Deaf And Hard Of Hearing People Research Articles

Care Partner Experiences in Supporting Deaf and Hard of Hearing Adults With Diabetes

OBJECTIVE Care partners play an important role in diabetes management of people with diabetes. Although deaf and hard of hearing (DHH) adults experience diabetes at a higher rate than their hearing counterparts, there is a lack of information regarding the experience of care partners assisting those in the DHH community. There is a need to identify intentional support for this population. The purpose of this study was to explore how care partners of DHH people with diabetes provide helpful and unhelpful support, the care partner experience of providing support, and care partners’ perceived diabetes self-management education, support needs, and recommendations. METHODS We engaged a community advisory board of care partners to DHH people with diabetes to explore how care partners provide support, their individual experiences in providing support, and their suggestions for diabetes self-management education. We used thematic analysis to analyze individual and collective responses. RESULTS Three emergent themes were identified suggesting that care partners give support in a variety of ways, are often overwhelmed in meeting the demanding and ongoing needs of DHH people with diabetes, and have a multitude of suggestions for implementing a future diabetes care partner education program. We also identified some DHH population-specific challenges to diabetes care, including communication barriers with health care providers, inability to use hearing cues if a person with diabetes experiences a fall, and limited access to diabetes care education in sign language. CONCLUSION These findings highlight a need to provide more support for care partners of DHH people with diabetes and to address the needs of DHH populations to ensure more equitable diabetes care. Further research is needed to adequately inform successful interventions for DHH people with diabetes and their care partners.

Augmented-reality visual presentation of sounds for deaf and hard of hearing people

To support deaf and hard of hearing (DHH) people by helping them detect environmental sounds in their dwellings, evaluation experiments on environmental sound recognition using a visualization device were conducted. The current study proposes an augmented reality-based system for presenting household sounds to DHH people as visual information. The effect of displaying both the icons indicating sounds classified by machine learning and a dynamic spectrogram indicating the real-time time-frequency characteristics of the environmental sounds were examined. The results confirmed that the comfort of daily life in residential spaces can be improved by combining not only the classification results of machine learning but also the real-time display of spectrograms.

Subtitling for people with hearing impairments in the Arab world context: The case of <i>the Blue Elephant 2</i> movie

Although technology advancements have increased the availability of screens everywhere, making it possible to watch AV products anytime, the deaf-and-hard-of-hearing (DHH) accessibility to these materials in the Arab world is still poor. Only a few Arabic movies with this feature are available via Netflix. In this study, the subtitles for the deaf and hard of hearing (SDH) in <i>The Blue Elephant 2</i> movie are analyzed. This study qualitatively examines the type of information covered in the subtitles of the investigated Arabic movie for Arab viewers with hearing impairment. It also quantitatively investigates the reactions of people with hearing impairment to the technical aspects of the subtitles using a structured questionnaire, which consisted of five open-ended questions. The qualitative analysis revealed two main types of information, namely, para-linguistic/extra-linguistic and linguistic. The para-linguistic/extra-linguistic aspect includes information about music, speakers, vocal non-linguistic features, and non-verbal signs. The linguistic aspect is related to the code-switching between languages where the speaker may use some languages other than Arabic. The quantitative analysis showed that the participants reacted positively to the technical aspects of the subtitles, including the length and synchrony. They stated that they had enough time to read and process the information included in the subtitles. The paralinguistic information was reflected in the subtitles and helped them better understand the movie. The sample attitude towards SDH was good and positive, and they like to watch more Arabic movies with this feature in the future. This study concludes that more attention to DHH people in terms of accessibility to audiovisual content should be paid. This will likely improve their linguistic and cultural skills and help them integrate more with the surrounding community. The study’s findings have substantial implications for enhancing DHH individuals’ access to audiovisual content in Jordan and the wider Arab region. The study emphasizes the need to deliver high-quality SDH that incorporates both linguistic and paralinguistic information to DHH viewers in order to improve their viewing experience.

Emergency department patient-centred care perspectives from deaf and hard-of-hearing patients.

Deaf and hard-of-hearing (DHH) patients are a priority population for emergency medicine health services research. DHH patients are at higher risk than non-DHH patients of using the emergency department (ED), have longer lengths of stay in the ED and report poor patient-provider communication. This qualitative study aimed to describe ED care-seeking and patient-centred care perspectives among DHH patients. This qualitative study is the second phase of a mixed-methods study. The goal of this study was to further explain quantitative findings related to ED outcomes among DHH and non-DHH patients. We conducted semistructured interviews with 4 DHH American Sign Language(ASL)-users and 6 DHH English speakers from North Central Florida. Interviews were transcribed and analysed using a descriptive qualitative approach. Two themes were developed: (1) DHH patients engage in a complex decision-making process to determine ED utilization and (2) patient-centred ED care differs between DHH ASL-users and DHH English speakers. The first theme describes the social-behavioural processes through which DHH patients assess their need to use the ED. The second theme focuses on the social environment within the ED: patients feeling stereotyped, involvement in the care process, pain communication, receipt of accommodations and discharge processes. This study underscores the importance of better understanding, and intervening in, DHH patient ED care-seeking and care delivery to improve patient outcomes. Like other studies, this study also finds that DHH patients are not a monolithic group and language status is an equity-relevant indicator. We also discuss recommendations for emergency medicine. This study convened a community advisory group made up of four DHH people to assist in developing research questions, data collection toolsand validation of the analysis and interpretation of data. Community advisory group members who were interested in co-authorship are listed in the byline, with others in the acknowledgements. In addition, several academic-based co-authors are also deaf or hard of hearing.

Technological socialities: The impact of information and communication technologies on belonging among deaf and hard‐of‐hearing people

AbstractThis review article examines how different types of communication technologies, from the specialized medical to generic social devices, influence belonging and sociality among deaf and hard‐of‐hearing (DHH) people. The emphasis is on DHH adolescents and young adults who may be impacted differently across countries, given state‐specific policies regarding the status of sign language and deaf education, and based on different availability, affordability, and accessibility of communication technologies. We introduce different perspectives on deafness, ranging from pathological to cultural, a heuristic on which we build to explore DHH socialities as complex and evolving. We then analytically review ethnographic research on how cochlear implants impact DHH people's belonging to the “deaf world” and/or the “hearing world,” and how they navigate between these worlds. Then we move on to technologies such as text messages and social media, which enable DHH people to extend their socialities beyond local communities. Belonging is a fluid phenomenon, and technologies which are in a constant process of innovation and development may influence it in complex ways. We argue that to explore questions of belonging, identity, and sociality among DHH people, and how they are shaped by technologies, (visual) ethnographic methods are particularly productive.

Unmet Dental Needs Among Mid-to-Older Deaf and Hard of Hearing Women in the U.S.

IntroductionDespite the significant number of deaf and hard of hearing (DHH) people living in the U.S., oral health research on DHH people who use American Sign Language (ASL) is virtually nonexistent. This study aims to investigate dental needs among mid-to-older DHH women and identify social determinants of health that may place them at higher risk for unmet dental health needs as the primary outcome.MethodsThis cross-sectional study uses data drawn from Communication Health domain in the PROMIS-DHH Profile and oral health data from the National Health and Nutrition Examination Survey. Both measures were administered in ASL and English between November 2019 and March 2020. Univariate and bivariate analysis included only complete data, and multivariable logistic regression analyses were conducted on multiply imputed data.ResultsOut of 197 DHH women (41 to 71+ years old) who answered the dental visit question, 48 had unmet dental needs and 149 had met dental needs. Adjusting for sociodemographic variables, disparity in dental needs was observed across education [OR (95% CI): 0.45(0.15, 1.370)] and communication health [0.95 (0.90, 1.01)].DiscussionOur study is the first to describe DHH mid-to-older women's access to oral health care. DHH women who do not have a college degree may be impacted. Further research is needed to elucidate the particular risk factors, including cultural, to which DHH individuals from marginalized racial groups are susceptible to unmet oral health needs.ConclusionsEvidence shows that DHH ASL users who have less years of education or are single experience barriers in accessing dental care.

Exploring accommodations along the education to employment pathway for deaf and hard of hearing healthcare professionals.

BackgroundDeaf and hard of hearing (DHH) people are an underserved population and underrepresented among healthcare professionals. A major barrier to success for DHH healthcare professionals is obtaining effective accommodations during education and employment. Our objective: describe DHH individuals’ experiences with accommodations in healthcare education.MethodsWe used an online survey and multipronged snowball sampling to recruit participants who identify as DHH and who had applied to a U.S. health professional school (regardless of acceptance status). One hundred forty-eight individuals representing multiple professions responded; 51 had completed their training. Over 80% had been accepted to, were currently enrolled, or had completed health professions schools or residency programs, and/or were employed. The survey included questions addressing experiences applying to health professions programs and employment; satisfaction with accommodations in school and training; having worked with a disability resource professional (DRP); and depression screening.ResultsUse and type of accommodation varied widely. While in school, respondents reported spending a mean of 2.1 h weekly managing their accommodations. Only 50% were highly satisfied with the accommodations provided by their programs. Use of disability resource providers (DRPs) for accommodations was highest during school (56%) and less frequent during post-graduate training (20%) and employment (14%). Respondents who transitioned directly from school to employment (versus via additional training) were more satisfied with their accommodations during school and were more likely to find employment (p = 0.02). Seventeen respondents screened positive for risk of depression; a positive screen was statistically associated with lower school accommodation satisfaction.ConclusionsDHH people study and practice across many health professions. While respondents were mostly successful in entering health professions programs, accommodation experiences and satisfaction varied. Satisfaction with accommodations was related to successful employment and wellness. Low satisfaction was associated with higher likelihood of depression symptoms. To increase representation in the workforce, healthcare professional schools, training programs, and employers should enhance support for the learning and working climates for people with disabilities.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12909-022-03403-w.

Conceptual Model of Emergency Department Utilization among Deaf and Hard-of-Hearing Patients: A Critical Review.

Deaf and hard-of-hearing (DHH) populations are understudied in health services research and underserved in healthcare systems. Existing data indicate that adult DHH patients are more likely to use the emergency department (ED) for less emergent conditions than non-DHH patients. However, the lack of research focused on this population’s ED utilization impedes the development of health promotion and quality improvement interventions to improve patient health and quality outcomes. The purpose of this study was to develop a conceptual model describing patient and non-patient (e.g., community, health system, provider) factors influencing ED utilization and ED care processes among DHH people. We conducted a critical review and used Andersen’s Behavioral Model of Health Services Use and the PRECEDE-PROCEED Model to classify factors based on their theoretical and/or empirically described role. The resulting Conceptual Model of Emergency Department Utilization Among Deaf and Hard-of-Hearing Patients provides predisposing, enabling, and reinforcing factors influencing DHH patient ED care seeking and ED care processes. The model highlights the abundance of DHH patient and non-DHH patient enabling factors. This model may be used in quality improvement interventions, health services research, or in organizational planning and policymaking to improve health outcomes for DHH patients.

External Communication Barriers among Elderly Deaf and Hard of Hearing People in China during the COVID-19 Pandemic Emergency Isolation: A Qualitative Study.

The COVID-19 pandemic poses a great risk to older people with hearing impairment, who face a higher threshold of external communication after the implementation of the emergency isolation policy. As part of a study on the optimization of external communication among the deaf and hard of hearing (DHH) population in central China, this study employed a qualitative research method based on in-depth interviews to explore the needs and difficulties faced by the older DHH group in external communication during public health emergencies in Wuhan, China, in the context of the COVID-19 pandemic. The results showed that older DHH people had weak reception of critical information about the epidemic, and had suboptimal access to medical care during emergency quarantine, which increased interpersonal communication barriers to this group. The current findings highlight the urgent need for targeted strengthening of the original emergency communication and coordination mechanisms in public health emergencies, and for improving policy inclusiveness for older DHH individuals during the COVID-19 pandemic and emergencies alike.

Signing and the Brain: The Importance of Early Education for Deaf and Hard of Hearing Children

Language skills are developed as one is exposed to auditory input from birth to adolescence. However, a majority of deaf and hard-of-hearing (DHH) individuals do not receive adequate—or appropriate—guidance from their parents at an early age. Since the brain develops significantly during the early years of childhood, children need robust and persistent instruction to develop the ability to recognize language. DHH children who lack the ability to perceive audio and spoken language, the universal language format, have poor outcomes in the future. In fact, hearing-disabled Americans are more likely to be unemployed, imprisoned, or have poor physical health. This paper will discuss the obstacles DHH people face in society as well as introduce a program to improve the standard of living for the deaf community. It will focus on preventative methods, most importantly, the adoption of a visual language, to protect DHH children from facing major neurological issues that would intrude on their ability to communicate with others fluently.

A Computational Approach to Sign Language Understanding

Sign language is the primary mode of communication in the Deaf and Hard-of-Hearing (DHH) communities. Unfortunately, sign language is not as well understood among the non-signing hearing population leading to limited access and services to the DHH community, and also acts as a barrier between non-signing and DHH people. In my Ph.D. thesis, I am working on improving the sequence modeling for sign language translation and understanding by considering different types of sequence models, various input features, and by understanding the semantic relation between the words and the signs. Currently, my research focuses on a popular publicly available German Sign Language dataset.

Perception of COVID-19 Physical Distancing Effectiveness and Contagiousness of Asymptomatic Individuals: Cross-sectional Survey of Deaf and Hard of Hearing Adults in the United States.

BackgroundDuring the COVID-19 pandemic, there has been a rapid increase in the amount of information about the disease and SARS-CoV-2 on the internet. If the language used in video messages is not clear or understandable to deaf and hard of hearing (DHH) people with a high school degree or less, this can cause confusion and result in information gaps among DHH people during a health emergency.ObjectiveThe aim of this study is to investigate the relationship between DHH people's perception of the effectiveness of physical distancing and contagiousness of an asymptomatic person.MethodsThis is a cross-sectional survey study on DHH people's perceptions about COVID-19 (N=475). Items pertaining to COVID-19 knowledge were administered to US deaf adults from April 17, 2020, to May 1, 2020, via a bilingual American Sign Language/English online survey platform.ResultsThe sample consisted of 475 DHH adults aged 18-88 years old, with 74% (n=352) identifying as White and 54% (n=256) as female. About 88% (n=418) of the sample felt they knew most things or a lot about physical distancing. This figure dropped to 72% (n=342) for the question about the effectiveness of physical distancing in reducing the spread of COVID-19 and 70% (n=333) for the question about the contagiousness of an infected person without symptoms. Education and a knowledge of the effectiveness of physical distancing significantly predicted knowledge about the contagiousness of an asymptomatic individual. Race, gender, and age did not emerge as significant predictors.ConclusionsThis results of this study point to the strong connection between education and coronavirus-related knowledge. Education-related disparities can be remedied by making information fully accessible and easily understood during emergencies and pandemics.

Food Worry in the Deaf and Hard-of-Hearing Population During the COVID-19 Pandemic.

The coronavirus disease 2019 (COVID) pandemic has highlighted preexisting health disparities, including food insecurity, in the deaf and hard-of-hearing (DHH) population. We examined factors associated with food worry during the COVID-19 pandemic. We collected survey data on worry about food shortages, worry about contracting COVID-19, and concerns about DHH people staying home and being lonely from April 17 through May 1, 2020, via a bilingual American Sign Language/English online survey platform. The sample consisted of 537 DHH adults living in the United States. We examined the relationship between demographic characteristics and food worry. We used logistic regression and model fitting to predict the likelihood of experiencing food worry. The mean (SD) age of survey respondents was 47 (16), and 25% of the sample identified as people of color. Forty-two percent of survey respondents had a high level of food worry. Increased worry about contracting COVID-19 and concerns about DHH people staying home and being lonely among DHH younger adults or those without a college degree predicted food worry. Gender and race/ethnicity did not contribute to the model for food worry. Food worry was explained by multiple, intersecting factors, including demographic variables, worry about contracting COVID-19, and concerns about loneliness. Interventions or programs implemented by DHH-serving organizations as well as government programs, social service providers, and food banks should be fully accessible to subgroups of DHH young adults without a college degree who are at risk for food insecurity.

Deaf and hard of hearing awareness training: A mentor-led workshop.

People who are deaf and hard of hearing (DHH) comprise a significant and increasing proportion of the population. They face many barriers to accessing good health care and major communication challenges with health professionals. There is evidence that DHH awareness training for health professionals needs improvement but little information about how such training is incorporated into curricula. The research question we address is how to develop and deliver an effective workshop for students led by people who, by definition, have barriers to communication due to hearing loss and deafness. Workshop development was initiated and led by a medical student as a course project, in collaboration with DHH people, other students, and university faculty in an iterative participatory educational design process, supported by a community-based organization that provides programs and services for DHH people. Development resulted in a pilot workshop suitable for all health professional students. Three workshops were attended by a total of 49 students from 10 different health disciplines. Workshops were highly rated. Thematic analysis of post-workshop reflections written by occupational therapy students showed learning in the domains of knowledge, skills (practical tips and techniques), and attitudes (assumptions, motivation, reflection). Partnership with a community organization makes it feasible for DHH people to design and facilitate workshops. The organization can provide the necessary environment, technology, and support, and identify people with lived experience to be workshop mentors. Workshops help make students more aware of the needs of DHH people and motivate them to provide better care.

Mediterranean nutrition and physical activity education program at deaf and hard of hearing community

Abstract Background Today's eating reality includes a more westernized dietary pattern which seems to erode sensitive groups of our populations, such as people with disabilities. Deaf and hard of hearing people(DAHOHP) are a marginalized community in our country, whose access to the health system, health education, nutrition and exercise is limited. Our aim was to promote health education, focusing on Mediterranean diet and physical activity, through an alternative approach, that of the Greek sign language. Methods A three-day training program was created for the members of the Association of deaf and hard of hearing persons in Central Greece. Analysis of the nutritional profile of everyone was performed and an in-depth presentation of all aspects of the Mediterranean nutrition was showed. Furthermore, an experiential training on the size of food portions of all categories was performed and information and recommendations on physical activity were given. Adherence to the Mediterranean diet was assessed by the MedDietScore (range 0-55), Body Mass Index (BMI) and frequency of food consumption were evaluated. Results A total of 25 individuals (25-70 years old, 62% men) participated in the program. The average BMI was 26.2 kg/m2 in women and 25.9 k/m2 in men. Increased body weight was observed in women, whereas in men it was normal. The average questionnaire score was 31/55 for women and 29.6/55 for men, which indicates a good compliance with the Mediterranean-Diet in both. Women consumed smaller portions and fewer meals in all food groups/day, whereas men showed a high intake of alcohol/day. Conclusions Concerning DAHOHP's knowledge and adherence at the Mediterranean nutrition pattern, a good compliance was observed. However, hearing loss tends to disrupt interpersonal communications. Consequently, it severely restricts/isolates such individuals to their own closed groups with possibly experiencing diminished self-esteem and becoming more vulnerable to abuse. Key messages A need to promote health and dietary-behavior modification in people with disabilities such as DAHOHP, is obvious and immediate, by exploring incentives to improve their quality-of-life.

Who am I with others?: Selfhood and shuwa among mainstream educated deaf and hard-of-hearing Japanese youth

ABSTRACT Drawing upon long-term ethnographic research, this article examines the interlinking processes of “self-searching” (jibun sagashi) and sign language acquisition among deaf and hard-of-hearing (DHH) Japanese youth, together with the role of friendships. At the center of this study are self-identified “inte” (short for “integration”): DHH youth ages 18 to 24 who were educated in mainstream schools. Schools for the deaf have been positioned as one of the “pillars” of deaf communities around the world, playing an important role in transmitting language and culture while providing spaces for belonging. These schools are perceived by many DHH people as sites of inclusion, sameness, and mutually intelligible communication. Japan is part of an international trend toward educating children with disabilities in mainstream settings. Despite being the norm in Japan, the long-term effects of educating DHH in mainstream schools are poorly understood. This study reveals that these spaces are often marked by isolation, difference, and barriers. By focusing on tōjisha (the person in question) rather than gatekeepers (educators, parents, policy makers), this article illustrates how Sign language (shuwa) and DHH peers are essential factors in the formation of positive deaf youth selfhood. As inte move between the hearing, spoken-language world they were raised in, and a new deaf world with an unknown visual-spatial language, they work to reconcile internalized stigma with a desire to create social bonds through friendships as they (re)negotiate selfhood and redefine deafness. Friendships based on “shared difference” are shown to help mitigate the assimilative pressures facing marginalized youth in Japan.

UbiEar

Non-speech sound-awareness is important to improve the quality of life for the deaf and hard-of-hearing (DHH) people. DHH people, especially the young, are not always satisfied with their hearing aids. According to the interviews with 60 young hard-of-hearing students, a ubiquitous sound-awareness tool for emergency and social events that works in diverse environments is desired. In this paper, we design UbiEar, a smartphone-based acoustic event sensing and notification system. Core techniques in UbiEar are a light-weight deep convolution neural network to enable location-independent acoustic event recognition on commodity smartphons, and a set of mechanisms for prompt and energy-efficient acoustic sensing. We conducted both controlled experiments and user studies with 86 DHH students and showed that UbiEar can assist the young DHH students in awareness of important acoustic events in their daily life.

Crowdsourced real-time captioning of sign language by deaf and hard-of-hearing people

PurposeThe purpose of this paper is to explore the issues on how to achieve crowdsourced real-time captioning of sign language by deaf and hard-of-hearing (DHH) people, such that how a system structure should be designed, how a continuous task of sign language captioning should be divided into microtasks and how many DHH people are required to maintain a high-quality real-time captioning.Design/methodology/approachThe authors first propose a system structure, including the new design of worker roles, task division and task assignment. Then, based on an implemented prototype, the authors analyze the necessary setting for achieving a crowdsourced real-time captioning of sign language, test the feasibility of the proposed system and explore its robustness and improvability through four experiments.FindingsThe results of Experiment 1 have revealed the optimal method for task division, the necessary minimum number of groups and the necessary minimum number of workers in a group. The results of Experiment 2 have verified the feasibility of the crowdsourced real-time captioning of sign language by DHH people. The results of Experiment 3 and Experiment 4 have shown the robustness and improvability of the captioning system.Originality/valueAlthough some crowdsourcing-based systems have been developed for the captioning of voice to text, the authors intend to resolve the issues on the captioning of sign language to text, for which the existing approaches do not work well due to the unique properties of sign language. Moreover, DHH people are generally considered as the ones who receive support from others, but our proposal helps them become the ones who offer support to others.