Outcome measurement in community-based hearing rehabilitation: a scoping review.

Abstract

Community-based models of adult hearing rehabilitation are increasingly used to expand access to hearing care; however, outcome measurement practices in these models have not been systematically mapped. This scoping review aimed to characterize the range, nature, and timing of outcome measures reported in community-based adult hearing rehabilitation studies. Four databases were searched to identify studies published until 29 September 2025. Findings were synthesized narratively. Sixteen studies were included. Most (56.3%; <i>n</i> = 9) were conducted in high-income countries, with fewer in upper- and lower-middle-income countries (37.5%; <i>n</i> = 6) and none in low-income countries. Outcome measurement varied widely across domains, tools, and follow-up timing. Hearing and hearing aid-related outcomes, including perceived benefit or satisfaction (62.5%; <i>n</i> = 10), hearing disability (50%; <i>n</i> = 8), and device use (31.3%; <i>n</i> = 5), were most commonly assessed. Psychosocial outcomes were inconsistently included, while participation and well-being outcomes were rarely measured. Although standardized tools were frequently used, no measure was applied consistently across studies, and most assessments were short-term (68.8%; <i>n</i> = 11), with limited follow-up beyond 12 months (12.5%; <i>n</i> = 2). Outcome measurement remains highly variable and predominantly impairment- and device-focused, limiting evidence synthesis and the ability to inform equitable, scalable community-based hearing rehabilitation.Implications for RehabilitationOutcome measurement in community-based adult hearing rehabilitation is highly variable, highlighting the need for greater alignment on core outcome domains to support consistent evaluation of rehabilitation effectiveness.Current rehabilitation outcomes are predominantly impairment- and device-focused, suggesting that psychosocial, participation, and well-being outcomes should be more routinely integrated into hearing rehabilitation evaluation.Limited long-term follow-up in community-based hearing rehabilitation studies constrains understanding of sustained rehabilitation impact, underscoring the importance of incorporating longer-term outcome assessment into service delivery models.