Evaluation of benefits from motivational engagement in first-time hearing aid users

Chief investigator

Dr Melanie Ferguson

Study team

Dr David Maidment

William Brassington (Nottingham University Hospitals NHS Trust)
Naomi Russell (Nottingham University Hospitals NHS Trust)
Emily Balmer (Nottingham University Hospitals NHS Trust)
Zoe Slinger (Nottingham University Hospitals NHS Trust)
Joanne Sisson (Nottingham University Hospitals NHS Trust)
Anna Lindstrad (Nottingham University Hospitals NHS Trust)
Melanie Gregory (The Ida Institute)
Albert Wood (Patient and public involvement representative)
Pat Batchelor (Patient and public involvement representative)


Nottingham Hospitals Charity and Nottingham University Hospitals NHS Trust
Department of Research and Development Pump Priming (part funding)

Study period



Background and rationale

Despite recent advances in digital technology, it has become increasingly apparent that current strategies for hearing aid fitting do not provide the optimum intervention for people with hearing loss. Success with hearing aids can be improved by adopting person-centred, non-technological strategies. This research directly engaged practising audiologists and patients, examining whether motivational engagement strategies might improve hearing-aid benefit and usage in first-time hearing-aid users. Motivational engagement involves the person more actively in managing their own care. The benefits of motivational engagement have been recognised for many years in other disciplines, for instance smoking cessation, alcohol addiction and drug rehabilitation programmes.

This study is particularly ground-breaking because as yet, there has been no research on the efficacy of motivational engagement within NHS audiology practice, or on the motivational tools that have been designed by the Ida Institute specifically for this purpose. See the Ida Institute website for more information about their motivational tools.


Across the UK, the Ida Institute motivational tools are not yet widely adopted into clinical practice. A feasibility stage has so far identified how these might be implemented in a busy clinical appointment and what might be the clinical benefits to doing so. Please view our award-winning poster that gives practical advice on how to use tools in the clinic.

In conjuction with the Ida institute and Nottingham Audiology Services we have produced a 30-minute documentary which will be used to train audiologists how best to use the tools and implement them into routine practice.

© Ida Institute

Subsequent work then evaluated the effectiveness of the Ida Institute motivational tools in hearing-aid users in a cluster randomised controlled design with an intervention arm and a control, standard-care only arm. The Ida Institute’s Motivational Tools formed the basis for the motivational engagement intervention. 


The group that received motivational engagement showed greater self-efficacy, reduced anxiety, and greater engagement with the audiologist at assessment and fitting appointments. However, there were no significant between-group differences 10-weeks post-fitting.

For the motivational engagement intervention group, greater difficulties in communication predicted greater anxiety at the 10-week follow-up appointment, and greater social isolation predicted more depression. For the standard care group, readiness to address hearing difficulties predicted outcomes such as hearing aid use, benefit and satisfaction.

Future research should consider using qualitative methods to explore the longer-term benefits of motivational engagement in hearing aid users.