The development, implementation and evaluation of the Walk, Talk and Listen over Zoom program for hearing-impaired older adults.

In Phase 1 of this study, the Research Assistant will conduct face-to-face audio-recorded semi-structured interviews with older adults with hearing loss. Participants will primarily recruited from Macquarie University's MQ Speech and Hearing clinic, however other sources of recruitment include flyers posted around the Australian Hearing Hub (Macquarie University), word-of-mouth, and advertisement of the study on the Macquarie University Hearing website and email network. Interviews can be conducted over-the-phone if preferred. Interviews are expected to last 20-30 minutes and explore the barriers and facilitators to participating in WTL-Zoom. Upon completion of Phase 1, findings from the interviews will be used to inform the adaptation of the WTL-Zoom from the existing WTL program. Once WTL-Zoom has been adapted, participants for Phase 2 will be recruited from the same recruitment sources as Phase 1. The anticipated time between the Phase 2 start date relative to Phase 1 is 2 months. Participants from Phase 1 will also be invited to participate in Phase 2 and if interested, will be provided the Participant Information and Consent Form. Written consent is required before enrolment into Phase 2. A draft form of WTL-Zoom program delivered in Phase 2 will involve the following: Participants will be divided into subgroups based on their preference of available sessions (morning/afternoon). The WTL-Zoom program will be delivered via Zoom. The Research Assistant will contact participants at least 24 hours before their scheduled session with a Zoom link and any other relevant material e.g., activity material that has been specifically designed for this study. The Research Assistant’s phone number will also be provided in case any participant has difficulty accessing Zoom. Sessions will run for up to 60-minutes once/week over ten-weeks in groups of up to 10 participants. Sessions will include informal socialisation, and physical activity with social interaction (PASI) or group auditory rehabilitation (GAR) on alternate weeks. WTL-Zoom will include five PASI sessions that are designed to improve strength, coordination, and balance. The exercises will not require any equipment other than a chair and will be facilitated by the Research Assistant (with an exercise-related qualification) and a research student who will be enrolled in a medical/allied health degree. Each physical activity session will include mindful breathing, warm-up exercises (e.g. stretching and bodyweight strengthening exercises), moderate-to-vigorous intensity shadow boxing, and cool down exercises (e.g. bodyweight strengthening, balance exercises). Exercise intensity will be assessed using the Borg Rating of Perceived Exertion scale. WTL-Zoom will include five GAR sessions that are based on the Ida Institute’s GROUP (Group Rehabilitation Online Utility Pack) program (https://idainstitute.com/tools/group_ar/group_ar_session_plans/). The proposed GAR sessions as part of WTL-Zoom will run for approximately 30-45 minutes and include: 1) GAR overview, communication of shared experiences, and goal setting using the Client Oriented Scale of Improvement (COSI) questionnaire 2); 2) education on understanding hearing loss and impacts on communication; 3) communication strategies: conversational fluency and assertiveness; 4) stress management and personal adjustment; and 5) communication programs and consumer support organisations, review of goals from session 1. A few minutes at the start sessions 2-5 will review the content covered in the previous session.