{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T18:06:20Z","timestamp":1790186780282,"version":"4.1.0"},"reference-count":20,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The Extended Effort Assessment Scale (EEAS) is a recently developed questionnaire for measuring listening effort, but a validated version for Kannada speakers is lacking. This study aimed to translate, culturally adapt, and psychometrically validate the EEAS for the Kannada-speaking adults with hearing loss.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>The EEAS was translated into Kannada (EEAS-K) following rigorous forward and back translation, expert committee review and cognitive debriefing. The final EEAS-K was then field-tested with 100 native Kannada-speaking adults with hearing loss (predominantly non-hearing aid users, 92%). Psychometric validation included assessing construct validity via exploratory factor analysis, Rasch analysis using item response theory (IRT), internal consistency (Cronbach\u2019s alpha), convergent validity via a Visual Analogue Scale (VAS), test-retest reliability with an Intraclass correlation coefficient (ICC) and Differential Item Functioning (DIF).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      All 10 EEAS-K items demonstrated acceptable content validity (CVR\u2009\n                      <jats:bold>=<\/jats:bold>\n                      \u20091.00). EFA, guided by eigenvalues and the scree plot, provided initial support for a unidimensional structure, with a single factor accounting for 32.7% of the variance. Rasch analysis supported essential unidimensionality (first residual eigenvalue\u2009=\u20091.90). Nine of 10 items showed acceptable infit MNSQ values (0.64\u20131.34); Q8 (telephone) showed elevated infit (1.92) and outfit (1.83) values, indicating misfit, which may reflect the unique and multidimensional cognitive demands of technology-mediated communication in this population. Person-item targeting remained within acceptable clinical limits, though items were slightly easier for the average person\u2019s ability (person mean\u2009=\u20090.49 logits). The EEAS-K demonstrated excellent internal consistency (\u03b1\u2009=\u20090.886), moderate to strong convergent validity with the VAS (r\u2009=\u20090.611), and excellent test-reliability (ICC\u2009=\u20090.91). DIF analysis identified significant gender-based DIF for Q7 and age-based DIF for Q7 and Q8, suggesting raw scores for these specific items should be interpreted with caution across these demographics. No significant DIF was found for hearing-loss-severity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The EEAS-K is a reliable and valid tool for assessing listening effort in Kannada-speaking adults with hearing loss. The Wright map demonstrates adequate person-item targeting, and the dual-method psychometric approach provides satisfactory measurement evidence supporting clinical and research use.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0358439","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T17:27:41Z","timestamp":1790184461000},"page":"e0358439","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cross-cultural adaptation and psychometric validation of the Kannada version of the Extended Effort Assessment Scale (EEAS-K) in adults with hearing loss"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-7164-4129","authenticated-orcid":true,"given":"Bhavana","family":"Rhythm","sequence":"first","affiliation":[{"name":"Manipal College of Health Professions, Manipal Academy of Higher Education","place":["Manipal, India"],"department":["Department of Speech and Hearing"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8962-2484","authenticated-orcid":true,"given":"Kanaka","family":"Ganapathy","sequence":"additional","affiliation":[{"name":"Manipal College of Health Professions, Manipal Academy of Higher Education","place":["Manipal, India"],"department":["Department of Speech and Hearing"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8088-5731","authenticated-orcid":true,"given":"Archana","family":"Gundmi","sequence":"additional","affiliation":[{"name":"Manipal College of Health Professions, Manipal Academy of Higher Education","place":["Manipal, India"],"department":["Department of Speech and Hearing"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5631-9411","authenticated-orcid":true,"given":"Hari Prakash","family":"Palaniswamy","sequence":"additional","affiliation":[{"name":"Manipal College of Health Professions, Manipal Academy of Higher Education","place":["Manipal, India"],"department":["Department of Speech and Hearing"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,9,23]]},"reference":[{"key":"pone.0358439.ref001","doi-asserted-by":"crossref","unstructured":"Pichora-Fuller MK, Kramer SE, Eckert MA, Edwards B, Hornsby BWY, Humes LE. 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