BACKGROUND: Healthcare workers (HCWs) are commonly not prepared to properly communicate with D/deaf and hard of hearing (HoH) patients. The resulting communication challenges reinforce the existing barriers to accessing and benefiting from quality of care in these populations. In response, this study aimed to develop and evaluate a capacity-building intervention for HCWs to raise their awareness of D/deaf and HoH individuals\' experiences in healthcare and improve their capacity to communicate with these populations.
METHODS: This study featured a participatory action research design using qualitative and quantitative methods. The intervention was developed and tested through 4 iterative phases. Reactions (i.e., satisfaction and perception of the intervention content, quality, appropriateness and usefulness) were assessed quantitatively and qualitatively after the intervention, whereas perceived knowledge and self-efficacy in communicating with D/deaf and HoH patients and organizational payoffs (use frequency of basic rules and tools improving communication) were quantitatively assessed before, after and 6-month post-intervention.
RESULTS: Main qualitative and quantitative findings showed that the final version of the intervention reached high levels of satisfaction among participants. Next, perceived knowledge and self-efficacy scores obtained after receiving the intervention and 6 months later were significantly higher than those yielded in the initial assessment, although both scores significantly decreased at 6 months (compared to the scores obtained just after the intervention). Finally, findings showed no significant changes in organizational payoffs after receiving the intervention. Echoing these results, main qualitative findings documented that after receiving the intervention, participants felt more confident yet not more equipped to communicate with D/deaf and HoH patients.
CONCLUSIONS: Findings suggest that the capacity-building intervention is a promising means to sustainably increase HCWs\' perceived knowledge and self-efficacy on how communicating with D/deaf and HoH patients, although complementary approaches and follow-up intervention reminders may be necessary to enable practice changes in the working environment.

BACKGROUND: Children who are deaf or hard of hearing (DHH) are at risk for poor developmental outcomes related to incomplete language access. Evidence based interventions are available to improve early access to language. With a better understanding of caring for DHH children, pediatricians will be more prepared to work with families in improving outcomes for this population. To date, there are no formal curricula on educating pediatric trainees on childhood hearing differences.
METHODS: The authors designed a novel pilot curriculum to educate pediatric trainees on caring for DHH children, including screening, diagnosis, signed languages, and hearing technologies. The curriculum was delivered to pediatric interns in a 1-hour seminar. Pre-lecture, immediate post-lecture, and 6-month post-lecture surveys were developed and conducted to evaluate the effectiveness of the curriculum. Descriptive statistics were used to determine differences in understanding concepts before and after the curricular intervention.
RESULTS: A total of 55 residents participated in the curriculum over a 14-month study period from 2018 to 2019. There were significant differences in responses between the pre- and post- surveys related to residents\' understanding of childhood deafness and their confidence in their ability to care for DHH children.
CONCLUSIONS: Pediatric trainees gained an understanding of the challenges faced by DHH children and of the interventions that aim to provide them with access to language during the critical period of development. As a result, trainees will be in a better position to care for patients and their families after a new diagnosis of a hearing difference and guide them through early language-based interventions.

Infant-parent interaction forms the foundation for language learning. For the majority of deaf infants, hearing loss can impact access to, and the quality of communicative interactions, placing language development at risk. Support for families to meet the challenges faced during interaction is highly variable in the United Kingdom. In a step towards more standardized but tailorable family support, we co-produced an instructional, video-based intervention, testing for feasibility in terms of behavior change in seven communicative strategies and acceptability with 9 parents, forming study 1. Parents increased their use of the majority of behaviors and found content and delivery acceptable. However, further development was required to: (a) support use of semantically contingent talk and attention getting strategies to elicit infant attention, and (b) ensure the information was provided in a bite-size format that could be tailored to individual families. In study 2, the intervention was refined based on findings from study 1 and assessed for acceptability with 9 parents and 17 professionals, who reported similar high acceptability scores. Final refinements and modifications could be addressed in future interventions. The current studies provide a positive early step towards a standardized intervention to support communication that could be used in routine practice.

BACKGROUND: Mental health concerns are a significant issue among the deaf and hard of hearing (D/HH) community, but community members can face several unique challenges to accessing appropriate resources.
OBJECTIVE: The aim of this study was to investigate the mental health needs of the D/HH community and how mental health apps may be able to support these needs.
METHODS: A total of 10 members of the D/HH community participated in a focus group and survey to provide their perspectives and experiences. Participants were members of the Center on Deafness Inland Empire team, which comprises people with lived experience as members of and advocates for the D/HH community.
RESULTS: Findings identified a spectrum of needs for mental health apps, including offering American Sign Language and English support, increased education of mental health to reduce stigma around mental health, direct communication with a Deaf worker, and apps that are accessible to a range of community members in terms of culture, resources required, and location.
CONCLUSIONS: These findings can inform the development of digital mental health resources and outreach strategies that are appropriate for the D/HH community.

Background: D/deaf and hard of hearing populations are at higher risk for experiencing physical and mental health problems compared to hearing populations. In addition, they commonly encounter barriers to accessing and benefiting from health services, which largely stem from challenges they face in communicating with healthcare providers. Healthcare providers commonly lack tailored communication skills in caring for D/deaf and hard of hearing populations, which lead to difficulties and dissatisfaction for both staff and D/deaf and hard of hearing communities. This research project aims to develop and evaluate a capacity-building intervention for healthcare providers with the goal of increasing their awareness of D/deaf and hard of hearing individuals\' experiences with the healthcare system, their distinct needs, and improving their capacity to communicate effectively with this patient population. Methods: This research project features a participative action research design using qualitative and quantitative methods. Consistent with participative action research, the study will actively involve the target populations, key stakeholders and representative associations. The intervention will be developed and tested through iterative phases. The Integrated Model of Training Evaluation and Effectiveness will guide prospective evaluation of the intervention. The latter will involve qualitative and quantitative assessments in participants before and after the intervention and at 6-months follow-up. Discussion: Results will contribute to research aimed at decreasing barriers to accessing and benefiting from healthcare services for D/deaf and hard of hearing individuals. Findings will be presented to representative associations and political authorities, as well as disseminated at research conferences and in peer-reviewed journals.

BACKGROUND: Hearing loss is an important public health issue, since it has a very negative impact on peoples\' lives, irrespective of the age at which it develops. However, globally there is a noticeable lack of epidemiological data for health outcomes for people who are deaf and hard of hearing. In Greece, people with hearing disabilities are systematically not included in health policy and planning processes, despite there being a marked tendency for global efforts aimed at improving their quality of life.
METHODS: The sample consisted of 140 adults with hearing loss (86 d/Deaf and 54 hard of hearing) and 97 normal hearing as the control group. We run data collection from April to June 2015, using the Greek version of the 36-Item Short Form Health Survey (SF-36v2). Socio-demographic and characteristics about non-medical determinants of health (tobacco and alcohol consumption levels, BMI and physical activity).were also collected and were analysed as possible determinants. Data analysis included bivariate and multivariate analyses such as linear regression models.
RESULTS: Multivariate analyses identified that in all the SF-36v2 dimensions, the scores among deaf people were lower than those with normal hearing. Determinants included the hearing loss degree, educational level, body mass index, levels of physical activity, and alcohol consumption levels, while the variable \"number of family members per household\" was inversely associated with physical health summary scale score.
CONCLUSIONS: Improving knowledge of the health-related determinants that affect quality of life for the population with hearing loss is an important step in designing targeted services and interventions. In light of these findings, a special effort must be made to ensure the wellbeing of this population.