Over-the-Counter (OTC) Self-fitting Hearing Aid Survey

We invite you to take part in a research study. Please take as much time as you need to read the consent form. If you find the language difficult to understand, please ask questions. If you decide to participate, you will be asked to sign this form.

TITLE OF THE STUDY: Perception of OTCs and Self-Fitting Hearing Aids

NAME OF THE RESEARCHER: Dr. Anusha Yellamsetty Ph.D., Department of Audiology, San Jose State University

PURPOSE: We are interested in gathering your opinions and perspectives on Over-the-Counter (OTC) and self-fitting hearing aids. Your responses will help us better understand the perceptions and preferences of potential users. Thank you for participating in our survey.

PROCEDURES: Thank you for participating in our survey. This survey covers questions regarding the perception of self-fitting hearing aids, covering aspects such as awareness, orientation toward self-fitting, usability, satisfaction, assistance, features and functionalities of OTC hearing aids, service barriers, and the impact of OTC hearing aids.

CONFIDENTIALITY: The research team, which includes PI and co investigators of San Jose State University, will have access to the study data. No information that could result in identification of participants will be disclosed in the research findings/publications. The study’s principal investigator is a mandated reporter for pediatric populations, meaning that we would be unable to maintain participant confidentiality in situations where child abuse is suspected. This study will follow strict HIPAA guidelines no identifiable data will be shared with anyone outside the research team at SJSU.

PARTICIPANT RIGHTS: Your participation in this study is completely voluntary. You can refuse to participate in the entire study or any part of the study without any negative effect on your relations with San Jose State University. You also have the right to skip any question you do not wish to answer. This consent form is not a contract. It is a written explanation of what will happen during the study if you decide to participate. You will not waive any rights if you choose not to participate, and there is no penalty for stopping your participation in the study.

QUESTIONS OR PROBLEMS? You are encouraged to ask questions at any time during this study.
● For further information about the study, please contact Anusha Yellamsetty at anusha.yellamsetty@sjsu.edu or at 408-924-8686
● Complaints about the research may be presented to Wendy Quach at wendy.quach@sjsu.edu
● For questions about participants’ rights or if you feel you have been harmed in any way by your participation in this study, please contact Dr. Jessica Trask, Interim Associate Vice President of Research, San Jose State University, at 408-924-2479 or jessica.trask@sjsu.edu or irb@sjsu.edu

To take this survey, you must:
● Be at least 18 years old
● Ability to use a laptop/desktop computer to complete an online survey
● Fit in one of the following categories:

a) Clinicians: Licensed audiologists, certified hearing healthcare professionals or clinicians in related fields.

b) Hearing Aid Manufacturers: Established and reputable entities with expertise in current hearing healthcare trends.

c) Hearing Aid Users: Individuals that have current or prior experience using hearing aids.

d) Researchers/Scientists: Possess some experience in self-fitting hearing aids or working with hearing aid technology.

e) General Public: Individuals with personal or related experience with hearing loss or other members of the community.

f) Other: Have a relationship with self-fitting hearing aids that does not fit in any of the above categories.

Consent Form