What do hip-huggers, HEMI engines, and behind-the-ear (BTE) hearing aids have in common? Not a whole lot except that all three were trendy in the 1960s and 1970s, then fell into decline, and now, in the new millennium, are selling like those proverbial hotcakes! They have also all come back in somewhat different forms. Chrysler's new HEMI engine, introduced in 2002, is a little smaller than that of yesteryear. The old hip-huggers have been reincarnated as “low-rise jeans.” And the BTE's return to dominance of the hearing aid market has been fueled by the appearance of smaller instruments with open-canal (OC) fittings, beginning in 2003 with the GN ReSound Air®. Today, every manufacturer offers smaller BTEs, mostly fitted with an open canal, and often categorized under new names, such as post-auricular-canal, over-the-ear, and mini- and micro-BTEs. This new breed of products is also showing up in an amazing range of shapes and colors, as that old industry dream of stylish hearing aids is finally coming true. The Hearing Industries Association (HIA), the main source of U.S. market sales data, recently reported that 51.45% of all hearing aids sold in 2007 were of some BTE style. However, it remains uncertain how much of the boom in BTE sales has resulted from smaller open-fit BTE hearing aids, herein referred to as OC mini-BTEs. To find out the extent of the OC mini-BTE boom—and also what dispensers and their patients think of this product type—the 2008 Hearing Journal/AudiologyOnline (HJ/AO) survey included a special section of 10 questions for audiologists, hearing instrument specialists, and other hearing professionals about their experiences with and opinions on these devices. The survey also included questions on many other topics, which will be reported on next month. But this Cover Story focuses on what our survey learned about OC mini-BTEs—their popularity and their perceived benefits and drawbacks. First though, here's a quick look at how the survey was conducted and who took part.

Background: Several self-report measures exist that target different aspects of outcomes for hearing aid use. Currently, no comprehensive questionnaire specifically assesses factors that may be important for differentiating outcomes pertaining to hearing aid style. Purpose: The goal of this work was to develop the Style Preference Survey (SPS), a questionnaire aimed at outcomes associated with hearing aid style differences. Two experiments were conducted. After initial item development, Experiment 1 was conducted to refine the items and to determine its psychometric properties. Experiment 2 was designed to cross-validate the findings from the initial experiment. Research Design: An observational design was used in both experiments. Study Sample: Participants who wore traditional, custom-fitted (TC) or open-canal (OC) style hearing aids from 3 mo to 3 yr completed the initial experiment. One-hundred and eighty-four binaural hearing aid users (120 of whom wore TC hearing aids and 64 of whom wore OC hearing aids) participated. A new sample of TC and OC users (n 5 185) participated in the cross-validation experiment. Data Collection and Analysis: Currently available self-report measures were reviewed to identify items that might differentiate between hearing aid styles, particularly preference for OC versus TC hearing aid styles. A total of 15 items were selected and modified from available self-report measures. An additional 55 items were developed through consensus of six audiologists for the initial version of the SPS. In the first experiment, the initial SPS version was mailed to 550 veterans who met the inclusion criteria. A total of 184 completed the SPS. Approximately three weeks later, a subset of participants (n 5 83) completed the SPS a second time. Basic analyses were conducted to evaluate the psychometric properties of the SPS including subscale structure, internal consistency, test-retest reliability, and responsiveness. Based on the results of Experiment 1, the SPS was revised. A cross-validation experiment was then conducted using the revised version of the SPS to confirm the subscale structure, internal consistency, and responsiveness of the questionnaire in a new sample of participants Results: The final factor analysis led to the ultimate version of the SPS, which had a total of 35 items encompassing five subscales: (1) Feedback, (2) Occlusion/Own Voice Effects, (3) Localization, (4) Fit, Comfort, and Cosmetics, and (5) Ease of Use. The internal consistency of the total SPS (Cronbach'sa5 .92) and of the subscales (each Cronbach'sa..75) was high. Intraclass correlations (ICCs) showed that the test-retest reliability of the total SPS (ICC5.93) and of the subscales (each ICC..80) also was high. TC hearing aid users had significantly poorer outcomes than OC hearing aid users on 4 of the 5 subscales, suggesting that the SPS largely is responsive to factors related to style-specific differences. Conclusions: The results suggest that the SPS has good psychometric properties and is a valid and reliable measure of outcomes related to style-specific, hearing aid preference.

Background: Several self-report measures exist that target different aspects of outcomes for hearing aid use. Currently, no comprehensive questionnaire specifically assesses factors that may be important for differentiating outcomes pertaining to hearing aid style. Purpose: The goal of this work was to develop the Style Preference Survey (SPS), a questionnaire aimed at outcomes associated with hearing aid style differences. Two experiments were conducted. After initial item development, Experiment 1 was conducted to refine the items and to determine its psychometric properties. Experiment 2 was designed to cross-validate the findings from the initial experiment. Research Design: An observational design was used in both experiments. Study Sample: Participants who wore traditional, custom-fitted (TC) or open-canal (OC) style hearing aids from 3 mo to 3 yr completed the initial experiment. One-hundred and eighty-four binaural hearing aid users (120 of whom wore TC hearing aids and 64 of whom wore OC hearing aids) participated. A new sample of TC and OC users (n 5 185) participated in the cross-validation experiment. Data Collection and Analysis: Currently available self-report measures were reviewed to identify items that might differentiate between hearing aid styles, particularly preference for OC versus TC hearing aid styles. A total of 15 items were selected and modified from available self-report measures. An additional 55 items were developed through consensus of six audiologists for the initial version of the SPS. In the first experiment, the initial SPS version was mailed to 550 veterans who met the inclusion criteria. A total of 184 completed the SPS. Approximately three weeks later, a subset of participants (n 5 83) completed the SPS a second time. Basic analyses were conducted to evaluate the psychometric properties of the SPS including subscale structure, internal consistency, test-retest reliability, and responsiveness. Based on the results of Experiment 1, the SPS was revised. A cross-validation experiment was then conducted using the revised version of the SPS to confirm the subscale structure, internal consistency, and responsiveness of the questionnaire in a new sample of participants Results: The final factor analysis led to the ultimate version of the SPS, which had a total of 35 items encompassing five subscales: (1) Feedback, (2) Occlusion/Own Voice Effects, (3) Localization, (4) Fit, Comfort, and Cosmetics, and (5) Ease of Use. The internal consistency of the total SPS (Cronbach'sa5 .92) and of the subscales (each Cronbach'sa..75) was high. Intraclass correlations (ICCs) showed that the test-retest reliability of the total SPS (ICC5.93) and of the subscales (each ICC..80) also was high. TC hearing aid users had significantly poorer outcomes than OC hearing aid users on 4 of the 5 subscales, suggesting that the SPS largely is responsive to factors related to style-specific differences. Conclusions: The results suggest that the SPS has good psychometric properties and is a valid and reliable measure of outcomes related to style-specific, hearing aid preference.