Authors: Abubakar Mairiga, Naveed Anwar, Biddy Casselden
Abstract: Mobile applications for tinnitus management have proliferated rapidly, yet their real-world adoption remains strikingly low. A mixed-methods study, combining sentiment analysis of 13,096 user reviews from 42 tinnitus applications, a cross-sectional survey of 171 adults with self-reported tinnitus, and in-depth semi-structured interviews with 19 participants, was conducted to investigate the socio-demographic and systemic barriers that prevent diverse populations from adopting these tools. Only 8.6% of survey respondents reported active app use despite the availability of 42 identified applications. Chi-square tests confirmed no statistically significant association between app adoption and either age (χ² = 6.25, df = 4, p > .05) or gender (χ² = 0.42, df = 4, p > .05), indicating that barriers are systemic rather than demographic. A point-biserial correlation demonstrated a very strong positive relationship between app use and subjective well-being (rpb = 0.82, p < .001). Contrary to stereotypes, adults aged 30-49 years and full-time employed professionals constituted significant proportions of app users, challenging the assumption that tinnitus apps are used primarily by elderly retirees. Five principal barriers were identified through thematic analysis: low awareness and absent clinician referral pathways, lack of marketplace quality standardisation, limited personalisation, digital literacy challenges for older users, and privacy and data security concerns. Actionable recommendations are proposed for developers, clinicians, and policymakers to create user-centred, inclusive digital interventions that close the efficacy-accessibility gap in tinnitus self-management.
