HD560 Unit 5 Measurement Plan Example

Each Measure Earns Its Place: A Unit 5 Measurement Plan for Evaluating Free Hearing Aids Among English and Spanish Speakers

[Student Name]

Purdue University Global

HD560: Health Education Evaluation and Research

Unit 5 Measurement Plan

[Instructor Name]

[Date]

Within Earshot, Tamsen County and the procedures described are composite; the instruments and adaptation studies cited are real.

Principles

Every measure answers an evaluation question. Every measure is collected by someone other than the people who deliver the program, which fixes a problem in last year's report, where the audiologist asked the final question. And every self-report measure is given in the same way at both time points: by phone, by a trained assessor, in the participant's preferred language.

Measure 1: Loneliness

Instrument: the three-item loneliness scale developed from the longer UCLA scale for use in large surveys, with each item answered hardly ever, some of the time or often, for a total of 3 to 9 (Hughes et al., 2004).

Why it fits. It was developed and tested with older adults in the United States, administered by telephone, and showed good reliability and agreement with the longer scale. Its brevity matters for older adults with hearing loss, for whom a long phone interview is tiring.

What must be checked. Phone administration to people with hearing loss is a real concern; mishearing a question could change an answer. Assessors will speak slowly, confirm each answer and, for participants who request it, read items while the participant follows a large-print card mailed in advance. Spanish administration uses a translation already used in national surveys of older adults, and five Spanish-speaking applicants will be asked to explain each item in their own words before baseline.

Measure 2: Hearing Handicap

Instrument: HHIE-S, a ten-item screen of the emotional and social effects of hearing loss, scored 0 to 40 (Ventry & Weinstein, 1983).

Why it fits. It measures the everyday difficulty the program aims to reduce, it is widely used in audiology and it is short. A Spanish adaptation was developed and tested with older Mexican Americans (Lichtenstein & Hazuda, 1998), a close match for most of the county's Spanish-speaking applicants.

What must be checked. Because participants know whether they received aids, their answers may reflect expectation as well as change. This measure is therefore paired with an objective one.

Measure 3: Hours of Use

Source: the data logging built into the fitted hearing aids, which records average hours of daily use. Downloaded at the one-, three- and six-month visits.

Why it fits. It is objective and requires no recall. It shows whether people actually wear the aids, which matters for interpreting any effect.

Limits. It exists only for the group offered the program, so it cannot compare groups. It records whether aids are switched on, not whether they are worn in conversation.

A measure belongs in the plan only if it answers one of the evaluation questions and can be collected the same way for everyone it applies to, and each of these four is kept or limited by that rule.

Measure 4: Measured Hearing

Source: a pure-tone average from the audiology clinic's hearing test, done for eligibility before the lottery. Used as a baseline characteristic to check balance between groups and to describe the sample. Not repeated, since the program does not aim to change hearing thresholds.

Other Data

At six months both groups are asked whether they obtained hearing aids anywhere else, to measure contamination. For participants offered the program, the clinic records visits attended and drop-in hours, to describe how much contact each person had.

Measures Considered and Rejected

Three other measures were considered. A longer twenty-item loneliness scale would be more reliable but would double the interview time for people who find phone calls tiring. A depression screen was considered because loneliness and depression overlap, but the program does not claim to treat depression, and adding a mental health screen would require a referral protocol the agency cannot staff. A measure of social network size was considered and dropped because it would add questions without answering any of the three evaluation questions.

Burden on Participants

Each phone assessment takes about fifteen minutes. Participants can stop at any point, and assessors offer to call back if a participant tires or has trouble hearing. Large-print answer cards are mailed in advance. These steps protect both participants and the quality of the data, since a tired or confused respondent gives less reliable answers.

Quality Checks During Collection

Assessors record any call where the participant appeared to mishear a question, and the evaluator reviews those calls each month, repeating any assessment where an answer was clearly misheard.

Schedule

Baseline: within two weeks before the lottery. Six months: within two weeks of the six-month date. Hours of use: at one, three and six months for those offered the program.

Assessor Training

Two bilingual assessors complete a half-day training on administering both scales by phone to people with hearing loss, and each completes three practice calls observed by the evaluator before data collection begins.

References

Hughes, M. E., Waite, L. J., Hawkley, L. C., & Cacioppo, J. T. (2004). A short scale for measuring loneliness in large surveys: Results from two population-based studies. Research on Aging, 26(6), 655-672. https://doi.org/10.1177/0164027504268574

Lichtenstein, M. J., & Hazuda, H. P. (1998). Cross-cultural adaptation of the Hearing Handicap Inventory for the Elderly-Screening Version (HHIE-S) for use with Spanish-speaking Mexican Americans. Journal of the American Geriatrics Society, 46(4), 492-498. https://doi.org/10.1111/j.1532-5415.1998.tb02473.x

Ventry, I. M., & Weinstein, B. E. (1983). Identification of elderly people with hearing problems. ASHA, 25(7), 37-42.