The problem addressed in this study is the need for efficient and economic methods to train naive college students to operate microcomputers as a necessary step in their acquisition of computer proficiency. Two methods of training were compared. These were training by live demonstration and training by videotape. These methods were considered economically viable because each could be presented in a classroom and neither required a one-to-one student-to-computer or student-to-tutor ratio. Four sections of an introductory computer science class were used in the study. Two classes were presented each treatment. The effectiveness of the presentations was measured by means of a written quiz administered immediately after the presentation and by the number of microcomputer system operation tasks successfully completed during an individual laboratory session. The computer anxiety level of each participant was measured prior to the presentation to determine if anxiety was a factor in finding the best training method. When scores of naive users who saw the videotape were compared with the scores of naive users who saw the live demonstration, no significant differences were found. However, when novice users (those who had some previous experience with operating or programming a microcomputer) were included, the group that saw the videotape scored significantly higher on the written quiz than the group that saw the live demonstration. A two by two analysis of variance showed no significant interactions between anxiety and treatment. User satisfaction was found to be significantly higher for the videotape group than for the live demonstration group. This study concluded with the recommendation that the Computer Science Department of North Texas State University utilize videotapes to train students in introductory classes to use a microcomputer system. This recommendation was based on the superior test results for naive and novice users who saw the videotape, the user satisfaction scores and inherent advantages of videotapes over live demonstrations.

Hearing loss is considered a global health concern with 466 million people affected worldwide. Current hearing health care delivery models are based on several consecutive face-to-face consultations that occur in-person. Information and communications technology, and especially mobile technology, can be used to support or enhance health care delivery. This can be employed in addition, or as an alternative to, current patient treatment pathways. This project developed a hybrid hearing health care approach by combining online and face-to-face services. The services were offered using a five-step approach: (1) online hearing screening, (2) motivational engagement by voice/video calling, messaging, or emailing, (3) diagnostic hearing testing in a face-to-face appointment, (4) counseling, hearing aid trial and fitting using face-to-face and online methods, and (5) online aural rehabilitation, counseling and ongoing coaching using face-to-face and online methods. Three studies were conducted. Study I investigated the readiness, characteristics and behaviors of patients who sought hybrid hearing health care. Over three months (June–September 2017), 462 individuals completed the online hearing screening test: 59% (271/462) of those failed (age M = 60; SD = 12), indicating that further assessment and treatment might be required. These patients had been aware of their hearing loss for a period of between 5 to 16 years. A significant positive correlation was observed between age and speech reception threshold (r = 0.21; p < .001), where older participants presented with poorer scores. Five participants completed readiness measurement scales and attended a face-to-face diagnostic hearing evaluation during this time. Study II investigated patient uptake, experience and satisfaction with hybrid hearing health care using a process evaluation. The process evaluation study was conducted over a three-month period for patients who sought services from the clinic over a period of 19 months (June 2017–January 2019). A total of 46 patients seen at the clinic were invited to complete an online questionnaire regarding their experiences and satisfaction with the steps completed and services provided. Of those, 31 (67%) patients responded (age M = 66; SD = 16). Of the 61% of patients who had previously sought hearing services, 95% reported the hybrid clinic services as superior. Two main themes emerged from the patient’s comparison of their experience with the hybrid clinic versus previous experiences: clinician engagement (personal attention, patience, dedication, thorough explanations, professional behavior, exceeding expectations, friendliness and trust) and technology (latest technology, advanced equipment and hearing aid trial). Patients who completed all five steps, including acquiring hearing aids and taking part in an online aural rehabilitation program (continued with hearing health care), were significantly older and had significantly poorer speech reception thresholds compared to those who did not acquire hearing aids after the diagnostic hearing test and hearing aid trial (discontinued hearing health care). A significant positive correlation was found between age and the number of face-to-face appointments attended per patient (r = 0.37; p = .007). Study III investigated whether digital proficiency (proficiency with mobile devices and computers) was a predictor of the uptake of hybrid hearing health care. A total of 931 individuals failed the online hearing screening test and had submitted their details to the clinic for further care over a 24-month period (June 2017–June 2019). Of the 931 online test takers, 53 persons (age M = 64; SD = 15) who attended a face-to-face diagnostic hearing testing completed a mobile device and computer proficiency questionnaire. An exact regression model identified age as the factor associated with patients completing all five steps, including acquiring hearing aids and taking part in an online aural rehabilitation program (continued with hearing health care) from a hybrid model (β = .07; p = .018). Older patients were more likely to continue to seek hearing health care. Digital proficiency was not significantly associated with adults with hearing loss taking up services through a hybrid hearing health care model. The results from these three studies demonstrate that asynchronous internet-based services such as an online hearing screening test can be used to create awareness of hearing health care. It is possible to provide online support to patients during the initial stages of seeking hearing health care online prior to the first face-to-face visit. Patient uptake, satisfaction and experience of using hybrid hearing health care services are positive when compared to traditional methods of service delivery. Hearing health care models that combine face-to-face and online methods hold promise for audiologists willing to incorporate online modalities into current treatment pathways. This research project highlights the opportunity for audiologists to provide services and personalized support to patients using a combination of face-to-face and online modalities. / Thesis (PhD)--University of Pretoria, 2020. / This work was supported by the National Research Foundation (NRF) of South Africa under the grant number 107728. / Speech-Language Pathology and Audiology / PhD (Audiology) / Unrestricted

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