Associations Between Predisposing, Enabling, and Need Factors and Hours of Daily Hearing Aid Use in the Atherosclerosis Risk in Communities Study

Purpose: Hearing aids are the primary treatment for age-related hearing loss but are vastly underutilized. We explored cross-sectional associations between predisposing, enabling, and need factors and hours of daily hearing aid use. Method: In the Atherosclerosis Risk in Communities (ARIC) Study, 764 participants at Visit 6 (2016–2017) reported hearing aid use. Self-reported hours of daily hearing aid use were modeled continuously (hours) and categorically (< 6, 6–12, and > 12 hr). Covariates included predisposing (age, sex, race–center), enabling (education, marital status, years of prior hearing aid use, global cognitive factor score, depressive symptoms, access to health care, health literacy), and need factors (pure-tone average [PTA], Quick Speech-in-Noise Test [QuickSIN] score). Multivariable-adjusted linear and ordinal logistic models were used to examine associations between these factors and daily hearing aid use. Results: Every 1-year increase in prior hearing aid use was associated with 0.08-hr increase in daily hearing aid use (95% confidence interval [CI] [0.04, 0.13]); every 10-dB increase in PTA was associated with 0.63-hr increase in daily hearing aid use (95% CI [0.18, 1.08]); every 5-point increase in QuickSIN score was associated with 0.53-hr decrease in daily hearing aid use (95% CI [−0.99, −0.06]). Longer duration of prior hearing aid use and poor PTA and QuickSIN performance were associated with higher odds of being in a higher hearing aid use category. Conclusions: Hours of daily hearing aid use is driven primarily by audiometric hearing, SIN performance, and years of prior hearing aid use. Further research into determinants of hours of use can improve precision of hearing care. Supplemental Material: https://doi.org/10.23641/asha.30192826