Assessment of Consumer Attitudes Following Recent Changes in the US Hearing Health Care Market

Importance: The addition of over-the-counter hearing aid (HA) options has transformed the way individuals can access hearing health care (HHC). However, although critical to their adoption and use, consumer attitudes and opinions about direct-to-consumer (DTC) models of health care are often understudied. Objective: To assess how recent DTC market changes in HHC delivery may be associated with consumer choice and attitudes towards specific HHC models. Design, Setting, and Participants: A mixed-methods survey, distributed online between March 22 and 25, 2022, using Qualtrics Survey Panels. Participants were US residents older than 50 years with no previous hearing aid experience, enrolled using consecutive sampling. A minimum of 1000 completed responses was set; once the 70% threshold was met, any future respondent who identified as White would not be given the survey. Main Outcomes and Measures: Respondents were asked to report their level of comfort with using different variations of DTC-HHC and asked about their previous experience with other DTC health care models. Respondents then reported which model (in-person vs online) of HHC they would most likely pursue. Results: Of 1377 respondents, 1037 were included in the survey study (mean [SD] age, 61.4 [7.84] years; 714 [69.0%] were female; 674 [65.0%] were White). Most respondents reported discomfort with pursuing hearing aids via DTC pathways, with 84% (874 of 1037) indicating they would pursue HHC via an in-person model. Individuals who were older (odds ratio [OR], 0.95; 95% CI, 0.92-0.98), reported an income greater than $150000 (OR, 0.29; 95% CI, 0.08-0.91), and were not interested in HA (OR, 0.42; 95% CI, 0.23-0.79) were less likely to pursue HHC online. Those who had previous experience with DTC health care (OR, 1.97; 95% CI, 1.27-3.02), and did not have (OR, 2.61; 95% CI, 1.59-4.31) or were uncertain (OR, 2.05; 95% CI, 1.13-3.70) about their insurance coverage for HA were more likely to pursue HHC online. Conclusions and Relevance: Current consumer attitudes and opinions found in this survey study suggest that DTC-HHC may not find immediate acceptance by most potential HA seekers in the US.