# Feasibility of Ecological Momentary Assessment in the Indian Context to Address Challenges Associated with Hearing-Aid Use

## TL;DR

This study explores how real-time assessments can help understand hearing aid use in India, showing the need for personalized settings and noise optimization.

## Contribution

The study evaluates the feasibility of EMA in the Indian context for analyzing hearing aid outcomes and listener preferences.

## Key findings

- EMA revealed significant variations in hearing aid preferences within the same listening environments.
- Participants emphasized the benefits of hearing aids in quiet settings due to improved audibility.
- EMA highlights the need for incorporating background noise measurements to optimize hearing aid performance.

## Abstract

Ecological momentary assessment (EMA) involves the repeated real-time or near real-time sampling of individuals' behaviors and experiences within their natural settings, offering insights into the daily challenges experienced by individuals with hearing impairment.

The study aims to evaluate EMA's feasibility and construct validity in the Indian context, assessing its effectiveness in analyzing hearing aid outcomes at different times.

Twelve participants, aged between 49 and 66 (mean: 57.83) years, with bilateral hearing loss, participated in the study. A prospective cohort study was conducted from July to November 2023. Ecological momentary assessments were administered using a questionnaire hosted on Microsoft Forms (Microsoft Corp.), with links sent via WhatsApp (Meta Platforms, Inc.) 3 times daily over 10 days. On average, participants completed 3 surveys daily, each consisting of 15 questions.

A total of 237 entries was collected, with a 65.83% compliance rate. Most entries highlighted the evident advantages of hearing aids, especially in quiet surroundings. Utilizing Friedman's and Wilcoxon signed-rank tests for comparative analysis, significant variations were observed in EMA entries over time within identical listening environments.

The benefits of hearing aids in quiet environments were emphasized due to their capacity to restore audibility. The significant variations in individual preferences within the same environment emphasize the necessity for personalized hearing aid settings. These discrepancies in EMA entries highlight the importance of incorporating objective background noise measurements in surveys to optimize hearing aid performance. Ecological momentary assessment surveys provide valuable insights into listener preferences, facilitating optimal adjustments.