A Mixed Methods Investigation of Self-Care of Chronic Illness in Community-Dwelling Older Adults with Hearing Loss

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Project Summary The goal of this individual National Research Service Award (NRSA) application is to provide the applicant with research training to become an independent investigator addressing disability health equity for older adults with hearing loss (HL) by focusing on the role of hearing loss (HL) in health maintenance practices such as self-care of chronic illness. To achieve this goal, training will occur in a resource rich environment with support from a multidisciplinary mentorship team with expertise in HL, nursing, aging, disability health equity, health promotion, chronic illness, biostatistics, mixed methods, and qualitative research. The applicant proposes a training plan that includes coursework, practical training, seminars, and engagement in ongoing research. Specific training goals of this award include: 1) Gain a foundational understanding of the principles of health equity research, focusing on disability health equity, 2) Continue developing the methodological and analytical qualitative, quantitative, and mixed methods skills required to conduct rigorous mixed methods research, 3) Develop theoretical and conceptual knowledge in the science of HL, aging, chronic illness, and self-care to support empirical investigation and intervention development, and 4) Acquire professional development skills to support a career as an independent investigator at a research-intensive university. The research proposed for this NRSA addresses the role of HL in self-care of chronic illness. Millions of older adults have clinically meaningful HL and a chronic illness. Self-care is a cornerstone of health promotion and management chronic illness. Yet, the impact of HL on self-care of chronic illness is not well understood. Using an integrated biopsychosocial model of disability and self-care as the guiding framework, the applicant will examine the role of HL in self-care of chronic illness. This study proposes the following aims: 1) Describe self-care behaviors in older adults with unaided HL and compare self-care behaviors by HL severity, 2) Explore the experience of caring for chronic illness while having unaided HL, and how HL impacts self-care, and 3) Describe differences in the experiences of self-care of chronic illness by self-care behavior scores and HL severity. This mixed methods study will use a parallel-convergent design to enroll a single sample of community-dwelling hospitalized older adults with a chronic illness and unaided HL. The proposed study aligns with the priorities of the National Institute of Nursing Research by advancing health equity for people with disabilities, through addressing health promotion and disease prevention in older adults with HL. Having a greater understanding of how HL influences self-care behaviors will support the development of interventions enabling older adults with HL to maximize health through self-care.