The Hearing Aid Effect Revisited: Cultural Differences Lance A' Nelson, Robert E' Novak, Lata A' Kri

1
The Hearing Aid Effect Revisited Cultural
Differences Lance A. Nelson, Robert E. Novak,
Lata A. Krishnan Department of Speech, Language
and Hearing Sciences, Purdue University
Introduction
Preliminary Results
Discussion
Results shown are mean ratings of the observers
for each model and ear worn device condition.
(e.g. CH Caucasian observer and Hispanic model,
HC Hispanic observer and Caucasian model, etc.)
Hispanics make up 14.8 of the total population
in the United States, 44.3 million people (Census
Bureau, 2005). The prevalence of hearing loss
among this population is estimated between 10
and 23. Of those that have a hearing loss of 40
dB HL or greater, only 12 use hearing aids
(Kennedy Deapen, 1991, Lee et. al
1991). According to Sergio Kochkin, in 2004 of
the 32.5 million people who had a hearing loss
only 23.5 had adopted the use of amplification.
There is a significant difference in the use of
hearing aids between the Hispanic population and
that of the national average a difference of
11.5. There are many different reasons that
contribute to the lack of adoption of hearing
aids among minorities in general. Such reasons
are cost (Franks, 1985), insurance (Lee et. al.,
1996) and low consumer awareness (Kennendy
Deapen, 1991). In 1977, Blood and colleagues
found the lack of hearing aid use was due to
cosmetic and perceived negative stigma. This was
defined as the hearing aid effect. There has
been extensive work looking at the hearing aid
effect in various populations. However, there
is relatively little empirical evidence of the
cultural stigmas that may exist between and
within the Hispanic population using different
ear worn devices which may be contributing
factors to the low adoption rate of hearing aid
use among the Hispanic population. The purpose of
this study was to examine how Hispanics
(primarily Mexican-American and South American),
as compared with Caucasians, judge members of
their own race and of a different race wearing
and not wearing different styles of ear worn
devices on the basis of appearance, personality,
assertiveness, and achievement.
Graphs shown are preliminary results
demonstrating interesting trends.

• Between subjects, Caucasians were routinely rated
  higher in all 4 domains.
• Between ear worn device style, with exception to
  the Bluetooth condition, the Hispanic models were
  routinely rated more negatively than their
  Caucasian counterpart (by both Caucasian and
  Hispanic raters).
• The Bluetooth condition reveals in the
  Assertiveness and Achievement Domains the
  Hispanic models were routinely rated more
  positively, regardless of observer, compared to
  all other ear worn device conditions. The
  assessment of more positive character in the
  Domains of Assertiveness and Achievement can
  potentially be attributed to the use/adoption of
  new technology, otherwise known as the
  Technology Halo Effect. Perhaps the use of the
  Bluetooth by the Hispanic model lessens the
  negative self-image among Hispanics due to the
  Technology Halo Effect.
• The Hispanic observers rated the Hispanic models
  more negatively in all ear worn device styles and
  in all 4 domains compared to the ratings by
  Caucasian observers. This suggests a more
  general culturally/racially mitigated self-image
  among the Hispanic sample.

Domain II
Domain I
Range maximum possible -3 to 3
Range maximum possible -3 to 3
Domain IV
Domain III
Taking a closer look, the differences in observer
ratings between the most visible, FS-ITE, ear
worn device condition and the None ear worn
device condition show the following trends
Range maximum possible -3 to 3
Range maximum possible -3 to 3

• The Caucasian observers rated the Hispanic models
  more negatively in the FS-ITE condition as
  compared to the None condition. Whereas, the
  Hispanic observers showed more positive judgments
  for Hispanic models in the FS-ITE condition.
• The Hispanic observers varied greatly regarding
  their ratings as compared to the Caucasian
  observers in all 4 domains.

These pilot participants were not prompted to
look for models wearing and/or not wearing an ear
worn device. According to findings by Johnson
et. al., we would expect the OF condition and the
None condition to demonstrate comparable
results, however, preliminary results of this
investigation demonstrate no similar consistency
between these ear worn device conditions.
Although Caucasians models, rated by both
Caucasians and Hispanics, were rated more
positively in the Domains of Personality,
Assertiveness, and Achievement the ratings of
Hispanic models, by both Caucasian and Hispanic
raters, are not consistently in the same
direction. There is a more negative perception
of the Hispanic models regardless of the type of
ear worn device or race of the observer
(Caucasian or Hispanic). Future direction of the
study would be
Methods
Subjects 24 adult subjects. 11 Caucasian (6
Females, 5 Males) and 13 Hispanic (7 Females, 6
Males) with normal hearing and vision
participated in the study. Stimuli 11
Photographs 1 Practice photograph 5 Caucasian
photographs Consisted of 5 conditions (1)
No hearing aid (None), (2) Behind-The-Ear (BTE),
(3) Open-Fit (OF), (4) Full Shell In-The-Ear
(FS-ITE), (5) Bluetooth device. 5 Hispanic
photographs Consisted of 5 conditions (1) No
hearing aid (None), (2) Behind-The-Ear (BTE), (3)
Open-Fit (OF), (4) Full Shell In-The-Ear
(FS-ITE), (5) Bluetooth device. Procedure Partici
pants were randomly presented with 11
counterbalanced photographs. Participants rated
each photograph using the Semantic Differential
Scale in four dimensions I. Appearance II.
Personality III. Assertiveness
IV. Achievement Hispanic participants were
instructed and completed the scale in Spanish.
Domain I
Domain II
- Caucasians rated the Hispanic FS-ITE group more
negatively (-0.41) compared to the Hispanic None
group (0.13). - Preliminary trends reflect no
difference in judgment by Hispanic observers for
either group under the two conditions.
- Caucasians rated the Hispanic and Caucasian
FS-ITE group more negatively compared to the None
group respectively. - Hispanic observers rated
the Caucasian FS-ITE group (0.79) less compared
to the Caucasian None group (1.10).

• Add to the instructions given to the observers
  that the models they will be looking at may or
  may not be wearing an ear worn device and to look
  for this before making their judgments regarding
  appearance, personality, assertiveness, and
  achievement.
• Further research the impact of the Technology
  Halo Effect in mitigating cultural bias.
• Examining greater specificity among subjects of
  their Hispanic cultural ID (e.g.
  Mexican-American, Cuban-American, etc.)

Acknowledgements
Domain III
Domain IV
We extend our thanks to Siemens Hearing
Instruments, Westone, and Wal-Mart for their
generous donations. We would also like to thank
Aida Muñoz and the Latino Coalition of Tippecanoe
County for their contribution.
- No significant trend regarding judgment between
conditions for the Hispanic observers. -
Caucasian observers rated the FS-ITE models, both
Caucasian and Hispanic, more negatively than the
None models.
- Caucasians rated the Hispanic FS-ITE group more
negatively (-0.16) compared to the Hispanic None
group (0.31). - Hispanic observers rated the
FS-ITE models, both Caucasian and Hispanic, more
positively than the None models.
Stimuli Samples
References
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(2005). The hearing aid effect 2005 A
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