Driving Hearing Aid Adoption With Strategies From Anti-Smoking Campaigns

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The Food and Drug Administration will most likely release proposed rules for a new category of over-the-counter (OTC) hearing aids within the next three months. These new regulations will create a whole new category of affordable hearing aids. However, the hearing health industry will still need to focus on driving adoption by tackling an uncompromising challenge: stigma.

Once in place, OTC regulations will specify self-adjusting hearing aids, available without a prescription or professional advice, for adults with mild to moderate hearing loss.

OTC devices will join recent FDA-approved hearing aid market introductions by new hearing health players. These inputs are priced as low as 20% of the current average price of $ 5,000 per pair of hearing aids. Audiology and ENT clinics.

Lower prices will play an important role in boosting hearing aid adoption, with only 15% of people who would benefit from assistance currently wear hearing aids on a regular basis. Lower prices alone could double adoption by up to 30% (the adoption rate of people who use hearing aids in the UK, where the National Health Service provides coverage).

Once the price drops as a barrier to adoption, device makers will need to tackle the next frontier in hearing care: stigma. Looking outside hearing health care for inspiration, an iconic public health initiative is a compelling analogue: the anti-smoking campaigns in the United States.

By the mid-20th century, cigarettes symbolized urban elegance, with movie stars acting as brand ambassadors for cigarettes. In 1954, 45% of adults had smoked a cigarette in the previous week, but by 2019 that number had dropped significantly to 15%., thanks in large part to anti-smoking campaigns.

The intensity with which society stigmatizes hearing loss today parallels the power with which society once glorified smoking. Strategies to combat the intensity and infiltration of a set of beliefs that lead to poor health outcomes are what make anti-smoking campaigns a powerful analogue on the eve of a new category of aids. over-the-counter hearing aids.

Price is currently the biggest barrier to adoption in hearing healthcare

In a 2018 survey, a third of those surveyed with hearing loss complained that hearing aids are “too expensive” or that they don’t have insurance coverage.

Still, over the past year, low-cost options have proliferated:

  1. Private labeling at Costco. Costco’s Complete Kirkland Signature hearing aids are clinically programmable and offer streaming music and calls and rechargeable batteries, for $ 1,399.99 a pair. Sonova, one of the world’s leading manufacturers of hearing aids, provides the devices.
  2. Entries from consumer electronics brands. Apple, Bose and Samsung now compete in hearing health with FDA approved hearing aids or personal sound amplification products (PSAPs). Bose recently launched the SoundControl hearing aids for $ 849 a pair. Although this first iteration lacks streaming and rechargeable batteries, the hearing aids are self-adjusting, effectively serving as OTC grade test cases.
  3. D2C telehealth companies. Some direct-to-consumer (D2C) companies, such as Listen Lively, offer a full telehealth service. Their current price per pair of $ 2,000 provides significant savings over clinic hearing aids, and Lively audiologists consult via video calls to maximize hearing results.
  4. OTC category to come. Unlike PSAPs, over-the-counter hearing aids will have the imprimatur of FDA clearance. Once the FDA finalizes the OTC rules, consumer electronics brands will likely deepen their investments in the hearing aid category.

Stigma will gain in importance as a barrier to adoption

With a lower price range for good hearing outcomes becoming available, the stigma adoption barrier will gain in importance. An analysis of the same MarkeTrak survey mentioned above shows that 21% of people cited stigma as a barrier to continuing hearing care. People have expressed concern that hearing aids are “unattractive” or that they are “too young” to wear them.

An additional 30% cited reasons that fall under what we call “denial”, for example, that people “hear fairly well” without hearing aids, despite a medical diagnosis indicating otherwise. Since societal stigma typically operates at an underground level, the reasons people do not seek hearing care categorized under “Denial” may also be fueled by stigma.

Societal perceptions that reflect the stigma against hearing loss and hearing aids generally fall into three categories: “not full”, “disabled” and “cognitively impaired”, according to Marguerite Wallhagen. Stigma affects people throughout the hearing loss life cycle, from the initial acceptance of their hearing loss to deciding how often to wear hearing aids.

Anti-tobacco campaigns offer strategies to fight stigma

A comprehensive analysis of anti-smoking campaigns reveals three marketing strategies proven to dislodge entrenched societal beliefs, whether smoking is glamorous or hearing loss signals disability. The three strategies are to deploy a negative shock factor, to create empowerment and to advance the counter-narratives.

To deploy a negative shock factor, anti-smoking campaigns use visceral images and stories of real people to illustrate the consequences of smoking on regular smokers. To create empowerment, these campaigns provide people with factual information, positive reinforcement, and support programs. Finally, to advance counter-narratives, anti-smoking campaigns seek to rewrite entrenched societal scenarios, by opposing stereotypes about specific groups in society.

An impressive example of the strategy to create empowerment is FDA Every try counts campaign, launched in 2018. The campaign targets adult smokers, aged 25 to 54, who visit convenience stores at least once a month and who have tried unsuccessfully to quit in the past year. The campaign aims to empower smokers by reformulating past failures into positive steps, instilling a belief that they are ready to quit and celebrating every quit attempt without passing judgment. Visitors to the website can choose one of three SMS support programs and can contact a trained weaning coach who can be reached by chat or phone.

All three tobacco control strategies could be applied effectively to reduce the stigma associated with hearing loss.

Example of applying anti-smoking strategies to create empowerment

Consider the strategy for creating empowerment. An example of a specific campaign would be to help de-stigmatize the wearing of hearing aids in the workplace. Before the Covid-19 pandemic, one-third of people aged 66 to 69 were in the workforce, in part-time or full-time roles. With the economy changing in the distribution of jobs in response to the pandemic, people 65 and over face new challenges in maintaining their jobs.

Being able to hear at work is essential. Yet many people with hearing loss will wait to receive a negative performance review, potentially putting their job at risk, before seeking treatment with hearing aids.

The Creative Empowerment Strategy would target people with confirmed or suspected hearing loss who wish to continue working. Factual information would point out that people with hearing loss are more likely to be underemployed and even unemployed. Positive reinforcement would encourage people to experience different forms of hearing aid in the workplace, from closed captioning video calls, to headphones with personalized amplification, to full-fledged hearing aids. Support programs would structure participants’ goal setting by connecting them to both text programs and on-demand counselors.

Conclusion: the stigma remains

With consumer electronics brands introducing reasonably priced hearing aids, and with the upcoming regulation for OTC hearing aids, the price will block adoption less often. The challenge of stigma, on the other hand, remains. Hearing care companies would benefit from employing new and creative strategies to dispel the entrenched stigma against hearing loss and hearing aids. The three proven strategies highlighted by the above analysis of anti-smoking campaigns provide opportunities for the hearing health industry to take new approaches.

Audit Insight analyst Morgan Leppla contributed to the research and writing of this article.

Photo: PIKSEL, Getty Images


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