COVID-19 has unleashed a sudden and sustained disruption to usual healthcare and social milieu in the United States, and of particular concern are deaf/hard of hearing (DHH) children who rely on hearing healthcare and ancillary services for access to auditory language and other supports. Parents of DHH children experience psychosocial pressures even in the best of times, including social isolation, parenting struggles, and stress, all in the broader context of social determinants of health. These challenges have been com- pounded by the spread of COVID-19 which has limited in-person contacts outside the home, including access to hearing, speech, and language services. A swift response to this public health crisis is essential to inform provision of services to DHH children and their families in the context of ongoing shifts in the social/healthcare landscape. We will rapidly assess and disseminate timely information about COVID-19's effects on DHH chil- dren and their families.
In Aim 1, we will assess DHH child, parent, and family quality of life (QOL), as well as hearing healthcare access and use during the first 10 months of this global pandemic. We will survey parents of DHH children twice, six months apart, using the recently developed COVID-19 Exposure and Family Impact Survey (CEFIS) and other measures. Our analyses will identify characteristics of DHH children and families most negatively impacted by COVID-19. Following each survey wave, we will conduct rapid content analysis of key informant interviews with parents reporting better and worse outcomes to obtain deeper insights.
In Aim 2, we will assess barriers and facilitators to service provision for DHH children during this public health crisis. We will conduct key informant interviews with direct service providers and administrators and use rapid content analysis to identify actionable multilevel barriers and facilitators they describe.
In Aim 3, we will use a mixed- methods design to integrate our findings at each timepoint, then rapidly disseminate them to stakeholders to inform changes to practice and policy to meet the needs of DHH children and their families. We will use webi- nars, social media, policy briefs, and other modalities most likely to reach a wide array of stakeholders. Im- portantly, our research questions were developed with our Community Advisory Board (CAB), which guides our ongoing NIDCD-funded R01. The CAB includes parents, direct service providers, and administrators who are in key positions in state and local agencies and organizations across Kentucky, maximizing the chances that our results will influence policies and services responsive to the needs of our target population. This study is significant because it assesses the effects of COVID-19 on DHH children and their families using a rapid but rigorous approach. It is innovative as one of the first studies to assess the effects of COVID-19 on families with DHH children, a particularly vulnerable and often underrecognized population. Our results will impact the field by demonstrating a rapid community-engaged research response to a public health crisis, and by strategically disseminating findings in a timely manner to prioritize the needs of DHH children and their families.

Public Health Relevance

This study will assess the effects of COVID-19 on deaf/hard of hearing (DHH) children and their families, par- ticularly on (1) access and use of hearing healthcare and related services, and (2) quality of life. Administrators and direct service providers will identify barriers and facilitators to providing services and support to DHH chil- dren and their families during the COVID-19 public health crisis. Combined results from parents and providers will be disseminated to a broad range of stakeholders to inform practice and policy to meet the needs of this vulnerable population.

National Institute of Health (NIH)
National Institute on Deafness and Other Communication Disorders (NIDCD)
Research Project (R01)
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Psychosocial Development, Risk and Prevention Study Section (PDRP)
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King, Kelly Anne
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University of Colorado Denver
Schools of Medicine
United States
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