Investigating the implementation of an online Hearing Wellbeing Program on wellbeing in adults with hearing conditions - co-design development and feasibility study.

The existing Hearing Wellbeing Program (HWP) is an intervention that addresses the psychosocial and emotional needs of adults with hearing loss. It comprises 10 self-guided wellbeing modules, currently available only in hard copy (further information provided below). The first phase of the research will adapt the existing HWP to be self-paced and online, using co-design methods with adults with lived experience of hearing loss, audiologists, psychologists, educationalists, and digital technology experts. Co-design participants will first attend an online workshop for a duration of approximately 2-3 hours to formulate a plan and structure for the online version of the HWP. Following this development, a prototype of the online HWP will be created. Approximately three months later, participants will attend another online workshop for a duration of approximately 1-2 hours to test the prototype of the online HWP and provide feedback for further changes. Iterative versions of the HWP will then be asynchronously tested by co-design participants. An email link to the updated HWP will be provided for each iteration and feedback will be requested via return email. The online HWP will be deemed ready to be piloted in the feasibility study when there are no more significant issues or changes required. Participants will then be recruited for the feasibility study. Once a participant registers for the online program, they will be prompted to complete a brief questionnaire that enables the content of the program to be tailored to the individual. Where a person indicates that they may be impacted within an area of psychosocial concern, the appropriate module is suggested. The HWP comprises 10 self-guided wellbeing modules: 1. Acceptance and hearing loss 2. Anxiety and hearing loss 3. Confidence, self-efficacy and hearing loss 4. Grief and hearing loss 5. Identity and hearing loss 6. Loneliness and hearing loss 7. Low mood and hearing loss 8. Relationships 9. Respectful communication and hearing loss 10. Stigma and hearing loss Each module offers psychologically based information about the topic, followed by information about how this may relate to them as a person with a hearing condition. The modules use lay language and aim to validate the persons emotional and psychosocial experiences. This is enhanced via the inclusion of lived experience quotes and stories related to the topic. Every module concludes with three or more psychologically based strategies and participants can choose the ones that feel most suitable for them. Each strategy is introduced and explained followed by an applied exercise or activity, as applicable. The program also indicates where support of a psychologist may be required. It is anticipated that the content will be delivered via a combination of written text, infographics, captioned short videos, and interactive components. It is anticipated that each module will take a minimum of 30 minutes to complete however this will vary depending upon the strategies and activities selected by each individual (with many strategies suitable for use on multiple occasions). The program is completed securely online, and the participant can complete the program at a time and place of their choice, over a three month trial period. Learning Management System and web-based analytics will be used to monitor adherence and usage data. A sub-set of participants will be invited to a semi-structured interview to explore usability, understandability, ease of use, burden, recommendation, and willingness to pay. The participants invited to the interview will be purposively sampled based on engagement with the program and demographic variables to obtain a wide range of perspectives. Online interviews will be conducted within 1-2 months of trial completion.