Improving Hearing Healthcare Outcomes by Addressing Hearing Loss Stigma: A Mixed Methods Approach
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PROJECT SUMMARY Hearing loss is a significant public health issue that affects over 44 million adult Americans and is linked to negative health outcomes such as social isolation, depression, and cognitive decline. However, hearing healthcare engagement – including testing, diagnosis, and treatment – remains low. Stigma is a recognized obstacle to hearing healthcare utilization, yet interventions to reduce stigma related to hearing loss or hearing assistive devices are lacking and researchers and clinicians continue to seek ways to understand and mitigate this stigma. The goal of this Career Development Award is to expand the candidate’s skillset in survey design, administration, and analyses; conducting in-depth interviews; and co-designing hearing loss stigma-reduction interventions with people with hearing loss. This training will equip the candidate to become a leading researcher on implementing interventions that mitigate hearing loss stigma to promote better health and healthcare utilization outcomes for people with hearing loss. Over the course of the award, the candidate will develop: 1) advanced knowledge in understanding and measuring hearing loss stigma; 2) deeper insights into the hearing healthcare pathway, auditory rehabilitation, and treatment efficacy and effectiveness; 3) the theoretical and methodological skills to design, execute, and analyze mixed-methods studies; and 4) a skill base in stigma- reduction intervention design. These goals will be achieved through a combination of direct mentorship with leading experts, coursework, directed readings, seminars, workshops, conferences, and hands-on research experience found by executing the proposed aims. The overarching objective of this project is to characterize hearing loss stigma among U.S. adults with hearing loss and identify strategies to mitigate its impact on hearing healthcare engagement. Using a sequential explanatory mixed-methods design, hearing loss stigma will be measured using a web-based survey of validated scales developed by the Lancet Commission on Hearing Loss Measures, Models, and Stigma Reduction Subgroup that measure perceived, experienced, and internalized hearing loss stigma and anticipated hearing device-related stigma among adults with hearing loss (Aim 1). Next, stigma experiences will be described by conducting in-depth interviews with a subset of participants to understand how stigma manifests and influences decisions to seek and adhere to hearing healthcare (Aim 2). Finally, hearing loss stigma-reduction strategies will be identified through collaboration with a community co- design team to analyze findings from Aims 1 and 2 and co-develop actionable, evidence-based intervention strategies (Aim 3). Together, the training, research, and collaborations outlined in this award will provide the candidate with the skills and preliminary data to develop a future R-series grant for an iterative development and trial of a stigma-reduction intervention for adults with hearing loss.
