Search Results (880)

Background and Objectives: Payment parity laws require commercial health plans to pay for telehealth on the same basis as in-person care. We systematically reviewed open-access empirical studies to identify and synthesize empirical U.S. studies that explicitly evaluated state telehealth payment parity (distinct from coverage-only parity) and to summarize reported effects on telehealth utilization, modality mix, quality/adherence, equity/access, and expenditures. Methods: Following PRISMA 2020, we searched PubMed/MEDLINE, Scopus, and Web of Science for U.S. studies that explicitly modeled state payment parity or stratified results by payment parity vs. coverage-only vs. no parity. We included original quantitative or qualitative studies with a time or geographic comparator and free full-text availability. The primary outcome was telehealth utilization (share or odds of telehealth use); secondary outcomes were modality mix, quality and adherence, equity and access, and spending. Because designs were heterogeneous (interrupted time series [ITS], difference-in-differences [DiD], regression, qualitative), we used structured narrative synthesis. Results: Nine studies met inclusion criteria. In community health centers (CHCs), payment parity was associated with higher telehealth use (42% of visits in parity states vs. 29% without; Δ = +13.0 percentage points; adjusted odds ratio 1.74, 95% CI 1.49–2.03). Among patients with newly diagnosed cancer, adjusted telehealth rates were 23.3% in coverage + payment parity states vs. 19.1% in states without parity, while cross-state practice limits reduced telehealth use (14.9% vs. 17.8%). At the health-system level, parity mandates were linked to a +2.5-percentage-point telemedicine share in 2023, with mental-health (29%) and substance use disorder (SUD) care (21%) showing the highest telemedicine shares. A Medicaid coverage policy bundle increased live-video use by 6.0 points and the proportion “always able to access needed care” by 11.1 points. For hypertension, payment parity improved medication adherence, whereas early emergency department and hospital adoption studies found null associations. Direct spending evidence from open-access sources remained sparse. Conclusions: Across ambulatory settings—especially behavioral health and chronic disease management—state payment parity laws are consistently associated with modest but meaningful increases in telehealth use and some improvements in adherence and perceived access. Effects vary by specialty and are attenuated where cross-state practice limits persist, and the impact of payment parity on overall spending remains understudied. Full article

Backgrounds/Objectives: Mindfulness-based stress reduction (MBSR) programs may have applications for adults with cerebral palsy (CP), particularly as this population is at increased risk of mental health challenges relative to the general population. However, little is known about the experiences of adults with CP participating in these programs. The aim of this study was to explore the experiences of adults with CP, and a facilitator, who participated in a 9-week MBSR telehealth program. Methods: Adults who attended an MBSR telehealth program were invited to participate in focus groups. If a participant was unable to attend a focus group, they were offered a semi-structured interview. The facilitator participated in a semi-structured interview. Focus groups and interviews were recorded, transcribed verbatim, and inductively thematically analyzed using Framework Analysis. Results: Ten adults with CP and one facilitator participated. Feedback on the program spanned across three themes: (i) learning and creating my mindfulness toolbox; (ii) applying mindfulness to everyday life; and (iii) online together with expert facilitation. Participants appreciated having access to a variety of mindfulness techniques to accommodate individual preferences. Peer-learning in a facilitated, online group context was also valued. Participants recalled implementing mindfulness strategies in everyday life and provided recommendations of how to improve the program. These included incorporating a group orientation, shortening group sessions to reduce fatigue, and follow-up sessions to maintain mindfulness skills after program completion. Conclusions: This study provides new knowledge about the perspectives of adults with CP regarding MBSR delivered via telehealth. Participant recommendations should inform future implementation of group mindfulness telehealth programs for adults with CP. Full article

Objectives: This pilot study examined telerehabilitation, which has emerged as a crucial modality in light of recent global challenges such as the COVID-19 pandemic. We examined the effectiveness of a mobile health telerehabilitation intervention developed for older adults with frailty. Methods: Six participants received a telerehabilitation intervention (Rehab Studio) that included exercise training videos. The participants were aged ≥65 years, had no history of dementia or psychiatric disorders, and had mild-to-moderate care needs. For 1 month, the participants received 1 h live online rehabilitation sessions with real-time communication with rehabilitation specialists (physical therapists and occupational therapists: PTs/OTs). The quality of life (QoL) (EuroQol 5 dimensions 5-level [EQ-5D-5L] questionnaire) and self-rated health scores were recorded before and after the intervention, and the data were analyzed using paired t-tests to determine whether the service was effective. Results: Significant differences were found in the total EQ-5D-5L and self-rated health scores (p < 0.05). The mean EQ-5D-5L score increased from 0.63 ± 0.13 before the intervention to 0.77 ± 0.14 after the intervention (p = 0.010), while the mean self-rated health score increased from 66.0 ± 18.0 to 83.3 ± 10.3, respectively (p = 0.019). Conclusions: This study revealed that the mobile health telerehabilitation intervention is safe and can improve QoL for older adults with frailty. However, the effectiveness of the intervention needs to be further investigated in patients with poor performance in daily living activities. Telerehabilitation could help to reduce the burden of nursing care in aging societies with declining birthrates. However, given the extremely small sample size (N = 6), these p-values should be interpreted with considerable caution. Statistical significance in such a small sample does not provide strong evidence for population-level effects, and our findings should be regarded as hypothesis-generating rather than confirmatory. Full article

Background and Objectives: Telemedicine has become an essential component of chronic Inflammatory Bowel Disease (IBD) care, yet the factors that shape patient satisfaction with remote consultations remain only partially understood. This study aimed to assess satisfaction with institutional telemedicine services among Italian patients with ulcerative colitis (UC) and Crohn’s disease (CD), and to identify sociodemographic, clinical and organisational predictors to inform more person-centred telehealth models. Materials and Methods: We conducted a prospective, multi-centre, cross-sectional study in three IBD units in northern, central and southern Italy between June and October 2024. Consecutive adult patients who had completed a scheduled, non-emergency telemedicine visit were invited within 24–48 h to complete an online questionnaire including the Italian Telemedicine Satisfaction Questionnaire (I-TSQ), sociodemographic items, IBD-related variables, and telemedicine process indicators (accessibility, technology usability, technical support, time saved). Data were analysed descriptively and with multivariable linear regression to determine independent predictors of satisfaction, adjusting for recruiting centre. Results: A total of 705 patients participated (54.9% UC; 55.3% disease duration > 10 years). Overall, telemedicine satisfaction was high (mean I-TSQ total 57.5 ± 4.9; range 35–70), and all respondents reported reduced indirect costs compared with in-person visits. Greater ease of technology use, more frequent contact with the care team, male sex, older age, and employment were independently associated with higher satisfaction scores. Conversely, first-ever teleconsultations, CD, subcutaneous therapies, more difficult platform access, and the need for technical support were linked to lower satisfaction. Model fit was modest (R² up to 0.20), suggesting the presence of additional unmeasured relational and contextual factors. Conclusions: Telemedicine for IBD is widely accepted in Italy, but satisfaction is strongly conditioned by digital usability, previous experience, and clinical complexity. Tailored telehealth pathways that incorporate user-friendly platforms, proactive technical support, and attention to vulnerable subgroups are needed to translate high satisfaction into sustained, equitable remote care. Full article

Background/Objectives: Telemedicine has emerged as a pivotal approach to improving access to diabetic retinopathy (DR) screening, diagnosis, management, and monitoring. Over the past two decades, rapid advancements in digital imaging, mobile health technologies, and artificial intelligence have substantially expanded the role of teleophthalmology in DR, resulting in a large volume of pertinent publications. This study aimed to provide a scientific overview of telemedicine applied to DR through bibliometric analysis. Methods: A search of the Web of Science Core Collection was conducted on 15 November 2025 to identify English-language original research and review articles regarding telemedicine for DR. Bibliographic data from relevant publications were extracted and underwent quantitative analysis and visualization using the tools Bibliometrix and VOSviewer. Results: A total of 515 articles published between 1998 and 2025 were included in our analysis. During this period, the research field of telemedicine for DR exhibited an annual growth rate of 13.14%, with publication activity markedly increasing after 2010 and peaking in 2020–2021. Based on the number of publications, United States, China, and Australia were the most productive countries, while Telemedicine and e-Health, Journal of Telemedicine and Telecare, and British Journal of Ophthalmology were the most relevant journals in the field. Keyword co-occurrence analysis revealed three major thematic clusters within the broader topic of telemedicine and DR, namely, public health-oriented work, telehealth service models, and applications of artificial intelligence technologies. Conclusions: The role of telemedicine in DR detection and care represents an expanding multidisciplinary field of research supported by contributions from multiple authors and institutions worldwide. As technological capabilities continue to evolve, ongoing innovation and cross-domain collaboration could further advance the applications of teleophthalmology for DR, promoting more accessible, efficient, and equitable identification and management of this condition. Full article

Objective: The aim of this study was to systematically map evidence to inform best practices for sexual and reproductive healthcare delivered via telehealth (TeleSRH) in United States-based Title X-funded clinics. Methods: We searched three databases (2017–2025) for studies evaluating effectiveness, harms, patient and provider experiences, barriers/facilitators, and engagement strategies encompassing TeleSRH for sexually transmitted infections (STIs), contraceptive care/family planning (CC/FP), and sexual wellness, in countries with a human development index of ≥0.8. Results: From 5963 references and 436 articles, we included 142 eligible publications. TeleSRH use declined since the COVID-19 pandemic’s peak but remains higher than pre-pandemic. Evidence comes mostly from poor-quality studies. TeleSRH increases access and adherence to STI prevention (e.g., pre-exposure prophylaxis for HIV). Tele-follow-up may safely facilitate HIV care continuity. For CC/FP, TeleSRH is comparable to in-person care for patient satisfaction and uptake; patients are less likely to select long-acting reversible contraception but post-initiation tele-follow-up may increase its continuation rates. Vasectomy completion rates may be similar between pre-procedural counseling via telehealth versus in-person. TeleSRH’s potential benefits might include reduced travel time, wait times, no-show rates, and clinic human resource burden (via tele-triaging) and increased preventative screening rates for STIs and non-communicable diseases, prescription refill rates, ability to receive confidential care in preferred settings, and rural/marginalized community outreach. Implementation challenges span technological and capital constraints, provider availability, staff capability building, restrictive policies, language incompatibility, and patient mistrust. Supplementing synchronous TeleSRH with asynchronous communication (e.g., mobile application) may improve continued patient engagement. Conclusions: Preventive, diagnostic, and therapeutic TeleSRH can be effective, with high patient acceptability; however, effectiveness and adoption hinge on contextual factors outlined in this review. Full article

Objectives: Telemedicine has rapidly expanded in oral and maxillofacial surgery (OMFS), especially during the COVID-19 pandemic, but its specific roles and limitations across the care pathway remain unclear. This narrative review aimed to map telemedicine modalities and indications in OMFS, summarize reported outcomes, and identify priorities for future research. Methods: A narrative synthesis was undertaken after a systematic search of medical and engineering databases to 10 October 2025. Studies applying telemedicine, telehealth, telepresence or teleradiology to OMFS practice were eligible, including trials, observational cohorts, technical reports and surveys. Data were extracted in duplicate and organized thematically; heterogeneity precluded meta-analysis. Results: Fifty studies met the inclusion criteria. Telemedicine was mainly used for preoperative consultation and triage, postoperative follow-up, trauma teleradiology and tele-expertise, oncologic and oral medicine follow-up, temporomandibular disorders, and education or humanitarian work. In low-risk outpatient and postoperative settings, remote consultations showed high concordance with in-person plans, similar complication or reattendance rates, reduced travel, and high satisfaction. In trauma networks, telemedicine supported timely triage and reduced unnecessary inter-hospital transfers. Evidence in oral oncology and complex mucosal disease was more cautious, favouring hybrid models and escalation to face-to-face assessment. Data on cost-effectiveness and impacts on equity were limited. Conclusions: Telemedicine in OMFS has moved from niche innovation to a pragmatic adjunct across the clinical pathway. Current evidence supports its use for selected pre- and postoperative care and trauma triage within risk-stratified hybrid models, while underscoring the need for stronger comparative and implementation studies, clear governance on equity and data protection, and alignment with wider digital and AI-enabled health systems. Full article

This study evaluated the feasibility, image quality, and referral accuracy of a patient-operated optical coherence tomography (OCT) device (SightSync) compared with technician-acquired Heidelberg OCT. This study was conducted in a Veterans Affairs retina clinic (Cleveland, Ohio), resulting in a predominantly male (98%) study population representative of the local veteran demographics. One hundred patients attempted self-administered OCT imaging after brief instruction, yielding 118 successful scans (59% of eyes) with no significant association between scan success and age, visual acuity, or diagnosis. Quantitative analysis of 142 paired images showed that SightSync produced interpretable scans with comparable sharpness to Heidelberg OCT, though signal- and intensity-based metrics (signal-to-noise ratio; SNR, contrast-to-noise ratio; CNR, entropy, pixel intensity; p90) were lower, consistent with hardware differences between a compact patient-operated prototype and a clinical-grade system. Among 121 high-quality SightSync scans, referral decisions demonstrated strong agreement with Heidelberg OCT, with a sensitivity of 83.9%, specificity of 75.6%, and a negative predictive value of 93.2%, indicating reliable exclusion of clinically significant pathology. These findings demonstrate that patients can independently acquire clinically interpretable OCT images and that SightSync provides safe, conservative triage performance—supporting its potential as a scalable community-based retinal imaging solution—while a review of unsuccessful scans has identified prototype modifications expected to further improve device feasibility. Full article

Background: Heart failure (HF) patients with a ‘reduced’ ejection fraction (HFrEF) have several proven treatment options, but for those with a ‘preserved’ ejection fraction (HFpEF) there are very few. However, recent trials such as the EMPEROR-Preserved and DELIVER have shown that sodium-glucose cotransporter 2 (SGLT2) inhibitors significantly reduce HF hospitalization in HFpEF patients, and these are now supported by both Australian and international guidelines. Methods: We undertook a narrative review using a structured multi-database search (MEDLINE, Embase, CINAHL, Scopus) and key Australian sources (AIHW, ABS, Department of Health and Aged Care) without geographic or publication-year restrictions. Results: In Australia there were approximately 179,000 hospitalizations in 2020–2021 due to HF equating to a rate of 697 per 100,000 population. The age-standardized hospitalization rate for HF in remote and very remote areas was 1.8 times higher than in major cities. Likewise, since 2000 the prevalence of diabetes has nearly tripled, from 460,000 to 1.3 million. In remote areas, there were 47,600 diabetes hospitalizations in 2021–2022, with residents being 2.5 times more likely to be hospitalized for diabetes compared to those in major cities. Conclusions: In rural Australia, reducing preventable hospitalizations and premature mortality from heart failure and type 2 diabetes requires a stronger rural generalist and general practitioner workforce, improved access to essential medicines and telehealth, and equity-focused evaluation. Full article

Background: Due to the lack of curative treatments for inflammatory bowel disease (IBD), patients need lifelong follow-up care. Telehealth offers a valuable solution to balance routine visits with necessary monitoring. Objectives: To map what is known about the benefits and barriers encountered by nurses in their use of telehealth for the follow-up care of patients with IBD. Methods: Following the methodology from the Joanna Briggs Institute, we conducted a scoping review across four electronic databases from June 2024 to September 2025. Key search terms included “inflammatory bowel disease,” “nurse experience,” and “telehealth.” A content analysis was employed to summarize the key findings. Results: We screened 1551 records, ultimately including four original research articles from four countries. Benefits identified were as follows: (1) the vital contributions of IBD telenursing in empowering patients by bridging health literacy and self-care skills; (2) optimal use of staffing time supports patient-centred care; and (3) ease of use. Barriers included the following: (1) increased workload and task imbalances; (2) the need for customized interventions; (3) technical issues and concerns regarding the security of digital systems; (4) telehealth as a supplementary option or a standard procedure; and (5) concerns related to the patient–nurse relationship. Conclusions: Nurses view telehealth as a promising approach that enhances patients’ health literacy and self-care skills and improves patient outcomes through effective monitoring. To fully realize telehealth’s potential, implementing strategies like triage protocols, algorithmic alerts, electronic health record integration, and comprehensive nurse training to enhance patient care and engagement may be beneficial. This scoping review highlights the need for more research on nurses’ experiences with telehealth in IBD due to limited publications. Full article

Background/Objectives: Multidisciplinary care is the gold-standard approach for delivering comprehensive pediatric healthcare. For children undergoing cochlear implant (CI) evaluation, multiple appointments are required to assess candidacy, set realistic expectations, and counsel families on rehabilitation and the psychosocial impact of hearing loss. Established pediatric CI users also need coordinated follow-up to address ongoing auditory, educational, and psychosocial needs. This study evaluated the satisfaction and family perspectives of the implementation of a virtual, team-based multidisciplinary model for both CI candidates and established CI users. Methods: Thirty-nine children and their families participated in discipline-specific telehealth consultations, including audiology, listening and spoken language (LSL) therapy, psychology, and educational services, followed by a 60 min multidisciplinary team meeting. Team meetings occurred during pre-implantation and at six months post-activation for CI candidates. Team meetings for established CI users were scheduled following completion of individual consultations. Providers summarized findings from their individual visits before transitioning to a caregiver-led discussion. Post-visit surveys assessed satisfaction and perceived benefit from the multidisciplinary model. Results: Thirty-nine dyads were enrolled (11 Pre-CI; 28 Established CI). Caregivers were predominantly mothers (89.7%), most identified as Hispanic (55.3%) and White (71.1%). Over half of children identified as Hispanic (59%) and White (71.8%); most were diagnosed with hearing loss at birth (55.9%). Satisfaction with the virtual model was uniformly high: 100% of caregivers were satisfied or very satisfied, and most rated care quality as “very good” or “excellent.” LSL therapy was most frequently rated as the most beneficial visit (70% Pre-CI; 45% Established CI). Caregivers strongly preferred ongoing team-based care, with 55–80% reporting that they would like it to occur every six months and 95–100% preferring remote meetings. Conclusions: A virtual multidisciplinary model offers a high-quality, family-centered approach for both CI evaluations and ongoing management of established CI users. By integrating simultaneous team-based sessions, this model not only supports the ‘whole child’ but also strengthens the family system by improving communication, streamlining care, and reducing the burden of multiple in-person appointments. Families consistently report high levels of satisfaction with the convenience, clarity, and collaboration provided through virtual team visits. Incorporating routine check-ins with families is essential to ensure their needs are addressed, reinforce progress, and guide timely, targeted interventions that maximize each child’s developmental outcomes. Full article

Background: Obesity management is evolving with the integration of dual GIP/GLP-1 receptor agonists (Tirzepatide) into comprehensive Digital Weight-Loss Services (DWLSs). This model leverages virtual, app-based multidisciplinary care (MDT) to deliver continuous, supervised treatment, distinguishing it from traditional, intermittent clinic-based care. While clinical trials demonstrate high efficacy, real-world data are necessary to evaluate long-term adherence and identify predictive markers for patient persistence in these scalable care models. Specifically, there is a knowledge gap regarding the specific behavioral factors that govern 12-month persistence in these comprehensive, medicated DWLS settings. This study retrospectively assessed the 12-month effectiveness and adherence of a Tirzepatide-supported DWLS and identified demographic, clinical, and behavioral predictors of weight loss and program attrition. Methods: Data from 19,693 patients enrolled in the Juniper UK DWLS were analyzed. Adherence was defined by a minimum of 10 medication orders and 12-month weight submission. Weight loss in the full cohort was evaluated using the Last Observation Carried Forward (LOCF) method. Binary logistic and multiple linear regression models identified predictors of adherence and weight loss, respectively, using a comprehensive set of demographic, clinical (e.g., BMI, comorbidities), and behavioral variables. Results: The 12-month adherence rate was 27%. The adherent sub-cohort (n = 5322) achieved a mean weight loss of 22.60 (±7.46) percent, compared to 13.62 (±10.85) percent in the full cohort (LOCF). This difference in 12-month mean weight loss was statistically significant (p < 0.001). Consistent weekly weight tracking and health coach communication were the strongest positive predictors of long-term adherence and weight loss. Conversely, hyper-engagement, specifically intensive tracking frequency and high weight loss velocity in the first month, was a significant inverse predictor of 12-month adherence. Reporting side effects was positively correlated with adherence, suggesting a reporting bias among engaged patients. Conclusions: The DWLS model facilitates the maximum therapeutic effectiveness for adherent patients. However, patient persistence remains the primary translational challenge. As consistent weekly engagement (tracking, coaching) is the strongest predictor of success, clinical strategies should prioritize promoting sustainable, moderate behavioral pacing (i.e., emphasizing consistent weekly engagement over intensive daily tracking and rapid early weight loss) to mitigate attrition risk and optimize the public health effectiveness of medicated DWLSs. Full article

Fishermen operating in pelagic fisheries often experience significant barriers to medical care due to geographic isolation, harsh environmental conditions, and the absence of onboard healthcare personnel. Telemedicine offers an effective approach to overcome these limitations by enabling remote diagnosis, monitoring, and treatment through satellite-based communication systems. This review summarizes the progress and applications of telemedicine in maritime and other austere environments, focusing on technological advancements, clinical implementations, and emerging trends in artificial intelligence-driven healthcare. Evidence from pilot and retrospective studies highlights the growing use of wearable devices, telementored ultrasound, digital photography, and cloud-based monitoring systems for managing acute and chronic medical conditions at sea. The integration of machine learning and deep learning algorithms has further improved fatigue, stress, and motion detection, enhancing early risk assessment among seafarers. Despite challenges such as limited connectivity, data privacy concerns, and training requirements, the adoption of telemedicine significantly improves health outcomes, reduces emergency evacuations, and promotes occupational safety. Future directions emphasize the development of 5G-enabled Internet of Medical Things networks and predictive AI tools to establish comprehensive maritime telehealth ecosystems for fishermen in pelagic operations. Full article

Background and Objectives: Heart failure (HF) affects millions globally, with traditional cardiac rehabilitation (CR) improving outcomes but facing access barriers. Telehealth-based CR offers a promising alternative, yet its effectiveness and patient-centred outcomes require updated evaluation. This systematic review aimed to assess the effectiveness, accessibility, and patient-centred outcomes of telehealth-based CR compared with usual care or centre-based CR in adults with HF. Materials and Methods: This systematic review followed PRISMA 2020 guidelines. Eligible studies were randomized controlled trials involving adults with HF receiving telehealth CR (e.g., telephone, apps, remote monitoring) compared with usual care or centre-based CR; non-RCTs and studies lacking relevant outcomes were excluded. Searches of PubMed, Medline, CINAHL, EMBASE, and Web of Science identified studies published between 2020–2025. Primary outcomes were exercise capacity (six-minute walk distance [6MWD], peak VO₂) and quality of life (QoL); secondary outcomes included adherence, satisfaction, and clinical events. Meta-analyses used standardized mean differences (SMD) for 6MWD and QoL. Risk of bias was assessed using PEDro, Jadad, and RoB2 tools. Results: Fourteen randomized controlled trials (total n = 7371 participants) met the inclusion criteria. Telehealth CR significantly improved 6MWD (SMD 0.35, 95% CI 0.15–0.55, p < 0.001; 6 studies) and QoL (SMD 0.28, 95% CI 0.10–0.46, p = 0.002; 8 studies) compared to usual care, showing equivalence to center-based CR. Adherence ranged from 70–92% and satisfaction 75–96%, and hospitalizations declined in some studies, though mortality benefits were not observed. Conclusions: Telehealth CR is effective, accessible, and patient-centred for individuals with HF, performing comparably to centre-based CR and better than usual care. It should be integrated into standard HF management, supported by policy and technology investment. Evidence is limited by short follow-up durations and moderate heterogeneity among trials. Full article

Background/Objectives: Single-sided deafness (SSD) treatment options include Contralateral Routing of Signal (CROS) or Bilateral Routing of Signal (BiCROS) systems, bone conduction devices, cochlear implants (CIs) and no intervention. Aligning treatment recommendations with patient motivations is fundamental for satisfaction and successful outcomes. At our institution, a structured telehealth consultation precedes formal testing and includes treatment motivation exploration and comprehensive review of all interventions. This study examined SSD treatment motivations and their association with pursuing cochlear implantation. Methods: Adults who completed a pre-treatment SSD telehealth consultation over a four-year period were identified. Charts were retrospectively reviewed for demographics, SSD characteristics, treatment motivations, treatment choice, and CI outcomes. Results: A total of 122 adults were evaluated. Mean age was 56.3 (±13.0) years, and 59.8% were male. Mean SSD duration was 10.8 (±15.8) years. The most common etiology was sudden sensorineural hearing loss. The top primary motivations were improving overall hearing (23.0%), restoring hearing to the deaf ear (22.1%), and improving hearing in noise (21.3%). Most patients (45.1%) opted for a hearing aid, CROS or BiCROS system; 38.5% chose CI; and 14.8% declined treatment. Only 57.4% of those who selected CI had the implant, primarily due to surgery avoidance (31.5%) and insurance limitations (10.5%). Motivation did not predict treatment choice or CI receipt. Among CI recipients (n = 27), those motivated by hearing restoration demonstrated poorer speech outcomes and datalogging. Conclusions: Improving overall hearing and restoring hearing to the deaf ear were the most common motivations for seeking SSD treatment. Adult CI recipients had similar motivations to those who chose non-surgical options. Full article