Objectives: This systematic review examined the audiological and non-audiological factors that influence hearing help-seeking and hearing aid uptake in adults with hearing difficulties based on the literature published during the last decade.

Design: Peer-reviewed articles published between January 2011 and February 2022 were identified through systematic searches in electronic databases CINAHL, PsycINFO and MEDLINE. The review was conducted and reported according to the PRISMA protocol.

Results: Forty-two articles met the inclusion criteria. 71 (44 audiological and 27 non-audiological) hearing help-seeking factors and 159 (93 audiological and 66 non-audiological) hearing aid uptake factors were investigated with many reported only once (10/71 and 62/159, respectively). Hearing aid uptake had some strong predictors e.g., hearing sensitivity with others showing conflicting results (e.g., self-reported health). Hearing help-seeking had clear non-predictive factors e.g., education and conflicting factors e.g., self-reported health. New factors included cognitive anxiety associated with increased help-seeking and hearing aid uptake and urban residency and access to financial support with hearing aid uptake. Most studies were classified as level 4 evidence (67%) and rated as fair quality (86%).

Conclusions: Effective promotion of hearing help-seeking requires more research evidence. Investigating factors with conflicting results and limited evidence is important to clarify what supports help-seeking and hearing aid uptake in specific groups. These findings can inform future research and hearing health promotion and rehabilitation practices.