Development of the Hearing Rehabilitation for Older Adults (HeRO) Healthcare Mobile Application and Its Likely Utility for Elderly Users

Round 1

Reviewer 1 Report

Thank you for allowing me to review your paper. My comments are included on the text I have uploaded.

This is paper was very interesting to read. However, there are numerous Grammar and punctuation errors, which made the read difficult.

I have also marked in the introduction, where examples may benefit the reader understanding.

You may also like to consider the tense you use. Currently the paper is written in the past tense. This suggests this research will not progress. Is that correct?

I have also marked in the discussion section where there are some references absent. This needs correction.

 I look forward to reading the final publication

Comments for author File: Comments.pdf

Author Response

Thank you very much for your valuable and significant comments. Based on the comments received, we had discussed several times and understood the reviewer’s multiple concerns. Our paper changed into a better version while considering all comments which you pointed out. Please see our response in the table below and find newly changed parts of red letters in our revised manuscript. Again thanks.

Author Response File: Author Response.pdf

Reviewer 2 Report

The article rises an important issue of age-related hearing loss and its social and cognitive consequences. Telemedicine in no doubt is a future of self-aided healthcare. Authors propose a digital intervention and describe a mobile rehabilitation application (HeRO) and its implementation in a group of 44 elders together with an evaluation questionnaire. HeRO provides an interesting feature of initial self-assessment, which determines the baseline level of each trainee. The training itself is designed in accordance to the general gerontology research and consists of four different types of tasks: syllable training, sentence training, discourse training and working memory training. HeRO offers distinctive levels of difficulty and therefore provides differential material with increasing cognitive load.

The evaluation of HeRO was performed by users in a self-report questionnaire. The questions were divided into three categories: perceived ese of use, perceived usefulness and intention to use. This distinction seems valid and allowed for user experience analysis. The individual results throughout the training enabled an objective measure of one’s progress, whereas the self-report questionnaire evaluated one’s subjective attitude towards the app.  

An elaboration is much needed in the description of the usage of the HeRO. How did the elderly acquire the app? Did they install it by themselves? How were they trained in the usage of the app? There is no information on the means of access to the app: did subjects use their own mobile phones, or were they lend by the authors? The contact wit the clinician is not described either. When did the clinician contact the treinee?

An elaboration is much needed in the description of the usage of the HeRO. How did the elderly acquire the app? Did they install it by themselves? How were they trained in the usage of the app? There is no information on the means of access to the app: did subjects use their own mobile phones, or were they lend by the authors? The contact wit the clinician is not described either. When did the clinician contact the treinee?

There are no measures of program effects in the lives of respondents.

Did the effects of the respondents result from the material learning effect or from a real increase in competences?

In the discussion the authors omit an important problem of individual adaptation to hearing-aids usage. Is the app dedicated for usage after the first hearing-aids fitting? Or when? How do the authors address the problem of dual sound processing (first the mobile phone, then the hearing-aid) in the individual adaptation to hearing-aids usage?

The manuscript describes a tool, that has a potential in the future contact of the hearing impaired with the clinicians. After addressing the aforementioned issues, the article is an important contribution in the field of elders’ telemedicine.

Author Response

Thank you very much for your valuable and significant comments. Based on the comments received, we had discussed several times and understood the reviewer’s multiple concerns. Our paper changed into a better version while considering all comments which you pointed out. Please see our response in the table below and find newly changed parts of red letters in our revised manuscript. Again thanks.

Author Response File: Author Response.pdf