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Int J Audiol. 2019 Feb;58(2):107-115. doi: 10.1080/14992027.2018.1516895. Epub 2018 Oct 5.

Characteristics, behaviours and readiness of persons seeking hearing healthcare online.

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a Department of Speech-Language Pathology and Audiology , University of Pretoria , Pretoria , South Africa.
b Hearing Research Clinic Non-Profit Company , Durban , South Africa.
c Ear Sciences Centre , The University of Western Australia , Nedlands , Australia.
d Ear Science Institute Australia , Subiaco , Australia.
e Oticon Medical , Oticon A/S, Copenhagen , Denmark.
f Department of Behavioral Sciences and Learning , Linköping University , Linköping , Sweden.



This study describes characteristics, behaviours and readiness of people who are interested in seeking hearing healthcare (HHC) online.


A non-profit clinic was established from which services through a virtual clinic are offered. Most of the patient-audiologist interactions are conducted online. We used online means to invite individuals to take a free online digit-in-noise (DIN) test. Upon failing the test, individuals reported their readiness to seek HHC by using two tools: the line and the staging algorithm.


Individuals ≥18 years of age, within the greater Durban area, South Africa, were eligible to participate in the study.


A total of 462 individuals completed the online DIN test during the first 3 months. Of those, 58.66% (271/462) failed the test and 11.04% (51/462) submitted their details for further contact from the clinic audiologist. Five individuals proceeded to a comprehensive hearing evaluation and hearing aid trial: all those individuals showed readiness to seek further HHC on the measurement tools. These individuals have reported knowing of their hearing challenges prior to taking the test and have waited for a period of between 5 and 16 years before seeking HHC. A significant association between age and DIN test result was found.


This explorative study is the first clinic to utilise digital tools across the entire patient journey in combination with face-to-face interactions in providing HHC. Internet-connected devices provide an opportunity for individuals to seek HHC and for providers to offer initial services to detect, counsel and support persons through the initial engagement process of seeking HHC. This may open up new audiology patient pathways through online hearing screening, assessment of readiness to seek further HHC and enhancement of service delivery using hybrid services by combining online and face-to-face modes of synchronous and asynchronous communication.


Online hearing healthcare; South Africa; digit-in-noise test; eHealth; hearing screening; hearing status; mHealth; patient information; patient pathways; teleaudiology

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