We have ways to measure many things about our health: blood pressure, vision, heart rate, daily steps and even sleep. But for most people, hearing remains a mystery until something starts to change. 

A collaboration between the Johns Hopkins Center for Communication Programs (CCP) and the Johns Hopkins Cochlear Center for Hearing and Public Health is exploring how to make hearing something people understand, monitor and talk about as part of their overall health. 

“Changes to our hearing happen to everyone if you’re lucky enough to keep having birthdays,” says Molly Sheehan, communications manager for Cochlear Center. “But we don’t know how to talk about it.” 

For many people, the last time they remember having their hearing checked was in childhood. Unlike other aspects of health that people routinely monitor over time, hearing often goes unnoticed until changes begin to affect daily life. 

Hearing does not simply go from “normal” to “loss.” For many people, changes happen gradually over time. It may not mean that sounds disappear altogether; instead, people may begin missing certain parts of speech, making voices seem less clear or conversations harder to follow. Unlike other aspects of health, there has been no simple way for people to understand and talk about those changes. 

The Cochlear Center’s Know Your Hearing public health campaign aims to change that by giving people a simple way to understand their hearing. The campaign introduces a Hearing Number, a measure based on the same clinical assessment used by hearing specialists but designed to help people better understand and talk about their hearing and includes a smartphone app for people to test themselves. 

But the question for the Cochlear Center was not simply how to measure hearing, but how to help people understand what that measurement means in their lives. 

Over much of the past year, CCP researchers Erica Nybro, August Summers, and Shannon McAfee have talked with health departments, clinicians, community organizations, and other stakeholders to understand how different audiences think about hearing and what resources could support better conversations.  

“Even our team of public health professionals knew little about hearings impact on health when we started,” Nybro says. 

CCP brought a process it has used across many public health issues: identifying audiences, understanding their experiences and barriers, and developing resources based on what communities say they need.  

The team spoke with partners in communities with very different populations and resources: in Baltimore; Orange County, Florida; and Allegany County, Maryland. They also talked with clinicians, non-profit organizations, industry partners and groups working with people exposed to loud environments, including musicians and workers. 

What they heard challenged some assumptions about who should be part of the conversation. 

Health departments initially connected the team with programs serving older adults. But those conversations quickly highlighted another important audience: caregivers. 

Family members are often the first to notice when someone is struggling to hear, sometimes before that person recognizes the change themselves. The team heard that caregivers may be an important entry point for conversations about hearing health. 

The team also saw opportunities to reach people much earlier in life. 

“Young people are really into wearable devices and they like the technology,” Nybro says. “They’re used to knowing how many steps they took.” 

The conversations suggested that hearing should not be framed as something that only affects older adults, but as something people can pay attention to throughout their lives. 

The conversations also revealed that simply giving people a number may not be enough. 

“One of our stakeholders said to me, a number is not motivating by itself,” Nybro says. “But if it is matched with the reality of a change they are noticing in their own life, it will be powerful.” 

The team is using those findings to develop and test new communication materials, exploring how different audiences respond to messages about hearing, and working with partners to identify ways the Hearing Number can be shared in community and health care settings. 

“Although we are talking about hearing today, the process is the same across many health issues,” Summers says. “We work with communities and partners to understand what people need, and we use that to inform what comes next.” 

Want to help with the research? CCP and the Cochlear Center need participants to review test messages and help researchers better understand the barriers that keep people from seeking hearing screening and care. Click here for more details.