Covid 19: Covid19 Effects on Children and Youth who are Deaf or Hard of Hearing and their Families: Rapid and Rigorous Mixed-Methods Research to Inform Care

COVID-19 has unleashed a sudden and sustained disruption to usual healthcare and social milieu in the United States, and of particular concern are children who are deaf/hard of hearing (DHH) and 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—and these challenges have been compounded by public health measures limiting in-person contacts outside the home, including access to usual hearing healthcare and other supportive services, as well as by COVID-19-related illnesses and deaths. We do not know what the long-term effects of this global pandemic will be for vulnerable children and families, but a swift response is essential to inform provision of needed services and anticipate additional shifts in the social/healthcare landscape. This project will rapidly assess and disseminate timely information about COVID-19’s effects on DHH children and their families. Our first aim is to use mixed methods to assess DHH child, parent, and family quality of life (QOL), hearing healthcare access and use, and related variables. Associations among social determinants of health, QOL, and hearing healthcare access and use will be tested to identify characteristics of DHH children and families most negatively impacted by COVID-19. We will employ a prospective panel study design to survey parents of DHH children across Kentucky at two times, six months apart. Following each survey wave we will identify subsets of parents reporting better vs. worse outcomes on quantitative survey measures to engage in qualitative key informant interviews, investigating their experiences to inform practice and policy. Rapid content analysis methods will speed the analysis of qualitative data. Our second aim is to leverage our existing Hearing & Behavior Community Advisory Board (CAB) and professional networks to quickly disseminate our actionable study findings following each wave of data collection and analyses via webinars, social media, newspaper/newsletter articles, policy briefs, and other modalities relevant to stakeholders. Importantly, our research questions were developed in collaboration with our 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 study results will influence the development of 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