Lewis Charity T, Toman Julia, Sanchez Victoria A, Corvin Jaime, Arnold Michelle L
Auditory Rehabilitation & Clinical Trials Laboratory, University of South Florida, Tampa, Florida, USA.
School of Aging Studies, College of Behavioral & Community Sciences, University of South Florida, Tampa, Florida, USA.
Ear Hear. 2025;46(1):111-120. doi: 10.1097/AUD.0000000000001562. Epub 2024 Jul 29.
Hearing loss is a highly prevalent condition; however, it is widely under-treated, and Black Americans have been found to have significantly lower rates of hearing aid utilization than other ethnic/racial groups. In this exploratory study, we aimed to identify hearing health beliefs among Black adults, guided by the Health Belief Model, with social determinants of health, and examine individual differences in these perspectives.
The Hearing Beliefs Questionnaire (HBQ) was administered online to measure constructs of the Health Belief Model among 200 Black adults aged 18 to 75 ( M = 39.14, SD = 14.24). Approximately 13% reported hearing difficulty. In addition, 11 social determinants of health questions were included. Participants were recruited from a university otolaryngology clinic and local Black congregations, meeting inclusion criteria of being 18 or older and Black/African American. Mean scores and SDs for HBQ subscales were calculated. Analysis included analysis of variance and t tests to explore relationships with demographic variables and social determinants of health. Multiple regression analyses predicted HBQ subscale scores from sociodemographic variables.
Mean HBQ subscale scores ranged from 3.88 (SD = 2.28) for Perceived Barriers to 6.76 (SD = 1.93) for Perceived Benefits. Positive correlations were observed between Perceived Severity, Perceived Benefits, and Perceived Self-Efficacy scores and participant educational attainment. Lower economic stability was correlated with poorer scores in Perceived Self-Efficacy, Perceived Severity, and Perceived Benefits. Black adults' willingness to purchase a hearing aid was heavily influenced by their Perceived Benefit, Perceived Severity, and Perceived Self-Efficacy scores, with lower scores correlating with unwillingness to purchase devices. Higher frequency of racism/discrimination and financial hardship correlated with increased Perceived Barriers scores for accessing hearing healthcare. In addition, hearing health beliefs between participants with self-reported hearing difficulty and those without trouble only exhibited differences in the Perceived Susceptibility subscale, with those experiencing hearing difficulty having higher scores in this subscale; no other distinctions were identified.
The Health Belief Model, used with social determinants of health, revealed associations, and variations, in the hearing health beliefs held by Black adults. The present investigation reveals heterogeneity within this group and pinpoints individuals at higher risk for untreated hearing loss, stemming from their negative perceptions about hearing healthcare. These beliefs are influenced by demographics and social determinants of health, underscoring areas ripe for intervention.
听力损失是一种非常普遍的疾病；然而，其治疗普遍不足，且已发现美国黑人使用助听器的比例显著低于其他种族/族裔群体。在这项探索性研究中，我们旨在以健康信念模型为指导，结合健康的社会决定因素，确定成年黑人的听力健康信念，并研究这些观点中的个体差异。
在线发放听力信念问卷（HBQ），以测量200名年龄在18至75岁之间的成年黑人（M = 39.14，SD = 14.24）的健康信念模型结构。约13%的人报告有听力困难。此外，还纳入了11个健康的社会决定因素问题。参与者从大学耳鼻喉科诊所和当地黑人教会招募，符合18岁及以上且为黑人/非裔美国人的纳入标准。计算了HBQ子量表的平均分和标准差。分析包括方差分析和t检验，以探索与人口统计学变量和健康的社会决定因素之间的关系。多元回归分析从社会人口统计学变量预测HBQ子量表得分。
HBQ子量表平均分范围从感知障碍的3.88（SD = 2.28）到感知益处的6.76（SD = 1.93）。在感知严重性、感知益处和感知自我效能得分与参与者教育程度之间观察到正相关。经济稳定性较低与感知自我效能、感知严重性和感知益处得分较低相关。成年黑人购买助听器的意愿受其感知益处、感知严重性和感知自我效能得分的严重影响，得分较低与不愿意购买设备相关。种族主义/歧视的高频率和经济困难与获得听力保健的感知障碍得分增加相关。此外，自我报告有听力困难的参与者和没有听力问题的参与者之间的听力健康信念仅在感知易感性子量表上存在差异，有听力困难的人在该子量表上得分更高；未发现其他差异。
结合健康的社会决定因素使用的健康信念模型揭示了成年黑人所持听力健康信念中的关联和差异。本研究揭示了该群体内部的异质性，并指出了因对听力保健的负面看法而未治疗听力损失风险较高的个体。这些信念受人口统计学和健康的社会决定因素影响，突出了亟待干预的领域。
