PP1203 - Deaf American Sign Language Users: Hearing Aids and Accessibility

Abstract:
Culturally Deaf people who use American Sign Language have been reported to have poorer access to healthcare, because of lack of access to communication and information in healthcare. Interestingly, there is a paucity of studies on access to audiology services by this population, especially those who choose to wear hearing aids. An online survey of US Deaf signers who wear hearing aids on: 1) reasons they use hearing aids, 2) facilitators and barriers to accessing audiology services, 3) cultural competence of audiology clinics in meeting their needs, and 4) factors influencing effective hearing aid service provision.

Summary:
In the literature, culturally Deaf individuals who use American Sign Language (ASL) are reported to have poor access to healthcare services, which can be attributed to a lack of access to communication and information in healthcare and low health literacy (Fellinger et al., 2012; McKee et al., 2015; Kuenburg et al., 2015; James et al., 2021). In addition, audism (or the notion of biased superiority of individuals who can hear) may still be prevalent in the field of audiology today (Wilson & Atcherson, 2017). Last but not least, audiologists often have little exposure to Deaf culture and individuals who identify ASL as their first language, limiting their knowledge of Deaf culture and the importance of using qualified ASL interpreters in these appointments (Cottrell et al., 2021).

To date, four studies on the topic of the audiology and/or hearing aid clinic experiences by Deaf patients appear to have been published. Butler and Martin (1987) conducted one of the earliest survey studies of the Deaf community on their opinion, needs, and knowledge of audiology and audiology services; however, this study is outdated. More recently, Hulme and colleagues (2021; 2023; 2024) studied British Sign Language (BSL) users who wear hearing aids and their experiences with obtaining hearing services from the UK National Health Service (NHS). The general consensus of all of these studies indicate that audiology and hearing aid clinics require development or improvements to make services more Deaf-friendly while considering the unique needs of this population. The UK NHS is a universal health care model, which may not be generalizable to other health care models in other countries.

Supported by an intramural SEED grant, the purpose of this study was to query US Deaf signers who wear hearing aids on: 1) reasons they use hearing aids, 2) facilitators and barriers to accessing audiology services, 3) cultural competence of audiology clinics in meeting their needs, and 4) factors influencing effective hearing aid service provision. Following IRB approval (UAMS #275919), we recruited participants through contact with several different state-based and national Deaf organizations throughout the US. A web-based survey was developed (REDCap). To enhance the survey experience, we employed two certified ASL interpreters and a local Deaf ASL user to assist with survey development, forward and backward translations of English to ASL, and create ASL videos for each item. Thus, each participant had the option of reading each survey item in English, watching the video translation, or a combination of both before responding to that item.

Data collection is currently ongoing and data analysis will be completed well before February 3, 2025. This study will employ a mixed-methods approach. The majority of the data will be analyzed quantitatively using descriptive and frequency statistics. A qualitative thematic analysis will be conducted on open-ended comments (Yin, 2003; Braun & Clarke, 2006). The findings of this study will inform audiology and hearing aid clinics, as well as audiology training programs, about the experiences, needs, and motivations of cultural Deaf ASL users.

Brief Summary of Clinical Takeaways:
The clinical takeaway(s) for this session is knowledge about Deaf culture and the facilitators and barriers to the accessibility of audiology services for Deaf individuals/those who use ASL as their first language. This knowledge will serve attendees by enhancing their cultural competency and sensitivity when working with this population.