Requirements of health professionals and affected persons for an App-based dual-task training for hearing impaired older adults - a Delphi survey

Age-related hearing impairments significantly impact social interactions and physical activities for older adults. Recent studies have highlighted potential benefits of cognitive-motor training but lack specificity regarding the unique needs of this population. This study aimed to determine the preferences and specific needs of older adults with hearing impairments to develop tailored cognitive-motor training systems. A three-round Delphi survey was conducted involving health and exercise professionals (round 1: n = 18; round 2: n = 12; round 3: n = 11) and older adults with hearing impairments (round 1: n = 18; round 2: n = 14; round 3: n = 15). Round 1 collected qualitative input; rounds 2 and 3 assessed relevance and agreement of the items (≥ 70% agreement) using structured questions. Descriptive Statistics analyses and one-way ANOVA were used to compare responses between expert and user responses. The study gathered 570 responses that were clustered in 148 items and 35 were removed due to low relevance. Key themes included app features, exercise characteristics, especially dual-task combinations, feedback and monitoring, as well as barriers and facilitators. While revealing a high level of consensus the data showed significant differences between the groups. For example, in the preference for training types, health professionals differed from hearing-impaired participants. While professionals emphasised the integration of sensory challenges and dual-task exercises, participants preferred less demanding physical activities and those incorporating music or ambient sounds. Strength exercises and prescribed frequent sessions were deemed less feasible, indicating a preference for more adaptable and enjoyable training regimes. Digital dual-task training programs for hearing-impaired older adults should be tailored to individual capabilities and preferences. Programs that are flexible, easy to use and support autonomy may promote greater engagement. Integrating sensory accommodation and user-centred design could enhance physical and cognitive outcomes, contributing to improved independence and quality of life.