"I feel a little bit clueless" perceived barriers and enablers to help-seeking and informed decision-making in hearing care: a qualitative study.

Objective: To explore perceived barriers and enablers to help-seeking and informed decision-making in hearing care in order to inform an intervention targeted at maximising uptake of hearing care (HearChoice).

Design: Data were collected using semi-structured interviews and analysed qualitatively using a hybrid deductive and inductive thematic analysis approach based on the COM-B model of behaviour change.

Study sample: Sixteen adults with hearing difficulty took part (9 male, 7 female, age range 27 - 90), nine of whom had sought professional help for hearing difficulties and seven of whom had not.

Results: Participants described a range of interacting barriers and enablers to help-seeking and decision-making for hearing care that relate to psychological capability (e.g. knowledge; skills), environmental and social opportunity (e.g. supportive social circle and health care providers) and automatic and reflective motivation (e.g. shame; trust; beliefs about effectiveness of hearing aids).

Conclusion: Interventions to facilitate help-seeking and informed decision-making about care options for adults with hearing difficulties are likely to be most effective if factors that increase psychological capability, environmental and social opportunity, and automatic and reflective motivation are maximised. The framework developed from this study will inform the development of HearChoice and future research on help-seeking and decision-making.