Investigating Key Biopsychosocial Factors that Mediate Lifespan Management of Prelingual Deafness.

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ABSTRACT In comparison to the general population, prelingually deaf people experience poorer educational attainment, employment/income attainment, and mental and physical health. Yet, recent research indicates the presence of both positive and negative adaptations to being deaf in a predominantly hearing society. Deaf individuals’ ability to develop effective hearing loss management skills undoubtedly contributes to better or poorer lifespan outcomes. However, research to date has not undertaken a sufficiently broad approach to understanding how key biological, psychological, and social resources, beyond hearing and speech alone, interact to influence the development and effective use of hearing loss management skills. Nor has prior research explored how deaf persons utilize such management skills differently across different social contexts (e.g., in the general society vs. in the deaf community). This exploratory R21 project seeks to identify, and examine the interaction among, a range of biopsychosocial factors predicted to be relevant to effective management of deafness across different social contexts (i.e., at individual, group, and societal levels, à la Thompson, 2016). The proposed research employs a linked mixed-methods study design and community-based participatory research elements. In Phase I (Aim 1) of the study, qualitative data is gathered from fifteen key informant interviews and three focus groups (N=5 in each), involving a diverse sample of deaf adults with differing resources, experiences, and varied degrees of success, regarding the management of hearing loss. Three focus groups of hearing persons (N=5 in each), varied in their perceptions of and experiences with deaf people, will provide innovative societal-level input regarding successful management of hearing loss. After standard coding and thematic analysis yields initial Phase I results, two deaf community forum feedback sessions will help refine those results prior to dissemination, and also help fine-tune our plan for the Phase II (Aim 2) study methods. In Phase II, an array of quantitative methods (audiometry, self-report data, psychological testing, and various standardized measures) will be employed with 100 prelingually deaf subjects to identify key biopsychosocial precursors that influence the development of effective psychosocial management skills, as well as measure the effectiveness and outcomes of those management skills themselves. Another round of deaf community feedback follows the Phase II data collection, to inform our final conclusions. The results of this exploratory research project will identify and describe how key biopsychosocial resources interact with each other across different social contexts to influence the development of prelingually deaf persons’ psychosocial management skills. A deeper understanding of how individual, group, and societal contextual factors influence the development and expression of deaf persons’ hearing loss management skills will help guide future research and direct interventions toward optimizing prelingually deaf persons’ various lifespan outcomes.