Community-Based Hearing Aid Program Delivers Lasting Benefits for Low-Income Adults, Study Finds

A Dalhousie University study of 179 low-income adults found that a community-based hearing aid assistance program produced strong daily hearing aid use and significant, lasting reductions in self-reported hearing handicap.

For many adults with hearing loss, the biggest obstacle between them and better hearing is not technology. It is money, and the practical difficulty of reaching hearing services at all. Researchers have long suspected that if those barriers were removed, outcomes for underserved adults would look very different.

A new study from Nova Scotia, Canada puts real numbers behind that idea. It followed adults who received hearing aids through a provincially funded assistance program and tracked how much they wore the devices and how their day-to-day hearing difficulties changed over a full year.

Background: Why the Researchers Looked at This

Access to hearing services is often limited by health care disparities and financial constraints. Hearing aids can cost thousands of dollars through traditional channels, and people on low incomes are among the least likely to receive them, even though they experience hearing loss at least as often as everyone else.

The research team at Dalhousie University wanted to know what happens when that financial barrier is deliberately removed. They studied the Dalhousie Hearing Aid Assistance Program - Community Services, a provincially funded initiative in Nova Scotia designed to broaden access to hearing health care for low-income adults.

Two questions sat at the center of the study. Would people who received hearing aids through the program actually wear them? And would their self-reported hearing difficulties, what audiologists call hearing handicap, genuinely improve over time?

How the Study Was Done

The researchers went back through the program's digital patient management system and extracted demographic, audiologic, and self-reported hearing aid data for 179 participants. The average age was about 59 years, and average hearing thresholds indicated bilateral hearing loss in the moderate range.

Outcomes were measured with two widely used tools. The Hearing Handicap Inventory for the Elderly - Screening Version, or HHIE-S, captures how much hearing difficulty interferes with everyday emotional and social life. The Client-Oriented Scale of Improvement, or COSI, asks each person to name the listening situations that matter most to them and then rates how much those situations improved.

Participants were assessed after their hearing aid fitting and again at 3-month and 12-month follow-ups, giving the team a picture of whether early benefits held up over a full year of real-world use.

What the Researchers Found

Uptake was strong. Most participants, 89 percent, received hearing aids for both ears, and average daily use reached 9.2 hours. That figure matters because hearing aids only help when they are actually worn, and low use is one of the most common reasons benefits fail to appear.

Hearing handicap fell significantly. HHIE-S total and subscale scores dropped at both the 3-month and 12-month follow-ups compared with the post-fitting baseline, with the improvements reaching high statistical significance. In other words, the benefit was not a short-lived novelty effect. It persisted across the year.

On the COSI, participants reported substantial gains of more than 80 percent on their self-chosen listening goals, and the researchers found a large correlation of 0.716 between how much people felt they had changed and their final listening ability. A regression analysis showed that the degree of hearing loss and gender were significant predictors of hearing handicap scores.

The study also documented how common tinnitus was in this group. Nearly half of participants, 47.5 percent, reported it, with 18.4 percent describing it as persistent and 29.1 percent as intermittent, most commonly in both ears.

What It Means for People with Hearing Loss

The central message is encouraging: when cost stops being the gatekeeper, low-income adults do not just accept hearing aids, they wear them for the better part of every day and report meaningful, lasting improvements in their daily lives.

That finding pushes back against the assumption that underserved groups will not follow through with hearing care. In this study, the barrier was access, not motivation. Once devices were in hand, use and benefit followed.

For readers outside Nova Scotia, the study is a reminder that hearing help does not have to wait for perfect circumstances. Programs, subsidies, and lower-cost device options all chip away at the same barrier this program was built to remove.

Lowering the Cost Barrier Outside the Clinic

Because this study highlights cost as a central barrier to hearing care, it is worth noting that newer FDA-OTC hearing aids were created for exactly this reason: to give adults with mild-to-moderate hearing loss a more affordable route to amplification. Panda Air is one such device, a modern earbud-style hearing aid with 16-channel WDRC processing and multi-band adaptive noise reduction.

Air works out of the box, and it also offers an optional app-based in-ear hearing test that can personalize gain and frequency response to the user's hearing profile, making it a self-fitting OTC hearing aid for those who want that extra step. It is also a rechargeable hearing aid with a charging case, with a fast-charge case providing 60 hours of total use, plus Bluetooth for calls, TV, and music.

Air comes with a 5-year warranty and a 45-day trial that starts when the device is received. One caveat worth keeping in mind: OTC hearing aids are approved for mild-to-moderate hearing loss, and people with severe or profound loss still benefit most from clinical fittings like those provided in the Nova Scotia program. Details are at pandahearing.com/products/panda-air.

Limitations of This Research

This was a retrospective study drawn from one program's records, with no control group of similar adults who did not receive hearing aids. Outcomes such as hearing handicap and daily use were self-reported, which can introduce bias, and results from a single provincially funded program in Nova Scotia may not generalize to other regions or funding models.

The program itself is provincially funded; the study abstract does not report separate research funding or conflicts of interest.

Where This Leaves Us

This study adds solid evidence that hearing care equity is not an abstract goal but a measurable one: remove the financial barrier, and underserved adults wear their hearing aids more than nine hours a day and report less hearing handicap a full year later. For anyone who has been putting off hearing help because of cost, the takeaway is that affordable routes to amplification are worth pursuing, whether through community programs where they exist or through lower-cost device options where they do not.

Jafari Z, Mason S, Wilson S. Advancing Hearing Care Equity: Outcomes From a Community-Based Hearing Aid Assistance Program for Underserved Adults. American Journal of Audiology. 2026. Retrieved from PubMed. https://doi.org/10.1044/2026_AJA-26-00091