Abstract: Introduction: Help-seeking behaviors for chronic conditions such as hearing loss are complex. A screening test may provide individuals with a means to indicate the presence of a hearing loss but may be insufficient to motivate transition toward action (help-seeking). An individual’s motivation at the time of the screening may influence actions taken. More evidence on the stages of change as applied to hearing loss is required to understand the patient journey toward rehabilitation in order to provide appropriate person-centered intervention. Method: This study investigated user characteristics, help-seeking behavior, and follow-up actions of people who failed an app-based digits-in-noise hearing screening test. Test and user characteristics of 3,092 listeners who failed the test were retrospectively analyzed. A posttest survey to determine follow-up actions was sent to listeners who failed the test (n = 1,007), of whom only 59 responded. Results: Most listeners were in the precontemplation stage (75.5%). Age and stage of change were significant (p < .05) predictors of poorer digits-in-noise speech recognition threshold (DIN SRT). Listeners in the precontemplation stage were significantly younger than in other stages (p < .05) with poor DIN SRT scores obtained for older participants who were in a more advanced state of change. Posttest survey response rate was low (5.9%). Of those who responded, most (82.4%) did not think they had a hearing loss. Only 13.6% followed up with an audiology appointment. Conclusion: Older individuals presented with poorer DIN SRTs and were typically in a more advanced stage of change. The majority of those who did not follow up after failing the screening test did not believe they had a hearing loss. A combination of factors, including poor DIN SRT, older age, and a more advanced stage of change were positively associated with participant follow-up audiological care.
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