Purpose: Hearing aids play a pivotal role in mitigating the impact of hearing loss, yet their adoption and consistent usage remain suboptimal. Understanding the hearing aid needs of individuals with hearing loss is important to support uptake, use, and outcomes. The current study describes users’ perspectives on how hearing aids can be improved.

Method: A cross-sectional, qualitative, content analysis design was used for an open-ended question from an online survey, exploring user perspectives on hearing aid improvements. Participants were adult hearing aid users in the United States, surveyed from the Hearing Tracker and Lexie Hearing user database.

Results: 628 participants (mean age = 66 years) were surveyed. The majority of participants used bilateral, behind-the-ear hearing aids that were obtained either through a hearing healthcare professional or online. Three domains, highlighting areas for hearing aid improvement, was identified. 1. Hearing aid features domain describes user issues surrounding physical appearance and fit, general features, streaming, battery functionality, adjustments, smartphone applications and hearing aid related accessories. There was dissatisfaction with aesthetics and functionality, with a notable desire for improvements in physical appearance and fit (n=161), and features to improve self-efficacy. 2. Sound quality domain described user issues surrounding sound perception and difficult situations. Participants highlighted unmet needs for clarity, especially in noisy environments (n=143). 3. Service-delivery domain described user issues on audiology services and general satisfaction, with criticisms centered on the high cost of hearing aids (n=193) and the credibility of hearing healthcare professionals.

Conclusions: Hearing aid users appreciate current technological advances but express a need for improvements, to better align devices with their requirements. Key areas include physical aesthetics, user control over device adjustments, sound clarity, cost accessibility and trust between the user and hearing healthcare professional. Future designs should focus on features enhancing user autonomy and self-efficacy.