How Message Framing and Subsidy Design Shape Hearing Health Care Decisions Among Older Adults With Hearing Loss: Evidence From a Mixed-Methods Approach

Purpose: This study aims to examine how message framing and subsidy design influence hearing health care (HHC) services utilization among older adults with hearing loss (HL) in rural China. Method: The mixed-methods study used a survey experiment design in the quantitative phase and semistructured interviews in the qualitative phase. A survey experiment tested older adults and their family members' responses to gain-/loss-framed messages and in-kind/co-payment subsidies, followed by in-depth interviews with 68 participants. Results: Loss-framed messages increased hearing screening willingness ( p < .05) more than gain-framed messages, but neither affected hearing aid adoption. In-kind subsidies increased hearing aid uptake willingness ( p < .01), whereas co-payment discouraged family recommendations ( p < .05). The interviews further illustrated key barriers to HHC services, including viewing HL as normal aging, stigma concerns, and financial constraints. Conclusions: Integrating message framing, subsidy schemes, and behavioral intervention strategies is recommended to enhance the uptake of HHC services. Policymakers should use loss-framed messages for hearing screening promotion and provide in-kind subsidies for hearing aid adoption. Equally important are efforts to improve hearing health literacy, alleviate financial constraints, and implement patient-centered decision making in HHC services.