Usability and Performance of the Apple Over-the-Counter Hearing Aid Feature

Purpose: This study provides the first independent evaluation of the Apple Over-the-Counter Hearing Aid Feature (OTC-HAF), examining its usability and laboratory performance among adults with self-perceived mild-to-moderate hearing loss. Method: A cross-sectional evaluation was conducted at a university audiology clinic. Digitally literate iPhone users ( n = 25, ages 20–72 years) independently used AirPods Pro 2 to complete the Apple Hearing Test Feature and activate the OTC-HAF. The sample size aligns with usability model recommendations for moderately complex systems. Outcomes were assessed immediately after setup. Results: Usability was high, with a mean mHealth App Usability Questionnaire score of 6.7/7 ( SD = 0.3) and a mean Hearing Aid Skills and Knowledge Inventory–Clinical score of 93.4% ( SD = 9.0%). Study-specific questionnaire responses showed high satisfaction, good sound quality, and ease of use. Qualitative feedback highlighted affordability, convenience, and dual-purpose design, with some noting occlusion and difficulty locating settings. Some participants reported they would only use the device situationally. The audiogram import feature showed limited accuracy: 71% of thresholds were within 5 dB of the reference when both ears were scanned together and 73% when each ear was scanned separately, with 12% and 8% of thresholds missing for these methods, respectively. Objective performance measures showed nonsignificant speech-in-noise benefit (Quick Speech-in-Noise Test mean benefit of 0.1 dB SNR, SD = 1.9), and real-ear measurements showed gain levels generally below National Acoustic Laboratories–Non-Linear 2 targets. Conclusions: The Apple OTC-HAF showed high usability and satisfaction among digitally literate iPhone users, but nonsignificant speech-in-noise benefit and gain levels generally lower than prescriptive targets. Further research should explore broader applicability, long-term outcomes, and strategies to support uptake and consistent use. Supplemental Material: https://doi.org/10.23641/asha.31366123