User Awareness and Perspectives Survey on Privacy, Security and Usability of Auditory Prostheses

According to the World Health Organization, over 466 million people worldwide suffer from disabling hearing loss, with approximately 34 million of these being children. Hearing aids (HA) and cochlear implants (CI) have become indispensable tools for restoring hearing and enhancing the quality of life for individuals with hearing impairments. Clinical research and consumer studies indicate that users of HAs and CIs report significant improvements in their daily lives, including enhanced communication abilities and social engagement and reduced psychological stress. Modern auditory prosthetic devices are more advanced and interconnected with digital networks to add functionality, such as streaming audio directly from smartphones and other devices, remote adjustments by audiologists, integration with smart home systems, and access to artificial intelligence driven sound enhancement features. With this interconnectivity, issues surrounding data privacy and security have become increasingly pertinent. There is limited research on the usability perceptions of current HA and CI models from the perspective of end-users. In addition, no studies have investigated consumer mental models during the purchasing process, particularly which factors they prioritize when selecting a device. We developed a survey on the Research Electronic Data Capture (REDCap) platform. We assessed participants’ satisfaction levels with various features of their auditory prosthesis. 44% of participants reported complete satisfaction with performance, while 48% expressed complete dissatisfaction with flexibility. Comparable to satisfaction levels, 48% of participants considered performance to be the most important factor when making a purchase decision. Reliability (52%), durability (48%) and usability (22%) were the next highly ranked factors. Interestingly, price (30%) and recommendations from healthcare professionals (22%) were ranked the least important factors by most participants, while privacy, security, and customer support garnered mostly neutral sentiments. Most participants (23 out of 27) were found to be uninformed about privacy and security practices (such as password usage and data privacy) associated with the devices. When queried on strategies that could be adopted to enhance user awareness and education on privacy and security issues related to their devices, the most common responses were receiving regular email updates from manufacturers (18/27) and enhanced data security features in their devices (16/27).