WhatsApp AI Support vs Paper Support for First-Time Hearing Aid Users

The Measure of Audiologic Rehabilitation Self-Efficacy for Hearing Aids (MARS-HA)

The Measure of Audiologic Rehabilitation Self-Efficacy for Hearing Aids (West \& Smith, 2007) is a 24-item self-report instrument measuring four factors: (1) Basic Handling, (2) Advanced Handling, (3) Adjustment, \& (4) Aided Listening. Each item is rated on a 0-100% confidence scale in 10% increments (0% = no confidence at all, 100% = full confidence). The global score is the arithmetic mean of the 24 item responses \& ranges from 0 to 100, with higher scores indicating greater hearing aid self-efficacy. Subscale scores are calculated as the mean of the items contributing to each factor. A global score of 80% or higher is conventionally interpreted as high self-efficacy; scores below 80% indicate low to moderate self-efficacy. The MARS-HA has been translated into isiXhosa and Sepedi for use in this study; both translations underwent forward-backward translation and pilot testing for cultural equivalence (Hall et al., 2018). Participants can complete in English , isiXhosa, or Sepedi

International Outcome Inventory for Hearing Aids (IOI-HA)

The IOI-HA is a validated seven-item questionnaire to measure the effectiveness of the hearing aid intervention (Cox and Alexander, 2002). It targets seven domains, including (i) daily use, (ii) benefit, (iii) residual activity limitations, (iv) satisfaction, (v) residual participation restrictions, (vi) impact on others, and (vii) quality of life. Each item has five response choices, from worst to best outcome (Appendix V). The IOI-HA has been translated into the languages most commonly used in these communities, namely isiXhosa and Sepedi. All translated instruments underwent forward-backward translation and pilot testing for cultural equivalence (Hall et al., 2018). The participants will have the option to complete the IOI-HA in either of these languages or in English. The IOI-HA total score (range 7-35; higher scores indicate better hearing-aid outcomes, including use, benefit, satisfaction, and quality of life) will be measured at 5 weeks post-fitting.

Revised Hearing Handicap Inventory and Screening Tool (RHHI-S)

The RHHI-S is a validated 10-item questionnaire that is a strong, unidimensional, clinically informative measure of self-perceived hearing handicap that can be used by adults of all ages (Cassarly, Matthews, Simpson, \& Dubno, 2020). Each question has three possible responses: yes, sometimes, or no. The RHHI-S has been translated into the languages most commonly used in these communities, namely isiXhosa and Sepedi. All translated instruments underwent forward-backward translation and pilot testing for cultural equivalence (Hall et al., 2018). The participants will have the option to complete the RHHI-S in either of these languages or in English. RHHI-S total score (range 0-40; higher scores indicate greater perceived hearing handicap) will be measured at baseline and 5 weeks post-fitting (Appendix VI)

Berkman-Syme Social Network Index (SNI)

The SNI is a well-established tool used to assess the extent of an individual's social connections. The SNI examines the relationship between social networks and health outcomes. The SNI evaluates social integration by assessing four key domains: Marital status - Whether the individual is married or in a committed partnership. Contacts with close friends and relatives - Frequency of social interactions with family and friends. Religious group membership - Whether the individual is part of a church or religious group and attends regularly. Participation in voluntary or community organizations - Involvement in social or civic groups outside of family and work. The SNI assigns points based on the individual's responses to the above components. Scores range from 0 to 4, with higher scores indicating greater social integration. The SNI can be completed by the participants in English, isiXhosa or Sepedi

Hearing Aid Skills and Knowledge Inventory (HASKI-Clin)

The HASKI is a clinician-administered questionnaire designed to evaluate the practical skills \& knowledge of hearing aid users. It covers key areas such as basic handling (insertion, removal, cleaning, \& battery management), operational knowledge (using settings, adjusting controls, \& troubleshooting), communication strategies (effective use in different environments), self-management (accessing resources \& scheduling appointments), \& care \& maintenance (routine care \& recognizing when professional servicing is needed). This tool helps audiologists identify areas where users may need additional training or support, ultimately improving hearing aid outcomes \& user satisfaction. Scoring is calculated by summing the total number of items identified as competent (not problematic), dividing this by the number of items for which a response was given (i.e., excluding the "Not Applicable responses), and multiplying by 100 to give a percentage of competency. Items are equally weighted.