Abstract
Purpose: Over-the-counter (OTC) hearing aids can potentially improve access to hearing-health care and enable individuals with mild-to-moderate hearing loss to self-manage their condition. This study compared 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 participated in this study. Data Collection and Analysis: Participants were randomly assigned to two of six OTC-SF hearing aids and used the manufacturer-provided instructions and smartphone applications. These hearing aids 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 aid skills and knowledge (HASK), self-reported ease of the SF process, and Post-Study System Usability Questionnaire (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 Hearing PRO achieving the lowest score (6.8/10). Self-reported ease of SF and PSSUQ scores did not differ significantly between the OTC-SF hearing aids. Overall sound quality and clarity ratings significantly differed, with Lexie B2 receiving the highest rating (8.1/10 and 7.5/10) and HP Hearing PRO receiving the lowest rating (6.3/10 and 5.1/10). Speech-in-noise benefit did not differ significantly between devices. A thematic analysis identified seven themes of the participants' SF experiences and six themes of the researcher's field notes. Participants generally considered OTC-SF hearing aids user-friendly, although issues with Bluetooth connectivity, handling and insertion, and sound quality were noted by the researcher as common challenges. Conclusions: Usability and performance of OTC-SF hearing aids were similar across devices in terms of usability 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 the decisions of consumers and recommendations of health-care professionals. Further research of the long-term usability and selection processes of OTC-SF hearing aids is necessary.