Publications by authors named "Rebecca J Kelly-Campbell"

11 Publications

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Quality, Readability, and Suitability of Hearing Health-Related Materials: A Descriptive Review.

Am J Audiol 2020 Sep 18;29(3):513-527. Epub 2020 Jun 18.

Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX.

Objectives The objective of this descriptive review was to determine the quality, readability, and suitability of ear and hearing health information and materials for patients and their significant others. Method A literature search was conducted between August 2018 and April 2019 in the databases CINAHL Complete, MEDLINE, and PsychInfo. Inclusion and exclusion criteria were used to shortlist studies. Data regarding quality, suitability, and readability were extracted from the included studies. Data were assessed qualitatively. Results There were 34 studies included in this review. Of those, eight examined quality, 33 assessed readability, and four investigated the suitability of materials. The range of materials assessed included diagnostic reports, patient education materials (PEMs), patient-reported outcome measures, and websites. Quality elements were examined in studies focusing on website information. Findings indicated that most websites were of poor quality. Suitability was examined in studies focusing on PEMs such as hearing aid user guides. Findings indicated that most of the existing materials were not suitable for the intended populations. The reading grade level of information across all four categories was found to be higher than the recommended fifth or sixth reading grade level for health-related materials. Revisions of some diagnostic reports and PEMs showed that improvements are possible. Conclusions This review suggests that ear- and hearing-related materials generally have lower quality and suitability with higher readability (more difficult to read). Development of materials that are suitable, of high quality, and at the appropriate readability levels is required to improve accessibility of ear- and hearing-related materials.
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September 2020

Media Use by Older Adults With Hearing Loss: An Exploratory Survey.

Am J Audiol 2020 Jun 29;29(2):218-225. Epub 2020 Apr 29.

Department of Otolaryngology, Hearing and Balance Research Unit, University of Tampere, Finland.

Objectives There has been a substantial increase in people with health conditions seeking health-related information online. The aim of this study was to examine the media usage by older adults with hearing loss. Method The study used a cross-sectional survey design. A total of 556 older adults with hearing loss (Hearing Tracker website users) completed the survey that was focused on (a) demographic information, (b) general electronic media usage, (c) sources of hearing health information, and (d) social media use for hearing health information. Data were analyzed using descriptive statistics and chi-square tests. Results When seeking hearing health care information, the majority of the participants turned to the Internet (54%) followed by health professionals (34%) as the first response to their symptoms. Both sources were also rated as the easiest means of obtaining hearing health information. The information from health care providers was rated as more reliable and important for decision making than that from the Internet. Facebook and YouTube were the most frequently used social media platforms with over 40% of the respondents using them "most of the time" or "sometimes." All the social media platforms were rated less favorably than other sources for ease of finding information, reliability, and importance in decision making. Conclusion Older adults with hearing loss use various forms of electronic media for seeking hearing health information. They place the most trust on the information obtained from hearing health care professionals. These professionals need to be aware of the quality of information available on the Internet and social media sources in order to direct patients to credible sources. Supplemental Material
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June 2020

Quality and Readability of English-Language Internet Information for Tinnitus.

J Am Acad Audiol 2019 01 21;30(1):31-40. Epub 2017 Dec 21.

Department of Behavioural Sciences and Learning, The Swedish Institute for Disability Research, Linköping University, Linköping, Sweden.

Background: Because of the wealth of information available on the internet and increasing numbers of individuals relying on websites as a primary source of information for health-related questions, it is important that the readability of their content is within the comprehension level of most readers.

Objective: The study evaluated the quality and readability of English-language Internet information for tinnitus.

Research Design: Analysis of Internet websites on tinnitus.

Study Sample: A total of 134 websites with tinnitus information.

Data Collection And Analysis: Three key words (i.e., tinnitus, ringing in the ear, and buzzing in the ear) were entered in five country-specific versions of the most commonly used internet search engine in August 2016. For each of the 15 searches, the first 20 relevant websites were examined. After removing duplicates, a total of 134 websites were assessed. Their origin (commercial, nonprofit organization, government, personal, or university), quality (Health On the Net [HON] certification and DISCERN scores), and readability (Flesch Reading Ease score, Flesch-Kincaid Reading Grade Level Formula, and Simple Measure of Gobbledygook) were assessed.

Results: Most websites were of commercial (49.3%) or nonprofit organization (38.8%) origin. Their quality and readability was highly variable. Only 13.5% of websites had HON certification. χ² analysis showed that there was significant association between website origin and HON certification [χ²(4) = 132.9, p < 0.0001]. The mean DISCERN scores were 2.39. No association between DISCERN scores and website origin was found. Readability measures showed that on average, only people with at least 10-12 yr of education could read and understand the internet information for tinnitus in websites. Almost all the websites exceeded the most stringent reading level recommended for health information.

Conclusions: The results highlight great variability in the quality and readability of health information, specifically for tinnitus in the internet. These findings underscores the need for stakeholders (e.g., web-developers, clinicians) to be aware of this and to develop more user-friendly health information on websites to make it more accessible for people with low literacy.
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January 2019

Readability of Patient-Reported Outcome Measures in Adult Audiologic Rehabilitation.

Am J Audiol 2018 Jun;27(2):208-218

University of Canterbury, Department of Communication Disorders, Christchurch, New Zealand.

Purpose: The purpose of this study was to examine the readability of published patient-reported outcome measures (PROMs) designed for use in adult audiologic rehabilitation. The readability results were compared with the readability levels recommended for health information by health literacy experts.

Method: Reading grade levels were calculated using the Flesch-Kincaid Grade Level Formula (Flesch, 1948), Gunning Fog Index (Gunning, 1952), Simple Measure of Gobbledygook (McLaughlin, 1969), and FORCAST (Caylor, Sticht, Fox, & Ford, 1973) readability formulas for 10 published PROMs. Descriptive statistics were computed across the different PROM sections: instructions, items, response scale, and overall contents of the measure directed toward respondents.

Results: The majority of the PROM sections exceeded the 6th grade reading level recommended by health literacy experts, regardless of the formula applied. All PROM sections exceeded the 6th grade reading level when calculated according to the FORCAST formula, the most appropriate readability formula for use with a nonnarrative text format, such as PROMs.

Conclusions: When developing or reevaluating PROMs designed for use in adult audiologic rehabilitation, researchers should consider ways to improve the readability of their measure, as poor readability may affect the validity of the empirical data collected using the PROM. Additionally, the adequate readability of audiologic PROMs is required if patient/family-centered care values are to be adhered to within the field of adult audiologic rehabilitation.
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June 2018

Improving Hearing Aid Self-Efficacy and Utility Through Revising a Hearing Aid User Guide: A Pilot Study.

Am J Audiol 2018 Mar;27(1):45-56

Department of Communication Disorders, University of Canterbury, Christchurch, New Zealand.

Purpose: This pilot study aimed to investigate whether revising a hearing aid user guide (HAUG) is associated with improved hearing aid self-efficacy and utility performance.

Method: In Part 1, an HAUG was evaluated using the Suitability Assessment of Material (SAM) and readability formulas (Flesch Reading Ease [Flesch, 1943], Flesch-Kincaid Readability Formula [Kincaid, Fishburne, Rogers, & Chissom, 1957], and Simple Measure of Gobbledygook [McLaughlin, 1969]). The HAUG was revised using results from the SAM and best practice guidelines. The revision included generating a video. In Part 2, 30 adults with hearing impairment were randomly assigned to use either the original guide (N = 15) or the revised guide and video (N = 15) to perform a utility task. Participants' self-efficacy was measured using the Basic and Advanced Handling subscales of the Measure of Audiologic Rehabilitation Self-Efficacy for Hearing Aids questionnaire. SAM and readability were compared between the original and revised guides (Doak, Doak, & Root, 1996).

Results: SAM and readability were improved following the revision. Participants in the revised guide group performed significantly better on the utility task and on the Measure of Audiologic Rehabilitation Self-Efficacy for Hearing Aids subscales than participants in the original guide group.

Conclusions: These results are encouraging as they indicate that there is scope to influence self-efficacy and utility performance through the use of appropriate HAUGs.
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March 2018

Pediatric Audiology Report: Assessment and Revision of an Audiology Report Written to Parents of Children With Hearing Impairment.

J Speech Lang Hear Res 2016 04;59(2):359-72

Objective: The purpose of this study was twofold: first, to evaluate a typical pediatric diagnostic audiology report to establish its readability and comprehensibility for parents and, second, to revise the report to improve its readability, as well as the comprehension, sense of self-efficacy, and positive opinions of parent readers.

Method: In Experiment 1, a mock audiology report was evaluated via a readability analysis and semistructured interviews with 5 parents. In Experiment 2, the report was revised using best practice guidelines and parental recommendations from Experiment 1. The revision was verified by randomly assigning 32 new parent participants to read either the revised or unrevised report before their comprehension, self-efficacy, and opinions were assessed.

Results: In Experiment 1, results confirmed that the report was difficult to read and understand. In Experiment 2, parents who read the revised report had significantly greater comprehension, self-efficacy, and opinion ratings than those who read the unrevised report. In addition, the readability of the revised report was markedly improved compared with the unrevised report.

Conclusions: This study shows that pediatric diagnostic audiology reports can be revised to adhere to best practice guidelines and yield improved readability, in addition to improving the comprehension, sense of self-efficacy, and positive opinions of parents of children with hearing impairment.
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April 2016

The Relationship Between Hearing Aid Self-Efficacy and Hearing Aid Satisfaction.

Am J Audiol 2015 Dec;24(4):529-35

Purpose: The purpose of this study was to investigate the relationship between self-efficacy for hearing aids (HAs) and satisfaction with HAs in a group of adult HA owners.

Method: Forty-seven adults acquiring HAs (new and experienced owners) completed a demographic questionnaire, the Hearing Handicap Questionnaire (Gatehouse & Noble, 2004), and received an audiometric evaluation prior to HA fitting. Twelve weeks following the completion of the HA fitting, they completed the Measure of Audiologic Rehabilitation Self-Efficacy for Hearing Aids (Smith & West, 2006) and the Satisfaction with Amplification in Daily Life (Cox & Alexander, 1999) questionnaires.

Results: There were no significant differences between experienced and new HA owners in terms of self-efficacy or HA satisfaction. The majority of participants had adequate self-efficacy for basic HA handling and adjustment to HAs. Fewer participants had adequate self-efficacy for aided listening and advanced handling of HAs. HA self-efficacy was related to HA satisfaction in three domains: positive effect and negative features of HAs and service and cost.

Conclusion: Many HA owners do not have adequate self-efficacy in important HA-related domains. Clinical intervention to improve self-efficacy for HAs may help improve HA satisfaction.
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December 2015

Measuring cognitive anxiety through the consultation process for hearing aids: Older adults and their significant others.

J Commun Disord 2015 Jul-Aug;56:29-39. Epub 2015 Jul 2.

University of Canterbury, Hearing Technology, 29 Marshland Road, Shirley, Christchurch 8061, New Zealand. Electronic address:

Unlabelled: The purpose of this study was to assess the level of cognitive anxiety experienced by first-time hearing aid adopters and their significant others before, during, and after hearing aid fitting. A total of 16 couples were interviewed at three points: (1) at the initial consultation for hearing aids, (2) during the hearing aid trial, and (3) 1 month following the final clinical appointment in which the hearing aids were formally adopted. Cognitive anxiety was assessed through a content analysis of the interviews using the Cognitive Anxiety Scale. Results of this study show that the levels of cognitive anxiety generally decreased across the entire consultation process for both adults with hearing impairment and their significant others. The results also indicated that couples generally experienced similar levels of cognitive anxiety at initial consultation, but their levels of cognitive anxiety differed throughout the remainder of the study. These findings highlight the importance of inclusion of significant others in the rehabilitation process.

Learning Outcomes: The reader will be able to: (1) discuss the relationship between cognitive anxiety and hearing impairment, (2) define cognitive anxiety, (3) discuss the impact of hearing impairment on significant others, (4) describe the experience of cognitive anxiety through the hearing aid consultation process.
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May 2016

Outcomes of group audiological rehabilitation for unaided adults with hearing impairment and their significant others.

Am J Audiol 2015 Mar;24(1):40-52

Purpose: The purpose of this study was to evaluate the outcomes of a group audiological rehabilitation (GAR) program designed for working adults who do not use amplification and for their significant others.

Method: A quasirandomized control design was used to measure outcomes of the GAR program. Twenty-four couples participated in weekly GAR group sessions designed to address communication problems encountered in the workplace and at home. Twelve couples were placed on a waiting list as a control group. Assessments were completed at time frames prior to the sessions, post-waiting list, immediately after the sessions, and 12 weeks after. These included direct measures for the adults with hearing impairment, proxy measures from the significant others, and direct measures for the significant others.

Results: Results indicated adults with hearing impairment and their significant others experienced significant improvements following participation in the GAR program. These improvements were maintained in the short term (12 weeks).

Conclusions: Working adults with hearing impairment who do not use amplification can benefit from GAR sessions. Significant others of working adults with hearing impairment experience third-party disability, which can also be alleviated through participation in GAR sessions.
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March 2015

Hearing aid and hearing assistance technology use in Aotearoa/New Zealand.

Int J Audiol 2015 May 30;54(5):308-15. Epub 2015 Jan 30.

Department of Communication Disorders, University of Canterbury , Christchurch , New Zealand.

Objective: The purpose of this study was to describe factors that are related to hearing aid and hearing assistance technology ownership and use in Aotearoa/New Zealand.

Design: Adults with hearing impairment living in New Zealand were surveyed regarding health-related quality of life and device usage. Audiometric data (hearing sensitivity and speech in noise) were collected.

Study Sample: Data were obtained from 123 adults with hearing impairment: 73 reported current hearing-aid use, 81 reported current hearing assistance technology use.

Results: In both analyses, device users had more difficulty understanding speech in background noise, had poor hearing in both their better and worse hearing ears, and perceived more consequences of hearing impairment in their everyday lives (both emotionally and socially) than non-hearing-aid users. Discriminant analyses showed that the social consequences of hearing impairment and the better ear hearing best classified hearing aid users from non-users but social consequences and worse ear hearing best classified hearing assistance technology users from non-users.

Conclusions: Quality of life measurements and speech-in-noise assessments provide useful clinical information. Hearing-impaired adults in New Zealand who use hearing aids also tend to use hearing assistance technology, which has important clinical implications.
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May 2015

Perception of quality of life for adults with hearing impairment in the LGBT community.

J Commun Disord 2012 Sep-Oct;45(5):367-77. Epub 2012 Jun 6.

Department of Communication Disorders, University of Canterbury, Private Bag 4800, Christchurch 8140, New Zealand.

Unlabelled: The purpose of the this study was to examine the perception of both generic and disease-specific quality of life (QoL) in adults with hearing impairment who are members of the lesbian, gay, bisexual, and transgender (LGBT) community. Eighty-three adults who self-identified as having hearing impairment and as being members of the LGBT community and 80 adults with hearing impairment who do not self-identify as being members of the LGBT community (comparison group) participated in this study. The mean age of the participants in the LGBT group was 64.65 years, and the mean age for the comparison group was 63.26 years. Demographic information about the participants included: self-identification in the LGBT community, age, current and previous gender, relationship status, and hearing aid use. Participants received an audiometric evaluation and completed a disease-specific QoL instrument (Hearing Handicap Inventory for the Elderly/Adults) and a generic QoL instrument (Short-Form 36 Health Survey). The results from this study indicate that factors such as gender, relationship status, and hearing aid use are related to the perception of QoL for individuals with hearing impairment who are members of the LGBT community. Differences were found between the participants in the LGBT group and the comparison group.

Learning Outcomes: After reading this article, readers should be able to: (1) describe the disease-specific QoL affects of hearing loss on members of the LGBT community compared with a group of adults with hearing impairment who are not members of the LGBT community, (2) describe the gender diffferences in perception of QoL for members of the LGBT community and participants not in the LGBT community, and (3) discuss clinical implications of the findings.
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January 2013