scholarly journals The development and process evaluation of the ACTION study: A person-centred communication intervention targeting nurse assistants in home care for older persons

2019 ◽  
Author(s):  
Tanja Gustafsson ◽  
Annelie J Sundler ◽  
Elisabeth Lindberg ◽  
Pernilla Karlsson ◽  
Hanna Maurin Söderholm
Keyword(s):  
Health Care ◽  
Home Care ◽  
Process Evaluation ◽  
Educational Intervention ◽  
Older Persons ◽  
Complex Interventions ◽  
Implementation Process ◽  
Ageing Population ◽  
Web Based ◽  
The Web

Abstract Background A rapidly ageing population challenges the health care system in general and home care services in particular. Communication is a cornerstone of person-centred care. However, little research has been conducted on how to improve communication between health care professionals and older persons in home care contexts, despite research showing the importance of such interactions. The increasing demands on how to best and efficiently improve competence in health professionals is the reason why the ACTION intervention was conducted. This paper aims to describe the development and process evaluation of an educational intervention for nurse assistants (NAs) in home care and highlights the potential of self-directed web-based learning as well as the pitfalls of conducting complex interventions in home care. Methods A web-based educational intervention focusing on person-centred communication was developed that targeted NAs in home care for older persons. Twenty-seven NAs from two units in Sweden were recruited, and 23 NAs were offered the educational intervention. Data were collected from multiple sources before, during and after the intervention and were analysed using quantitative and qualitative methods. Data were extracted from the web platform and analysed to determine the NAs´ engagement in the intervention. Additionally, interviews, evaluation forms and field notes were used to evaluate the feasibility of the intervention. Results The main findings suggest that web-based education seems to be an appropriate strategy in the home care context. The majority of the NAs (91%) participated in full or in part in the intervention. During the implementation process, some adaptions were required to fit the local circumstances regarding technical support, scheduling, and the design of the lectures. The NAs perceived the format to be easy to use and flexible and appreciated the stepwise modules. The content was perceived as valuable. Conclusions Our findings show that the benefits of the web-based educational intervention included the short and focused lectures as well as its accessibility. Challenges with the implementation process included gaining access to the NAs and motivating and involving the NAs. This study emphasizes the environmental support needed to successfully conduct complex interventions, including physical, organizational and cultural aspects.

scholarly journals Process evaluation of the ACTION programme: a strategy for implementing person‐centred communication in home care

BMC Nursing ◽  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Tanja Gustafsson ◽  
Annelie J Sundler ◽  
Elisabeth Lindberg ◽  
Pernilla Karlsson ◽  
Hanna Maurin Söderholm
Keyword(s):  
Home Care ◽  
Process Evaluation ◽  
Organizational Support ◽  
Qualitative Data ◽  
Education Programme ◽  
Multiple Sources ◽  
Web Based ◽  
Action Programme ◽  
Web Based Education ◽  
The Web

Abstract Background There is currently a strong emphasis on person-centred care (PCC) and communication; however, little research has been conducted on how to implement person-centred communication in home care settings. Therefore, the ACTION (A person-centred CommunicaTION) programme, which is a web-based education programme focusing on person-centred communication developed for nurse assistants (NAs) providing home care for older persons, was implemented. This paper reports on the process evaluation conducted with the aim to describe and evaluate the implementation of the ACTION programme. Methods A descriptive design with a mixed method approach was used. Twenty-seven NAs from two units in Sweden were recruited, and 23 of them were offered the educational intervention. Quantitative and qualitative data were collected from multiple sources before, during and after the implementation. Quantitative data were used to analyse demographics, attendance and participation, while qualitative data were used to evaluate experiences of the implementation and contextual factors influencing the implementation. Results The evaluation showed a high degree of NA participation in the first five education modules, and a decrease in the three remaining modules. Overall, the NAs perceived the web format to be easy to use and appreciated the flexibility and accessibility. The content was described as important. Challenges included time constraints; the heavy workload; and a lack of interaction, space and equipment to complete the programme. Conclusions The results suggest that web-based education seems to be an appropriate strategy in home care settings; however, areas for improvement were identified. Our findings show that participants appreciated the web-based learning format in terms of accessibility and flexibility, as well as the face-to-face group discussions. The critical importance of organizational support and available resources are highlighted, such as management involvement and local facilitation. In addition, the findings report on the implementation challenges specific to the dynamic home care context. Trial registration This intervention was implemented with nursing assistants, and the evaluation only involved nursing staff. Patients were not part of this study. According to the ICMJE, registration was not necessary ().

Health Risk Appraisal Using Internet Technology

2005 ◽  
Vol 44 (02) ◽  
pp. 310-314 ◽  
Author(s):  
K. Yoshida ◽  
M. Suka
Keyword(s):  
Health Care ◽  
Health Education ◽  
Health Risk ◽  
Health Examination ◽  
Lifestyle Modifications ◽  
Web Based ◽  
Risk Appraisal ◽  
Health Risk Appraisal ◽  
Individual Health ◽  
The Web

Summary Objective: To develop a Web-based Health Risk Appraisal (HRA) system as a tool for health education based on personal health examination data. Methods: A Japanese health examination database was analyzed to develop models for HRA, which were designed to predict each of ten laboratory values in a year with and without lifestyle modifications. The HRA models were embedded into a server. Results: The Web-based HRA system has been introduced into a Japanese health care association having 37 branch centers. Following a health examination, an individual health education program using the Web-based HRA system is provided to a given client at each branch center or at a client’s office. A measured laboratory value and corresponding predicted laboratory values in a year with and without lifestyle modifications are displayed on the screen in forms of both numerical values and graphs. A trained nurse or another health care provider operates the system and explains the HRA result. Conclusion: The Web-based HRA system will be a practical tool for individual health education following health examination.

A Web-Based Course on Infection Control for Physicians in Training An Educational Intervention

2006 ◽  
Vol 27 (7) ◽  
pp. 704-708 ◽  
Author(s):  
Mohamad G. Fakih ◽  
Iram Enayet ◽  
Steven Minnick ◽  
Louis D. Saravolatz
Keyword(s):  
Infection Control ◽  
Educational Intervention ◽  
Multiple Choice Questions ◽  
Information Retention ◽  
Web Based ◽  
Residency Programs ◽  
Evaluation Test ◽  
Group 3 ◽  
The Mean ◽  
The Web

Objective.To evaluate the effectiveness of a Web-based course on infection control accessed by physicians in training.Design.Educational intervention.Setting.A 607-bed urban teaching hospital.Participants.A total of 55 physicians in training beginning their first postgraduate year (the iPGYl group) and 59 physicians completing their first, second, or third postgraduate year (the oPGY group).Intervention.Individuals in the iPGYl group took a Web-based course on infection control practices.Measurements.Persons in the iPGYl group who took the Web-based course completed an evaluation test consisting of 15 multiple-choice questions (total possible score, 15 points). The same test was given to persons in the oPGY group, who did not take the Web-based course. We compared scores of the Web-based test taken by subjects in the iPGYl group immediately after the course with scores of the test they took 3 months after the course and with test scores of subjects in the oPGY group.Results.The mean score (±SD) for subjects in the iPGYl group who took the Web-based course was 10.6 ± 2.2, compared with 8.0 ± 2.5 for subjects in the oPGY group (P<.001). The mean score (±SD) for subjects in the iPGYl group 3 months after completing the course decreased to 8.0 ± 2.4 (P< .001 by the paired f test). For the oPGY group, significant differences were found between the scores (±SD) for subjects in the internal medicine (9.9 ± 2.3), emergency medicine (8.4 ± 1.7), pediatrics (7.0 ± 1.7), and family medicine (5.8 ± 1.6) residency programs (P< .001); there were no significant differences in scores according to the year of residency.Conclusions.Web-based infection control courses are an attractive teaching tool for physicians in training and need to be considered for teaching infection control. The evaluation of information retention will help identify physicians in training who require further training.

scholarly journals Defining Symptom Concepts in Chronic Subjective Tinnitus: Web-Based Discussion Forum Study (Preprint)

2019 ◽  
Author(s):  
Alice Hibbert ◽  
Markku Vesala ◽  
Micky Kerr ◽  
Kathryn Fackrell ◽  
Stephen Harrison ◽  
...  
Keyword(s):  
Health Care ◽  
Discussion Forum ◽  
Delphi Survey ◽  
Core Outcome ◽  
Plain Language ◽  
Web Based ◽  
Core Set ◽  
Outcome Domain ◽  
Health Concepts ◽  
The Web

BACKGROUND A minimum standard based upon consensus decision making recommends a core set of tinnitus-specific health complaints (outcome domains) that should be assessed and reported in all clinical trials as this enables comparisons to be made across studies as well as data pooling for meta-analysis. OBJECTIVE This study aimed to further clarify how the outcome domain concepts should be defined for 5 of the core set: tinnitus intrusiveness, sense of control, acceptance of tinnitus, concentration, and ability to ignore. This step requires a clear and fully elaborated definition for each outcome domain, moving from an abstract or a vague concept to an operationalized and measurable health-related construct, so that a suitable measurement instrument can then be identified. METHODS A series of 5 focus group–style semistructured discussions were conducted via a Web-based discussion forum, each open for 2 weeks and ending with a vote. The participants included 148 tinnitus experts who completed a preceding e-Delphi survey that had generated the original set of minimum standards. The participants were health care users living with tinnitus, health care professionals, clinical researchers, commercial representatives, and funders. RESULTS The Web discussions led to a revision of all 5 original plain language definitions that had been used in the preceding e-Delphi survey. Each revised definition was voted by 8 to 53 participants and reached the prespecified threshold of 70% consensus for all except tinnitus intrusiveness. Although a single definition was not agreed upon for tinnitus intrusiveness, the majority of participants shared the view that the concept should be sufficiently broad to encapsulate a range of subdomains. The examples included tinnitus awareness, unpleasantness, and impact on different aspects of everyday life. Thematic analysis of the 5 Web-based discussion threads gave important insights into expert interpretations of each core outcome domain, generating an operationalized and measurable health construct in each case. CONCLUSIONS The qualitative data gathered during the Web-based discussion forum provided an important in-depth understanding of the health concepts that had raised a debate during earlier face-to-face meetings. The descriptive summaries and definitions provide sufficient operationalization of those concepts to proceed to the second stage of core outcome set development that is to identify and evaluate suitable measurement instruments. This study supports the use of Web-based peer discussion forums in defining health concepts.

scholarly journals Patient Uptake, Experience, and Satisfaction Using Web-Based and Face-to-Face Hearing Health Services: Process Evaluation Study (Preprint)

2019 ◽  
Author(s):  
Husmita Ratanjee-Vanmali ◽  
De Wet Swanepoel ◽  
Ariane Laplante-Lévesque
Keyword(s):  
Health Care ◽  
Hearing Loss ◽  
Patient Satisfaction ◽  
Process Evaluation ◽  
Screening Test ◽  
Instant Messaging ◽  
Hearing Screening ◽  
Web Based ◽  
Face To Face ◽  
Hearing Health

BACKGROUND Globally, access to hearing health care is a growing concern with 900 million people estimated to suffer from disabling hearing loss by 2050. Hearing loss is one of the most common chronic health conditions, yet access to hearing health care is limited. Incorporating Web-based (voice calling, messaging, or emailing) service delivery into current treatment pathways could improve access and allow for better scalability of services. Current electronic health studies in audiology have focused on technical feasibility, sensitivity, and specificity of diagnostic hearing testing and not on patient satisfaction, experiences, and sustainable models along the entire patient journey. OBJECTIVE This study aimed to investigate a hybrid (Web-based and face-to-face) hearing health service in terms of uptake, experience, and satisfaction in adult patients with hearing loss. METHODS A nonprofit hearing research clinic using online and face-to-face services was implemented in Durban, South Africa, using online recruitment from the clinic’s Facebook page and Google AdWords, which directed persons to an online Web-based hearing screening test. Web-based and face-to-face care pathways included assessment, treatment, and rehabilitation. To evaluate the service, an online survey comprising (1) a validated satisfaction measurement tool (Short Assessment of Patient Satisfaction), (2) a process evaluation of all the 5 steps completed, and (3) personal preferences of communication methods used vs methods preferred was conducted, which was sent to 46 patients who used clinic services. RESULTS Of the patients invited, 67% (31/46) completed the survey with mean age 66 years, (SD 16). Almost all patients, 92% (30/31) reported that the online screening test assisted them in seeking hearing health care. Approximately 60% (18/31) of the patients accessed the online hearing screening test from an Android device. Patients stayed in contact with the audiologist mostly through WhatsApp instant messaging (27/31, 87%), and most patients (25/31, 81%) preferred to use this method of communication. The patients continuing with hearing health care were significantly older and had significantly poorer speech recognition abilities compared with the patients who discontinued seeking hearing health care. A statistically significant positive result (<i>P</i>=.007) was found between age and the number of appointments per patient. Around 61% (19/31) of patients previously completed diagnostic testing at other practices, with 95% (18/19) rating the services at the hybrid clinic as better. The net promoter score was 87, indicating that patients were highly likely to recommend the hybrid clinic to friends and family. CONCLUSIONS This study applied Web-based and face-to-face components into a hybrid clinic and measured an overall positive experience with high patient satisfaction through a process evaluation. The findings support the potential of a hybrid clinic with synchronous and asynchronous modes of communication to be a scalable hearing health care model, addressing the needs of adults with hearing loss globally.

scholarly journals Process evaluation of a national elderly nutrition care program in Iran: Perspectives of clients and providers

2020 ◽  
Author(s):  
Sorayya Kheirouri ◽  
Mohammad Alizadeh ◽  
Elaheh Foroumandi ◽  
Rahim Khodayari-zarnaq
Keyword(s):  
Health Care ◽  
Process Evaluation ◽  
Group Process ◽  
Implementation Process ◽  
Care Program ◽  
Monitoring And Evaluation ◽  
Evaluation Study ◽  
Nutrition Care ◽  
East Azerbaijan ◽  
Health Care Centers

Abstract Background The rapid growth of Iran elderly population highlights the importance of more attention to nutritional needs of this age group. Process evaluation study on the nutritional part of the national Elderly-Integrated Care Program was conducted to examine degree of exposure and satisfaction of the targets with the program components, and assess the reach, delivery, fidelity, and external contexts of the program.Methods To evaluate perspectives of clients on elderly integrated nutrition care program (EINCP) implementation process, a self-administrated questionnaire was constructed, validated, and applied to 256 individuals with the age of above 60 years attending the program at 57 health care centers of Tabriz metropolitan area of East Azerbaijan province in Iran using convenience sampling method. Another valid questionnaire was also applied to investigate viewpoint of the perceptions of 76 staffs of these health care centers as the program providers around the EINCP.Results The reach rate of the clients was reported 20.0%. Delivery of the educational components to entire program providers was accomplished (100.0%); however, the delivery of some parts of the program to the clients had some main weaknesses. The fidelity of the program tools was considered inadequate from perspectives of both clients and providers. 77.5% of the clients had exposure to the program. Clients’ satisfaction rate was varied from 4.2 to 34.7% with various available services, but 42.8% of the clients had high satisfaction with overall parts of the EINCP. The program also suffered from some external contexts such as the lack of financial support of program providers.Conclusion The format of the EINCP and strategies related to recruitment of the clients should be improved in order to minimize the barriers highlighted in this study. The providers should focus on raising the compliance of clients to receive a higher reach rate. It is suggested that program planners add periodic monitoring and evaluation of the program.

scholarly journals Digital Health Technologies Respond to the COVID-19 Pandemic In a Tertiary Hospital in China: Development and Usability Study

10.2196/24505 ◽  
2020 ◽  
Vol 22 (11) ◽  
pp. e24505 ◽  
Author(s):  
Wanmin Lian ◽  
Li Wen ◽  
Qiru Zhou ◽  
Weijie Zhu ◽  
Wenzhou Duan ◽  
...  
Keyword(s):  
Health Care ◽  
Digital Health ◽  
Tertiary Hospital ◽  
Service Platform ◽  
Web Based ◽  
Symptom Monitoring ◽  
Health Technologies ◽  
Epidemic Period ◽  
Control And Prevention ◽  
The Web

Background The outbreak of COVID-19 has caused a continuing global pandemic. Hospitals are integral to the control and prevention of COVID-19; however, they are facing numerous challenges during the epidemic. Objective Our study aimed to introduce the practical experience of the design and implementation of a web-based COVID-19 service platform at a tertiary hospital in China as well as the preliminary results of the implementation. Methods The web-based COVID-19 service platform was deployed within the health care system of the Guangdong Second Provincial General Hospital and Internet Hospital; the function of the platform was to provide web-based medical services for both members of the public and lay health care workers. The focal functions of this system included automated COVID-19 screening, related symptom monitoring, web-based consultation, and psychological support; it also served as a COVID-19 knowledge hub. The design and process of each function are introduced. The usage data for the platform service were collected and are represented by three periods: the pre-epidemic period (December 22, 2019, to January 22, 2020, 32 days), the controlled period (January 23 to March 31, 2020, 69 days), and the postepidemic period (April 1 to June 30, 2020, 91 days). Results By the end of June 2020, 96,642 people had used the automated COVID-19 screening and symptom monitoring systems 161,884 and 7,795,194 times, respectively. The number of general web-based consultation services per day increased from 30 visits in the pre-epidemic period to 122 visits during the controlled period, then dropped to 73 visits in the postepidemic period. The psychological counseling program served 636 clients during the epidemic period. For people who used the automated COVID-19 screening service, 160,916 (99.40%) of the total users were classified in the no risk category. 464 (0.29%) of the people were categorized as medium to high risk, and 12 people (0.01%) were recommended for further COVID-19 testing and treatment. Among the 96,642 individuals who used the COVID-19 related symptoms monitoring service, 6696 (6.93%) were symptomatic at some point during the monitoring period. Fever was the most frequently reported symptom, with 2684/6696 symptomatic people (40.1%) having had this symptom. Cough and sore throat were also relatively frequently reported by the 6696 symptomatic users (1657 people, 24.7%, and 1622 people, 24.2%, respectively). Conclusions The web-based COVID-19 service platform implemented at a tertiary hospital in China is exhibited to be a role model for using digital health technologies to respond to the COVID-19 pandemic. The digital solutions of automated COVID-19 screening, daily symptom monitoring, web-based care, and knowledge propagation have plausible acceptability and feasibility for complementing offline hospital services and facilitating disease control and prevention.

scholarly journals Defining Symptom Concepts in Chronic Subjective Tinnitus: Web-Based Discussion Forum Study

10.2196/14446 ◽  
2020 ◽  
Vol 9 (1) ◽  
pp. e14446
Author(s):  
Alice Hibbert ◽  
Markku Vesala ◽  
Micky Kerr ◽  
Kathryn Fackrell ◽  
Stephen Harrison ◽  
...  
Keyword(s):  
Health Care ◽  
Discussion Forum ◽  
Delphi Survey ◽  
Core Outcome ◽  
Plain Language ◽  
Web Based ◽  
Core Set ◽  
Outcome Domain ◽  
Health Concepts ◽  
The Web

Background A minimum standard based upon consensus decision making recommends a core set of tinnitus-specific health complaints (outcome domains) that should be assessed and reported in all clinical trials as this enables comparisons to be made across studies as well as data pooling for meta-analysis. Objective This study aimed to further clarify how the outcome domain concepts should be defined for 5 of the core set: tinnitus intrusiveness, sense of control, acceptance of tinnitus, concentration, and ability to ignore. This step requires a clear and fully elaborated definition for each outcome domain, moving from an abstract or a vague concept to an operationalized and measurable health-related construct, so that a suitable measurement instrument can then be identified. Methods A series of 5 focus group–style semistructured discussions were conducted via a Web-based discussion forum, each open for 2 weeks and ending with a vote. The participants included 148 tinnitus experts who completed a preceding e-Delphi survey that had generated the original set of minimum standards. The participants were health care users living with tinnitus, health care professionals, clinical researchers, commercial representatives, and funders. Results The Web discussions led to a revision of all 5 original plain language definitions that had been used in the preceding e-Delphi survey. Each revised definition was voted by 8 to 53 participants and reached the prespecified threshold of 70% consensus for all except tinnitus intrusiveness. Although a single definition was not agreed upon for tinnitus intrusiveness, the majority of participants shared the view that the concept should be sufficiently broad to encapsulate a range of subdomains. The examples included tinnitus awareness, unpleasantness, and impact on different aspects of everyday life. Thematic analysis of the 5 Web-based discussion threads gave important insights into expert interpretations of each core outcome domain, generating an operationalized and measurable health construct in each case. Conclusions The qualitative data gathered during the Web-based discussion forum provided an important in-depth understanding of the health concepts that had raised a debate during earlier face-to-face meetings. The descriptive summaries and definitions provide sufficient operationalization of those concepts to proceed to the second stage of core outcome set development that is to identify and evaluate suitable measurement instruments. This study supports the use of Web-based peer discussion forums in defining health concepts.

scholarly journals Prerequisites for a healthy and independent life among older people: a Delphi study

2020 ◽  
pp. 1-17
Author(s):  
Annelie K. Gusdal ◽  
Rose-Marie Johansson-Pajala ◽  
Viktoria Zander ◽  
Petra von Heideken Wågert
Keyword(s):  
Health Care ◽  
Older People ◽  
Health Professionals ◽  
Delphi Study ◽  
Social Life ◽  
Older Persons ◽  
Personal Control ◽  
Ageing Population ◽  
Next Of Kin ◽  
Independent Life

Abstract The number of older people (aged 65+) will more than double by 2050 in Sweden. The ageing population is an increasing concern due to rising health-care costs and a shortage of health professionals. Older people generally prefer ageing in place, as long as they feel confident and comfortable. However, preventive and supportive measures are needed to maintain older people's independence and active participation in society. The aim of this study is to explore the prerequisites for a healthy and independent life among older people in Sweden. A Delphi study was conducted in three rounds. In round 1, seven focus group interviews were performed with older persons aged 65–79, older persons aged ⩾80, next of kin of older persons, health professionals in primary and home health care, assistant nurses in home care, care managers and local politicians. The data were analysed using thematic analysis, resulting in 35 statements of the prerequisites needed for a healthy and independent life. These statements were sent to the participants from round 1, who were asked to evaluate the degree to which they agreed with each statement in round 2, and again in round 3. There was an agreement of at least 80 per cent for 31 of the 35 statements. When asked to identify the three prerequisites of most importance for a healthy and independent life, most participants stated: to have a social life, to have freedom of choice and power over one's own situation, and to have the possibility to choose independently one's type of housing. There was an overall high group agreement on the prerequisites needed for a healthy and independent life among older people. The main areas of importance were to have a social life, several dimensions of feeling safe and to retain one's personal control.

scholarly journals Patient Uptake, Experience, and Satisfaction Using Web-Based and Face-to-Face Hearing Health Services: Process Evaluation Study

10.2196/15875 ◽  
2020 ◽  
Vol 22 (3) ◽  
pp. e15875 ◽  
Author(s):  
Husmita Ratanjee-Vanmali ◽  
De Wet Swanepoel ◽  
Ariane Laplante-Lévesque
Keyword(s):  
Health Care ◽  
Hearing Loss ◽  
Patient Satisfaction ◽  
Process Evaluation ◽  
Screening Test ◽  
Instant Messaging ◽  
Hearing Screening ◽  
Web Based ◽  
Face To Face ◽  
Hearing Health

Background Globally, access to hearing health care is a growing concern with 900 million people estimated to suffer from disabling hearing loss by 2050. Hearing loss is one of the most common chronic health conditions, yet access to hearing health care is limited. Incorporating Web-based (voice calling, messaging, or emailing) service delivery into current treatment pathways could improve access and allow for better scalability of services. Current electronic health studies in audiology have focused on technical feasibility, sensitivity, and specificity of diagnostic hearing testing and not on patient satisfaction, experiences, and sustainable models along the entire patient journey. Objective This study aimed to investigate a hybrid (Web-based and face-to-face) hearing health service in terms of uptake, experience, and satisfaction in adult patients with hearing loss. Methods A nonprofit hearing research clinic using online and face-to-face services was implemented in Durban, South Africa, using online recruitment from the clinic’s Facebook page and Google AdWords, which directed persons to an online Web-based hearing screening test. Web-based and face-to-face care pathways included assessment, treatment, and rehabilitation. To evaluate the service, an online survey comprising (1) a validated satisfaction measurement tool (Short Assessment of Patient Satisfaction), (2) a process evaluation of all the 5 steps completed, and (3) personal preferences of communication methods used vs methods preferred was conducted, which was sent to 46 patients who used clinic services. Results Of the patients invited, 67% (31/46) completed the survey with mean age 66 years, (SD 16). Almost all patients, 92% (30/31) reported that the online screening test assisted them in seeking hearing health care. Approximately 60% (18/31) of the patients accessed the online hearing screening test from an Android device. Patients stayed in contact with the audiologist mostly through WhatsApp instant messaging (27/31, 87%), and most patients (25/31, 81%) preferred to use this method of communication. The patients continuing with hearing health care were significantly older and had significantly poorer speech recognition abilities compared with the patients who discontinued seeking hearing health care. A statistically significant positive result (P=.007) was found between age and the number of appointments per patient. Around 61% (19/31) of patients previously completed diagnostic testing at other practices, with 95% (18/19) rating the services at the hybrid clinic as better. The net promoter score was 87, indicating that patients were highly likely to recommend the hybrid clinic to friends and family. Conclusions This study applied Web-based and face-to-face components into a hybrid clinic and measured an overall positive experience with high patient satisfaction through a process evaluation. The findings support the potential of a hybrid clinic with synchronous and asynchronous modes of communication to be a scalable hearing health care model, addressing the needs of adults with hearing loss globally.

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