support further investigating the use of a one-item measure to determine stages of change in people with hearing impairment.

    Place, publisher, year, edition, pages
    TAYLOR & FRANCIS LTD, 2017
    Keywords
    Hearing screening; motivation; stages of change
    National Category
    Other Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-139671 (URN)10.1080/14992027.2017.1309466 (DOI)000404938300009 ()28420270 (PubMedID)
    Note

    Funding Agencies|Swedish Council for Working Life and Social Research [2009-0055]

    Available from: 2017-08-16 Created: 2017-08-16 Last updated: 2019-08-29Bibliographically approved
    2. Measuring motivation using the transtheoretical (stages of change) model: A follow-up study of people who failed an online hearing screening.
    Open this publication in new window or tab >>Measuring motivation using the transtheoretical (stages of change) model: A follow-up study of people who failed an online hearing screening.
    Show others...
    2016 (English)In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 55, no Suppl 3, p. S52-S58Article in journal (Refereed) Published
    Abstract [en]

    OBJECTIVE: Acceptance and readiness to seek professional help have shown to be important factors for favourable audiological rehabilitation outcomes. Theories from health psychology such as the transtheoretical (stages-of-change) model could help understand behavioural change in people with hearing impairment. In recent studies, the University of Rhode Island change assessment (URICA) has been found to have good predictive validity.

    DESIGN: In a previous study, 224 Swedish adults who had failed an online hearing screening completed URICA and two other measures of stages of change. This follow-up aimed to: (1) determine prevalence of help-seeking at a hearing clinic and hearing aid uptake, and (2) explore the predictive validity of the stages of change measures by a follow-up on the 224 participants who had failed a hearing screening 18 months previously.

    STUDY SAMPLE: A total of 122 people (54%) completed the follow-up online questionnaire, including the three measures and questions regarding experience with hearing help-seeking and hearing aid uptake.

    RESULTS: Since failing the online hearing screening, 61% of participants had sought help. A good predictive validity for a one-item measure of stages of change was reported.

    CONCLUSIONS: The Staging algorithm was the stages of change measure with the best ability to predict help-seeking 18 months later.

    Place, publisher, year, edition, pages
    Taylor & Francis, 2016
    National Category
    Psychology
    Identifiers
    urn:nbn:se:liu:diva-130826 (URN)10.1080/14992027.2016.1182650 (DOI)000381035200007 ()27206679 (PubMedID)
    Note

    Funding agencies: Swedish Council for Working Life and Social Research [2009-0055]

    Available from: 2016-08-26 Created: 2016-08-26 Last updated: 2019-08-29Bibliographically approved
  • 4.
    Ingo, Elisabeth
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Brännström, K Jonas
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences. Department of Logopedics, Phoniatrics and Audiology, Lund University, Sweden.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Department of Clinical Neuroscience, Karolinska Institute, Sweden; Eriksholm Research Centre, Oticon a/S, Denmark.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Eriksholm Research Centre, Oticon a/S, Denmark.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Eriksholm Research Centre, Oticon a/S, Denmark.
    Measuring motivation using the transtheoretical (stages of change) model: A follow-up study of people who failed an online hearing screening.2016In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 55, no Suppl 3, p. S52-S58Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Acceptance and readiness to seek professional help have shown to be important factors for favourable audiological rehabilitation outcomes. Theories from health psychology such as the transtheoretical (stages-of-change) model could help understand behavioural change in people with hearing impairment. In recent studies, the University of Rhode Island change assessment (URICA) has been found to have good predictive validity.

    DESIGN: In a previous study, 224 Swedish adults who had failed an online hearing screening completed URICA and two other measures of stages of change. This follow-up aimed to: (1) determine prevalence of help-seeking at a hearing clinic and hearing aid uptake, and (2) explore the predictive validity of the stages of change measures by a follow-up on the 224 participants who had failed a hearing screening 18 months previously.

    STUDY SAMPLE: A total of 122 people (54%) completed the follow-up online questionnaire, including the three measures and questions regarding experience with hearing help-seeking and hearing aid uptake.

    RESULTS: Since failing the online hearing screening, 61% of participants had sought help. A good predictive validity for a one-item measure of stages of change was reported.

    CONCLUSIONS: The Staging algorithm was the stages of change measure with the best ability to predict help-seeking 18 months later.

  • 5.
    Laplante-Lévesque, Ariane
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Oticon AS, Denmark.
    Brannstrom, Jonas K.
    Lund University, Sweden.
    Ingo, Elisabeth
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Institute, Sweden.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, The Swedish Institute for Disability Research. Linköping University, Faculty of Arts and Sciences. Oticon AS, Denmark.
    Stages of Change in Adults Who Have Failed an Online Hearing Screening2015In: Ear and Hearing, ISSN 0196-0202, E-ISSN 1538-4667, Vol. 36, no 1, p. 92-101Article in journal (Refereed)
    Abstract [en]

    Objectives: Hearing screening has been proposed to promote help-seeking and rehabilitation in adults with hearing impairment. However, some longitudinal studies point to low help-seeking and subsequent rehabilitation after a failed hearing screening (positive screening result). Some barriers to help-seeking and rehabilitation could be intrinsic to the profiles and needs of people who have failed a hearing screening. Theories of health behavior change could help to understand this population. One of these theories is the transtheoretical (stages-of-change) model of health behavior change, which describes profiles and needs of people facing behavior changes such as seeking help and taking up rehabilitation. According to this model, people go through distinct stages toward health behavior change: precontemplation, contemplation, action, and finally, maintenance. The present study describes the psychometric properties (construct validity) of the stages of change in adults who have failed an online hearing screening. Stages of change were measured with the University of Rhode Island Change Assessment (URICA). Principal component analysis is presented, along with cluster analysis. Internal consistency was investigated. Finally, relationships between URICA scores and speech-in-noise recognition threshold, self-reported hearing disability, and self-reported duration of hearing disability are presented. Design: In total, 224 adults who had failed a Swedish online hearing screening test (measure of speech-in-noise recognition) completed further questionnaires online, including the URICA. Results: A principal component analysis identified the stages of precontemplation, contemplation, and action, plus an additional stage, termed preparation (between contemplation and action). According to the URICA, half (50%) of the participants were in the preparation stage of change. The contemplation stage was represented by 38% of participants, while 9% were in the precontemplation stage. Finally, the action stage was represented by approximately 3% of the participants. Cluster analysis identified four stages-of-change clusters: they were named decision making (44% of sample), participation (28% of sample), indecision (16% of sample), and reluctance (12% of sample). The construct validity of the model was good. Participants who reported a more advanced stage of change had significantly greater self-reported hearing disability. However, participants who reported a more advanced stage of change did not have a significantly worse speech-in-noise recognition threshold or reported a significantly longer duration of hearing impairment. Conclusions: The additional stage this study uncovered, and which other studies have also uncovered, preparation, highlights the need for adequate guidance for adults who are yet to seek help for their hearing. The fact that very few people were in the action stage (approximately 3% of the sample) signals that screening alone is unlikely to be enough to improve help-seeking and rehabilitation rates. As expected, people in the later stages of change reported significantly greater hearing disability. The lack of significant relationships between stages-of-change measures and speech-in-noise recognition threshold and self-reported duration of hearing disability highlights the complex interplay between impairment, disability, and behaviors in adults who have failed an online hearing screening and who are yet to seek help.

  • 6.
    Laplante.Lévesque, Ariane
    et al.
    Eriksholms Research Centre, Denmark.
    Brännström, Jonas
    Lunds Universitet, Lund, Sverige.
    Öberg, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Ingo, Elisabet
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Månsson, Kristoffer
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Lunner, Thomas
    Eriksholm Research Centre, Denmark.
    An online information transfer support system for audiologists and their first-time hearing aid clients2014Conference paper (Other academic)
  • 7.
    Weineland, Sandra
    et al.
    Linköping University.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Lunner, Thomas
    Oticon AS, Denmark.
    Carlbring, Per
    Stockholm University, Sweden.
    Hesser, Hugo
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Ingo, Elisabeth
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Molander, Peter
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Nordqvist, Peter
    Horselskadades Riksforbund, Sweden.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Oticon AS, Denmark.
    Bridging the Gap Between Hearing Screening and Successful Rehabilitation: Research Protocol of a Randomized Controlled Trial of Motivational Interviewing via Internet2015In: American Journal of Audiology, ISSN 1059-0889, E-ISSN 1558-9137, Vol. 24, no 3, p. 302-306Article in journal (Refereed)
    Abstract [en]

    Purpose: Studies point to low help-seeking after a failed hearing screening. This research forum article presents the research protocol for a randomized controlled trial of motivational interviewing via the Internet to promote help-seeking in people who have failed an online hearing screening. Method: Adults who fail a Swedish online hearing screening, including a speech-in-noise recognition test, will be randomized to either an intervention group (participating in motivational interviewing) or an active control group (reading a book on history of hearing aids). Both of the conditions will be delivered via the Internet. The primary outcome is experience with seeking health care and using hearing aids 9 months after the intervention. Secondary outcomes are changes in before and after measures of self-reported hearing difficulties, anxiety, depression, and quality of life. Stages of change and self-efficacy in hearing help-seeking are measured immediately after intervention and at a 9-month follow-up for the purpose of mediation analysis. Results: The results of this randomized controlled trial may help bridge the gap between hearing screening and successful hearing rehabilitation. Conclusion: Although no large instantaneous benefits are expected, a slow change toward healthy behaviors-seeking health care and using hearing aids-would shed light on how to use the Internet to assist people with hearing impairment.

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