American Journal of Audiology最新文献

{"title":"Audiologic Characteristics of Military Service Members and Veterans With and Without Tinnitus and Comorbid Posttraumatic Stress Disorder.","authors":"Quintin A Hecht, Fatima T Husain, Emilia Kaniewska, Andrew J Fallon, Suheily M Lovelace, Crystal G Franklin, Carlos R Esquivel, Stacey Young-McCaughan, Alan L Peterson, Amanda Flores, Peter T Fox, John C Moring","doi":"10.1044/2026_AJA-26-00017","DOIUrl":"10.1044/2026_AJA-26-00017","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to evaluate audiologic characteristics of service members (SMs) and veterans who have tinnitus alone or have both tinnitus and posttraumatic stress disorder (T&P), as compared to healthy controls.</p><p><strong>Method: </strong>Participants included active duty military SMs and veterans with both T&P (<i>n</i> = 16), tinnitus only (TO; <i>n</i> = 25), and healthy controls (HCs) without posttraumatic stress disorder (PTSD) or tinnitus (<i>n</i> = 20). All participants underwent audiologic evaluation composed of tympanometry, distortion product otoacoustic emissions, pure-tone audiometry, speech audiometry, and loudness discomfort levels. Multivariate analysis of variance was conducted to determine differences in hearing thresholds between the three groups (T&P, TO, and HC). All participants completed the Hyperacusis Questionnaire. Participants with tinnitus (T&P, TO) also received a tinnitus psychoacoustic assessment and completed tinnitus-specific questionnaires. Tinnitus questionnaires included the Tinnitus Functional Index, tinnitus annoyance and loudness rating scales (visual analogue scale), and the Tinnitus Acceptance Questionnaire. Independent-samples <i>t</i> tests were conducted to test for differences between these two groups.</p><p><strong>Results: </strong>Pure-tone and speech audiometry results between the TO and TP groups did not significantly differ. Compared to the TO group, the T&P group reported significantly greater functional impairment due to their tinnitus, perceived their tinnitus as significantly more annoying, and endorsed significantly less acceptance of their tinnitus. Although not statistically significant, participants in the T&P group perceived their tinnitus louder than those in the TO group.</p><p><strong>Conclusions: </strong>Study findings suggest that PTSD is associated with increased tinnitus distress and annoyance. Symptoms of PTSD may also reduce the capacity to accept tinnitus. These results are consistent with previous studies that demonstrate the additive and negative effects that PTSD may have on health conditions, such as tinnitus. Clinicians within audiology clinics may consider screening specifically for PTSD and make appropriate referrals to behavioral health. Future studies should examine the best sequence of interventions for efficient and effective clinical outcomes among individuals with both conditions.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"1135-1149"},"PeriodicalIF":1.7,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13549737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148727178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caregiver Experiences of Student-Facilitated Teleaudiology Infant Diagnostic Testing.","authors":"Jocelyn Phillips, Dani Tomlin, Kelley Graydon, Julia Sarant","doi":"10.1044/2026_AJA-25-00219","DOIUrl":"10.1044/2026_AJA-25-00219","url":null,"abstract":"<p><strong>Purpose: </strong>Early diagnosis is crucial for infants with hearing loss, but access to specialized services can be challenging for some families. This study piloted a student-facilitated teleaudiology model for infant diagnostics and investigated caregiver opinions of this service in Victoria, Australia.</p><p><strong>Method: </strong>Eight families with infants under 6 months old participated in either in-person or teleaudiology appointments, followed by interviews with caregivers to explore their experiences. Thematic analysis was used to analyze interview data.</p><p><strong>Results: </strong>Four main themes emerged: (a) improved accessibility of appointments; (b) effective rapport building and communication, with concerns for supporting challenging scenarios; (c) varying perceptions of facilitator involvement; and (d) level of concern influencing family preferences for appointment type. Caregivers reported positive experiences with teleaudiology, citing improved convenience and reduced travel time as major benefits. However, some expressed concerns about the provision of adequate emotional support in complex cases via telehealth and some impacts of having student facilitators on caregiver confidence in the results.</p><p><strong>Conclusions: </strong>While a student-facilitated teleaudiology service could improve access to infant diagnostic audiology, family preferences and appointment complexity should be considered when offering this option. Future research should explore the feasibility of this service with a larger sample size.</p><p><strong>Supplemental material: </strong>https://doi.org/10.23641/asha.32144953.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"846-856"},"PeriodicalIF":1.7,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148254199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and Demographic Characterization of Tinnitus and Factors Associated With Discomfort in a Large Sample of Patients Evaluated in Bogotá, Colombia.","authors":"German Alejandro Pabón Ochoa, Miguel Humberto Parra Pinto","doi":"10.1044/2026_AJA-25-00322","DOIUrl":"10.1044/2026_AJA-25-00322","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to clinically and demographically characterize tinnitus in a large sample of patients evaluated in Bogotá, Colombia, and to analyze the factors associated with the level of discomfort.</p><p><strong>Method: </strong>A total of 763 medical histories of adults seen between 2018 and 2024 at a specialized tinnitus center were analyzed. Demographic, clinical, and audiological data were collected, in addition to scores from self-report instruments (Tinnitus Handicap Inventory, Tinnitus Reaction Questionnaire, Visual Analog Scale, and percentages of awareness and irritability). A synthetic discomfort index was constructed by utilizing principal component analysis, and subgroup comparisons and correlation analyses were carried out.</p><p><strong>Results: </strong>In the studied sample, the most frequent presentation was nonpulsatile, constant, sudden-onset, bilateral tinnitus, with a median duration of 18 months, primarily affecting sleep and concentration. Besides, both noise exposure and stress were mentioned as triggering factors that increased discomfort. Higher distress levels were observed in women, individuals from cities other than Bogotá, and those reporting a history of migraine or headache, stress, anxiety, or depression; clinically estimated higher noise exposure; or prior tinnitus treatments. Moreover, tinnitus-related discomfort showed a positive correlation with symptom duration and with the number of affected daily-life activities.</p><p><strong>Conclusions: </strong>These findings contribute to a better understanding of the tinnitus profile in the Colombian population and provide useful evidence to guide intervention strategies. The observed associations underscore the need for comprehensive, individualized management approaches and for continued research on the factors that may influence its progression and treatment.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"1164-1177"},"PeriodicalIF":1.7,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148726957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Cochlear Implant Competence of Caregivers, Educators, and Speech-Language Service Providers With the Pediatric Cochlear Implant Skills Review.","authors":"Kristen E T Thornton, Cassandra Bosworth, Anne M Smith, Matthew A Lopez, Claire Buxton, Melissa Oliver, Claire M Bernstein","doi":"10.1044/2025_AJA-24-00255","DOIUrl":"10.1044/2025_AJA-24-00255","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to adapt the Cochlear Implant Skills Review to assess the real-time demonstration of skills and device knowledge of the adults who care for their child's, client's, or student's cochlear implant (CI). This study also sought to assess inter- and intrarater reliability of the newly adapted Pediatric Cochlear Implant Skills Review (Ped-CISR) and provide evidence for its construct validity by assessing group performance differences.</p><p><strong>Method: </strong>The Ped-CISR was administered to (a) caregivers of new pediatric CI recipients (less than 1 year of device use), (b) caregivers of experienced pediatric CI recipients (greater than 1 year of device use), (c) educators of the deaf and hard of hearing, and (d) speech-language service providers working in an educational or hospital setting. Participant skills and knowledge were scored by three independent raters. One rater rewatched and rescored each session at least 4 weeks following initial review. Inter- and intrarater reliability and agreement were assessed for all raters, and between-groups differences were analyzed.</p><p><strong>Results: </strong>Reliability across all raters was high with an intraclass correlation coefficient of .801, 95% confidence interval [.785, .817]. There were no significant between-groups differences on the total score of the Ped-CISR; however, participant groups demonstrated significantly different knowledge and skills in the Battery and Indicator Light subcategories.</p><p><strong>Conclusion: </strong>The Ped-CISR is a valuable clinical tool to help identify deficits in knowledge and skills of caregivers, educators, and speech-language service providers of children who use CIs.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"819-845"},"PeriodicalIF":1.7,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cochlear Implantation in Children Without a Hearing Aid Trial: A Case Series of 22 Patients.","authors":"Caitlin Sapp, Marisa Temple, Molly Widney, Lisa Park","doi":"10.1044/2026_AJA-24-00127","DOIUrl":"10.1044/2026_AJA-24-00127","url":null,"abstract":"<p><strong>Objectives: </strong>Timely access to hearing technology is paramount to ensure early auditory access to the sounds needed for listening and learning in children with early hearing loss (HL). Although children typically move to cochlear implants (CIs) after first having tried hearing aids (HAs), there are some cases where the HA trial may create unnecessary additional delays. This clinical focus article presents three categories of patients where implantation appears warranted without an HA trial.</p><p><strong>Method: </strong>This study examines 3 years of retrospective chart data for pediatric CI patients at a tertiary care center who did not complete an HA trial before surgery.</p><p><strong>Results: </strong>We identified 22 cases and examined their diagnostic audiological profiles and preimplant trajectory of care. Our results coalesced around three broad categories where omission of the HA trial appears warranted: cases of late-onset/progressive HL, cases of children lost to follow-up after newborn hearing screening, and cases of auditory neuropathy spectrum disorder where hearing technology was deferred until behavioral testing was possible. Following surgery, we observed wide variability in device use rates, suggesting that some families may struggle with full-time use of CIs despite the streamlined candidacy process.</p><p><strong>Conclusions: </strong>Taken together, our results show that, in appropriate cases, CIs may be considered for children with HL without first completing an HA trial. This has important implications for closing the timing gaps introduced by loss to follow-up in the United States' national Early Hearing Detection and Intervention program.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"796-803"},"PeriodicalIF":1.7,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Validation of Modified Basic English Lexicon Sentences for Use With a Pediatric Population.","authors":"Lauren Calandruccio, Emily Buss, Lori J Leibold","doi":"10.1044/2026_AJA-25-00309","DOIUrl":"10.1044/2026_AJA-25-00309","url":null,"abstract":"<p><strong>Purpose: </strong>This article describes a new sentence corpus developed for use with children 5 years of age and older that is based on the Basic English Lexicon (BEL) sentence corpus and is referred to as the BabyBEL.</p><p><strong>Method: </strong>Sentences were constructed using words found in the expressive vocabulary of native English-speaking kindergarten and first-grade children and organized into 20 lists of 20 sentences each. A female talker recorded all sentences, and speech-shaped masking noise was created based on these recordings. First, psychometric properties of each list as a function of signal-to-noise ratio (SNR) in a cohort of adults were evaluated. Second, speech recognition in noise by list at -2 dB SNR in a cohort of 5- to 7-year-olds was evaluated. Participants had normal hearing and were native speakers of English.</p><p><strong>Results: </strong>Results indicate some differences between lists. The speech recognition threshold associated with 75% correct in adult data varied by no more than ±0.5 dB for 17 of 20 lists. Percent correct scores for children varied by no more than 3 percentage points for 12 of 20 lists. The pattern of performance across lists was similar for adults and children.</p><p><strong>Conclusions: </strong>The vocabulary and sentence structure of the BabyBEL sentences are appropriate for use with children as young as 5 years of age. Recordings of the BabyBEL corpus are freely available for download. When designing future experiments, it is important to consider performance patterns both across lists and between groups of child and adult listeners.</p><p><strong>Supplemental material: </strong>https://doi.org/10.23641/asha.32715975.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"965-972"},"PeriodicalIF":1.7,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13549740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148333984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why Family Physicians Refer (or Don't) for Adult Hearing Assessment: A Qualitative Interview Study.","authors":"Jessica Tsiolkas, Jermy Pang, Padraig Kitterick","doi":"10.1044/2026_AJA-25-00318","DOIUrl":"https://doi.org/10.1044/2026_AJA-25-00318","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to identify factors that influence family physicians' (FPs') referral behaviors when referring adult patients for hearing assessments.</p><p><strong>Method: </strong>A qualitative study was conducted in which FPs were recruited for 30-min semistructured interviews. The interview schedule was developed using a topic schedule approach and analyzed using reflexive thematic analysis. Nine FPs with clinical experience ranging from 4 to 32 years (<i>M</i> = 25 years) were recruited.</p><p><strong>Results: </strong>When referring adult patients, FPs consider overall patient health, potential benefits and risks of hearing assessments, reported symptoms, medical history, physical examinations, and observed behaviors indicating hearing loss. Government and clinical protocols, personal experiences with hearing loss, and relevant education programs also influence referral practices. FPs consider contraindications such as medical reasons, patient motivation, limited specialist services, and logistical challenges for patients in regional and remote areas. They expressed a desire for increased involvement of audiologists in primary care and sought education on the hearing assessment process, interpretation of audiology results, and hearing rehabilitation options.</p><p><strong>Conclusions: </strong>Multiple factors influenced FPs' referral behaviors for hearing assessments. Further research is needed to understand these factors and to implement findings to expand knowledge and develop effective referral tools for FPs.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"1-16"},"PeriodicalIF":1.7,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Auditory Emotion Recognition in Children With Bilateral Cochlear Implants: Vocal and Musical Stimuli.","authors":"Erva Degirmenci Uzun, Emre Orhan","doi":"10.1044/2026_AJA-25-00266","DOIUrl":"https://doi.org/10.1044/2026_AJA-25-00266","url":null,"abstract":"<p><strong>Objective: </strong>The objectives of this study were to evaluate auditory emotion recognition in children with bilateral cochlear implants (CIs) using nonlinguistic vocal and musical stimuli, to compare their performance with that of age-matched normal-hearing (NH) peers, and to examine the relationship between auditory emotion recognition and speech perception.</p><p><strong>Design: </strong>Auditory emotion recognition was assessed using the Montreal Affective Voices (MAV) and the Music and Emotion Stimulus (MES) sets, focusing on five emotions: happiness, sadness, anger, fear, and surprise. Speech perception was evaluated using speech reception thresholds (SRTs) and word recognition scores (WRSs).</p><p><strong>Study sample: </strong>The study included 29 children with bilateral CIs (study group) and 29 NH children (control group) aged 6-12 years.</p><p><strong>Results: </strong>In the study group's MAV and MES scores, the highest recognition score was obtained for the emotion of happiness, followed by sadness, anger, surprise, and fear. Significant correlations were identified between all vocal and musical emotion scores (<i>p</i> < .001). The WRS scores of the study group showed significant positive correlations with all MAV and MES scores.</p><p><strong>Conclusions: </strong>Vocal and musical emotion-recognition performance was associated in children with CIs, suggesting related performance patterns across auditory stimulus types. In addition, the association between word recognition and auditory emotion recognition suggests that speech perception and emotion perception may share broader auditory-perceptual demands.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"1-11"},"PeriodicalIF":1.7,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subjective Listening Effort in Adult Cochlear Implant Users: Insights From the Listening Effort Questionnaire.","authors":"Angelika Illg, Timo Bräcker, Michael Schulte, Anke Lesinski-Schiedat","doi":"10.1044/2026_AJA-25-00220","DOIUrl":"https://doi.org/10.1044/2026_AJA-25-00220","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to assess the subjective listening effort in daily life situations of adult cochlear implant (CI) users in a clinical setting using a questionnaire designed for hearing aid (HA) users.</p><p><strong>Method: </strong>The listening effort of CI users with progressive sensorineural hearing loss was measured using the Listening Effort Questionnaire (LEQ). In addition, speech comprehension results and demographic data were recorded in order to statistically examine correlations with the LEQ results.</p><p><strong>Results: </strong>A total of 112 participants-unilateral CI users with bilateral deafness, bilateral CI users, unilateral CI users with single-sided deafness (SSD), and bimodal users (CI + HA)-were included in the study (<i>M</i>_age = 56.5 years, <i>SD</i> = 13.6). The median listening effort score (scale ranges from 0 = <i>no effort</i> to 10 = <i>maximum effort</i>) was 5.7 for situations affected by the signal-to-noise ratio, 6.6 for situations with low sound quality, and 3.8 for quiet situations with lipreading. The differences in listening effort between the three types of situations were significant. Speech comprehension in noise was associated with listening effort in noisy situations. In situations with low sound quality and quiet situations with lipreading, less listening effort was required by participants with SSD than by bilateral CI users and bimodal users.</p><p><strong>Conclusions: </strong>The LEQ appears to be suitable for measuring adult CI users' subjective listening effort in daily life. The highest listening effort was experienced in situations with low sound quality, while the lowest effort was experienced in situations involving speech perception in quiet and lipreading.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"1-12"},"PeriodicalIF":1.7,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing Hearing Care Equity: Outcomes From a Community-Based Hearing Aid Assistance Program for Underserved Adults.","authors":"Zahra Jafari, Sarah Mason, Sarah Wilson","doi":"10.1044/2026_AJA-26-00091","DOIUrl":"https://doi.org/10.1044/2026_AJA-26-00091","url":null,"abstract":"<p><strong>Purpose: </strong>Access to hearing services is often limited by health care disparities and financial constraints. This retrospective longitudinal study examined hearing aid uptake and outcomes among low-income adults enrolled in the Dalhousie Hearing Aid Assistance Program-Community Services, a provincially funded initiative in Nova Scotia, Canada, designed to broaden access to hearing health care.</p><p><strong>Method: </strong>Demographic, audiologic, and self-reported hearing aid data were extracted from the digital patient management system. The study included 179 participants, with a mean age of 59.30 years.</p><p><strong>Results: </strong>Most participants (89.0%) received bilateral amplification. Average hearing thresholds indicated bilateral hearing loss in the moderate range. Tinnitus was reported by 47.5% of participants (18.40% persistent, 29.10% intermittent), most commonly affecting both ears (68.45%). Participants demonstrated strong hearing aid uptake, with an average daily use of 9.20 hr. Significant improvements were observed, including reductions in Hearing Handicap Inventory for the Elderly-Screening Version (HHIE-S) total and subscale scores (<i>p</i> < .001) at both 3-month and 12-month follow-ups relative to postfitting baseline, as well as substantial gains on the annual Client-Oriented Scale of Improvement (COSI) outcomes (> 80%), with a large correlation between Degree of Change and Final Ability outcomes (<i>r</i> = .716, <i>p</i> < .001). Hierarchical linear regression analysis indicated that average hearing loss (<i>p</i> < .003) and gender (<i>p</i> < .048) were significant predictors of HHIE-S scores.</p><p><strong>Conclusion: </strong>The findings demonstrate significant improvements in perceived hearing handicap and functional outcomes and highlight the value of accessible, community-based hearing aid services in reducing barriers to care and promoting hearing care equity.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"1-12"},"PeriodicalIF":1.7,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}