Help-seeking behaviour of older adults towards hearing loss based on the health belief model: a qualitative research study

Hearing loss is common among older adults in Singapore, yet many do not seek early assessment or adopt hearing aids despite the availability of community hearing screening services. This may lead to preventable consequences such as reduced quality of life and dementia. This study aimed to explore the health beliefs and help-seeking behaviour of older adults towards hearing loss. The study leveraged the Health Belief Model (HBM) to develop a topic guide to field in-depth interviews (IDIs) on 16 Asian adults aged 65 years and older with diagnosed or self-reported hearing impairment in primary care. The interviews were audio-recorded, transcribed verbatim, audited and analysed to identify emerging themes based on the HBM. The identified themes were grouped under perceived susceptibility, severity, barriers and cues to action that enhanced self-efficacy. Older adults did not consider hearing loss as a disability, attributing it to natural ageing and being “untreatable” with minimal daily disruption. Few regarded it as a serious health condition unless they experienced significant social consequences or emotional distress, often seeking treatment only as a last resort. Cost to fit hearing aid was deemed a barrier, with devices perceived as ineffective or inconvenient. Cues to action that could enhance their self-efficacy include family support, greater awareness of available hearing aid financial subsidies and community hearing screening programmes. Using the HBM, this study highlights that older adults commonly underestimate their susceptibility to and severity of hearing loss. Many seek help only when it causes significant impairment and are deterred by perceived cost or doubts about the usefulness of hearing aids. These findings underscore the importance of leveraging effective cues to action to enhance self-efficacy, thereby promoting timely help-seeking and better management of hearing loss.