A Comparative Study of Readability, Acceptability, and the Adaptation of an Internet-based Cognitive Behavioral Therapy for Tinnitus

Emre Gürses; Eldre Beukes; Sıdıka Cesur; Gerhard Andersson; Vinaya Manchaiah

doi:10.5152/iao.2023.221023

A Comparative Study of Readability, Acceptability, and the Adaptation of an Internet-based Cognitive Behavioral Therapy for Tinnitus

J Int Adv Otol. 2023 Jun;19(3):182-190. doi: 10.5152/iao.2023.221023.

Authors

Emre Gürses¹, Eldre Beukes², Sıdıka Cesur³, Gerhard Andersson⁴, Vinaya Manchaiah⁵

Affiliations

¹ Department of Audiology, Hacettepe University, Faculty of Health Sciences, Ankara, Turkey;Virtual Hearing Lab, Collaborative initiative between University of Colorado School of Medicine, Aurora, Colorado, USA, and University of Pretoria, Pretoria, South Africa.
² Virtual Hearing Lab, Collaborative initiative between University of Colorado School of Medicine, Aurora, Colorado, USA, and University of Pretoria, Pretoria, South Africa;Vision and Hearing Sciences Research Group, Anglia Ruskin University, School of Psychology and Sport Science,Cambridge, United Kingdom.
³ Virtual Hearing Lab, Collaborative initiative between University of Colorado School of Medicine, Aurora, Colorado, USA, and University of Pretoria, Pretoria, South Africa;İstanbul Medeniyet University, Faculty of Health Sciences, İstanbul, Turkey.
⁴ Department of Behavioral Sciences and Learning, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden; Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
⁵ Virtual Hearing Lab, Collaborative initiative between University of Colorado School of Medicine, Aurora, Colorado, USA, and University of Pretoria, Pretoria, South Africa; Department of Speech-language Pathology and Audiology, University of Pretoria, Pretoria, South Africa; Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, Colorado, USA;UCHealth Hearing and Balance, University of Colorado Hospital, Aurora, Colorado, USA;Department of Speech and Hearing, School of Allied Health Sciences, Manipal Academy of Higher Education, Manipal, India.

Abstract

Background: Internet-based cognitive behavioral therapy has shown effectiveness in managing chronic tinnitus. Internet-based cognitive behavioral therapy is currently available in only a few languages (English, Swedish, Spanish, and German). The current study aimed to adapt, evaluate, and compare the readability and acceptability of the Turkish internet-based cognitive behavioral therapy materials compared to previous versions.

Methods: Internet-based cognitive behavioral therapy materials were adapted from the preexisting American English to the Turkish population in a 4-step process: (1) cultural adaptations, (2) acceptability adaptation of materials to the Turkish-speaking population, and (3) literacy-level adjustments. Experts (n=11) and patients (n=11) rated the intervention materials and the ePlatform for acceptability, including usability, content, presentation, and suitability (4).

Results: Literacy-level adjustments generated acceptable and readability levels of the Turkish version of the internet-based cognitive behavioral therapy program. The average readability score was 76.15 ± 0.35. The Turkish internet-based cognitive behavioral therapy (Mdn: 7.00) was statistically lower compared to the Swedish (Mdn: 9.00) but higher when compared to the American English and Spanish (Mdn: 5.00) versions. There were no statistical differences between the British English and Turkish versions in readability scores. Acceptability in the internet-based cognitive behavioral therapy platform was rated favorably.

Conclusion: The Turkish internet-based cognitive behavioral therapy was found to be user-friendly and easy to understand, with navigations that are straightforward, have clear information, and are supported by audiologists. The readability score of the Turkish internet-based cognitive behavioral therapy is within recommended limits to ensure comprehensibility. We suggest that an online cognitive behavioral therapy program is adaptable for other languages for countries with a limited number of clinicians focused on cognitive behavioral therapy and tinnitus.

MeSH terms

Cognitive Behavioral Therapy*
Comprehension
Humans
Internet
Language
Tinnitus* / therapy
United States