Knowledge, attitude and preventive practices of COVID-19 among deaf persons in the Greater Accra region of Ghana.

BACKGROUND: Since the emergence of the COVID-19 pandemic, studies continue to investigate the KAP of COVID-19 among diverse groups. We examined the KAP of COVID-19 among deaf persons living in the Ayawaso North Municipality in Accra. METHODS: A descriptive cross-sectional design was used for this study. Our sample comprised deaf persons registered with the Municipal Directorate. In all, 144 deaf persons were interviewed using an adapted KAP COVID-19 questionnaire. RESULTS: Regarding knowledge, majority of the deaf persons (> 50%) were not in the know of 8 out of 12 items of the knowledge subscale. For attitude, deaf persons (> 50%) showed optimistic attitude in all 6 items of the attitude subscale. Deaf persons "always" practised 5 items and "sometimes" practised 4 items in the preventive practices to COVID-19. A positive moderate and significant correlation existed between the subscales. Regression analysis showed that, a one-unit increase in knowledge will result in a 1.033-unit increase in preventive practices while a one-unit increase in knowledge will result in a 0.587-unit increase in attitude. CONCLUSIONS: Campaigns about COVID-19 should emphasize the teaching of the science of the virus and the disease and not just the preventive practices, paying special attention to deaf persons.

Eastern Mediterranean Health Journal [2023; Vol.29, Issue 1]

Eastern Mediterranean Health Journal is the official health journal published by the Eastern Mediterranean Regional Office of the World Health Organization. It is a forum for the presentation and promotion of new policies and initiatives in health services; and for the exchange of ideas concepts epidemiological data research findings and other information with special reference to the Eastern Mediterranean Region. It addresses all members of the health profession medical and other health educational institutes interested NGOs WHO Collaborating Centres and individuals within and outside the Region

المجلة الصحية لشرق المتوسط هى المجلة الرسمية التى تصدرعن المكتب الاقليمى لشرق المتوسط بمنظمة الصحة العالمية. وهى منبر لتقديم السياسات والمبادرات الجديدة فى الصحة العامة والخدمات الصحية والترويج لها، و لتبادل الاراء و المفاهيم والمعطيات الوبائية ونتائج الابحاث وغير ذلك من المعلومات، و خاصة ما يتعلق منها باقليم شرق المتوسط. وهى موجهة الى كل اعضاء المهن الصحية، والكليات الطبية وسائر المعاهد التعليمية، و كذا المنظمات غير الحكومية المعنية، والمراكز المتعاونة مع منظمة الصحة العالمية والافراد المهتمين بالصحة فى الاقليم و خارجه

La Revue de Santé de la Méditerranée Orientale est une revue de santé officielle publiée par le Bureau régional de l’Organisation mondiale de la Santé pour la Méditerranée orientale. Elle offre une tribune pour la présentation et la promotion de nouvelles politiques et initiatives dans le domaine de la santé publique et des services de santé ainsi qu’à l’échange d’idées de concepts de données épidémiologiques de résultats de recherches et d’autres informations se rapportant plus particulièrement à la Région de la Méditerranée orientale. Elle s’adresse à tous les professionnels de la santé aux membres des instituts médicaux et autres instituts de formation médico-sanitaire aux ONG Centres collaborateurs de l’OMS et personnes concernés au sein et hors de la Région

Technology challenges among deaf and hard of hearing elders in China during COVID-19 pandemic emergency isolation: A qualitative study.

Digital technology can be an effective tool to facilitate emergency assistance in a pandemic, but many deaf and hard-of-hearing elders may experience challenges in using and adopting these technologies. In the context of the second wave of the COVID-19 outbreak, this study employs a qualitative research method based on in-depth interviews to explore technology challenges among deaf and hard-of-hearing elders in China. The results showed that this group's technology challenges arose mainly from barriers to the mastery of digital technology tools, among which barriers to the use of smartphones, to the accessibility of online medical consultations, and to the presentation of health codes, were most noteworthy. For the informants, these barriers led to social isolation and technology avoidance. What's more, the expectation of individuals to adopt certain types of digital intelligence technologies can inadvertently create inequities for disadvantaged groups and exacerbate the "digital divide." This study highlights the need for emergency management systems to be inclusive of elders with hearing loss in times of public health crises, by providing effective technology support and training to facilitate individuals' access to services and to safeguard their health, interests, and livelihood.

Health Literacy and Difficulty Accessing Information About the COVID-19 Pandemic Among Parents Who Are Deaf and Hard-of-Hearing.

People who are deaf and hard-of-hearing (DHH) struggle with information marginalization and limited health literacy, challenging their ability to access information on preventing coronavirus disease 2019 (COVID-19). This study assessed the relationship between language preference, health literacy, and COVID-19 information barriers among parents who are DHH in the United States. Data were drawn from a larger study focused on individuals who are DHH who had given birth in the past 10 years. Respondents completed a web-based survey between March 2020 and July 2021. We segmented respondents by language preference [i.e., American Sign Language (ASL), English, or bilingual ASL/English] and used logistic regression models to test the hypothesis that language preference and health literacy were both associated with COVID-19 information marginalization. Of the total sample (N = 417), approximately 17% had limited health literacy, and 22% reported experiencing difficulty accessing information about COVID-19. In adjusted analyses, respondents with limited health literacy ([adjusted odds ratio] aOR = 2.245) and Hispanic ethnicity (aOR = 2.149) had higher risk of reporting information access barriers. There was no association between language preference and reporting COVID-19 information barriers. However, individuals who are DHH with limited health literacy were at higher risk of experiencing information marginalization during the ongoing COVID-19 pandemic, highlighting the need for tailored information based on access needs. [HLRP: Health Literacy Research and Practice. 2022;6(4):e310-e315.].

Perception of COVID-19 Physical Distancing Effectiveness and Contagiousness of Asymptomatic Individuals: Cross-sectional Survey of Deaf and Hard of Hearing Adults in the United States.

BACKGROUND: During the COVID-19 pandemic, there has been a rapid increase in the amount of information about the disease and SARS-CoV-2 on the internet. If the language used in video messages is not clear or understandable to deaf and hard of hearing (DHH) people with a high school degree or less, this can cause confusion and result in information gaps among DHH people during a health emergency. OBJECTIVE: The aim of this study is to investigate the relationship between DHH people's perception of the effectiveness of physical distancing and contagiousness of an asymptomatic person. METHODS: This is a cross-sectional survey study on DHH people's perceptions about COVID-19 (N=475). Items pertaining to COVID-19 knowledge were administered to US deaf adults from April 17, 2020, to May 1, 2020, via a bilingual American Sign Language/English online survey platform. RESULTS: The sample consisted of 475 DHH adults aged 18-88 years old, with 74% (n=352) identifying as White and 54% (n=256) as female. About 88% (n=418) of the sample felt they knew most things or a lot about physical distancing. This figure dropped to 72% (n=342) for the question about the effectiveness of physical distancing in reducing the spread of COVID-19 and 70% (n=333) for the question about the contagiousness of an infected person without symptoms. Education and a knowledge of the effectiveness of physical distancing significantly predicted knowledge about the contagiousness of an asymptomatic individual. Race, gender, and age did not emerge as significant predictors. CONCLUSIONS: This results of this study point to the strong connection between education and coronavirus-related knowledge. Education-related disparities can be remedied by making information fully accessible and easily understood during emergencies and pandemics.

External Communication Barriers among Elderly Deaf and Hard of Hearing People in China during the COVID-19 Pandemic Emergency Isolation: A Qualitative Study.

The COVID-19 pandemic poses a great risk to older people with hearing impairment, who face a higher threshold of external communication after the implementation of the emergency isolation policy. As part of a study on the optimization of external communication among the deaf and hard of hearing (DHH) population in central China, this study employed a qualitative research method based on in-depth interviews to explore the needs and difficulties faced by the older DHH group in external communication during public health emergencies in Wuhan, China, in the context of the COVID-19 pandemic. The results showed that older DHH people had weak reception of critical information about the epidemic, and had suboptimal access to medical care during emergency quarantine, which increased interpersonal communication barriers to this group. The current findings highlight the urgent need for targeted strengthening of the original emergency communication and coordination mechanisms in public health emergencies, and for improving policy inclusiveness for older DHH individuals during the COVID-19 pandemic and emergencies alike.

Disparities in health literacy during the COVID-19 pandemic between the hearing and deaf communities.

BACKGROUND: Barriers to communication for those with hearing loss are not only associated with social, emotional, educational and occupational difficulties, but also with reduced access to essential healthcare services, health information, and poorer health outcomes (Emond et al., 2015). These concerns are amplified with mandates such as physical distancing and the use of masks, which although needed to prevent respiratory transmission of SARS-Cov-2, obscure access to facial features needed for lipreading and sign language. OBJECTIVES: To compare the disparities of health knowledge and practice surrounding COVID-19, if any, among hearing and Deaf or Hard of Hearing (DHH) individuals. METHODS: A total of 110 (70 hearing and 40 DHH) participants were recruited in the unique linguistic context of Kuwait and Saudi Arabia utilising a cross-sectional electronic survey. Participants were differentiated according to status of hearing loss, communication mode, as well as country, age, sex, occupation, education level and satisfaction with available information. Various aspects of knowledge relating to COVID-19 and associated public health measures were tested by means of a questionnaire. RESULTS: A multivariate regression analysis showed that both the degree of hearing loss, and use of sign language as the primary means of communication were associated with lower scores. In addition, disparities exist in the use of health information sources, where DHH participants relied mostly on social media compared to the hearing group who relied predominantly on official government sources. CONCLUSIONS: In light of the pandemic, bridging the gap in health literacy for DHH individuals is essential in both policy and practice, in order to ensure equal access to healthcare and universal compliance with health directives at the population level.

Educational Challenges During the Pandemic for Students Who Have Hearing Loss.

Purpose The COVID-19 pandemic introduced new educational challenges for students, teachers, and caregivers due to the changed and varied learning environments, use of face masks, and social distancing requirements. These challenges are particularly pronounced for students with hearing loss who often require specific accommodations to allow for equal access to the curriculum. The purpose of this study was to document the potential difficulties that students with hearing loss faced during the pandemic and to generate recommendations to promote learning and engagement based on findings. Method A qualitative survey was designed to document the frequency of various learning situations (i.e., in person, remote virtual, and blended), examine the accessibility of technology and course content, and quantify hearing issues associated with safety measures and technology use in school-age students with hearing loss. Survey questions were informed from key educational issues reported in published articles and guidelines. The survey was completed by 416 educational personnel who work with students with hearing loss. Results Respondents indicated that most of their schools were providing remote or blended (in-person and remote) learning consisting of synchronous and asynchronous learning. Common accommodations for students with hearing loss were only provided some of the time with the exception of sign language interpreters, which were provided for almost all students who required them. According to the respondents, both students and caregivers reported issues or discomfort with the technology required for remote learning. Conclusion To ensure that students with hearing loss are provided equal access to the curriculum, additional accommodations should be considered to address issues arising from pandemic-related changes to school and learning practices including closed captioning, transcripts/notes, recordings of lectures, sign language interpreters, student check-ins, and family-directed resources to assist with technology issues.

Health care of deaf persons during coronavirus pandemics.

OBJECTIVE: To reflect about the barriers experienced by the deaf population during the COVID-19 pandemic, the proposals to overcome communication barriers in health care and the role of public policies in effecting the social inclusion of deaf people. METHODS: Reflection based on studies on health care for deaf people, the COVID-19 pandemic and public accessibility policies. RESULTS: The global crisis of COVID-19 has deepened pre-existing inequalities in the world, in addition to highlighting the vulnerability of people with disabilities, including deaf. Government, institutional and social initiatives to mitigate difficulties in communicating to deaf people have been made, but they are still insufficient to guarantee protection for them in this pandemic and full inclusion in health care. FINAL CONSIDERATIONS: Social inclusion, supported by law, and the linguistic accessibility of deaf people still need to generate broad and concrete actions so that deaf people can enjoy their rights as citizens.

Distance Education for d/Deaf and Hard of Hearing Students during the COVID-19 Pandemic in Saudi Arabia: Challenges and Support.

BACKGROUND: On March 11, 2020, the World Health Organization declared COVID-19 to be a global pandemic. This prompted many countries, including Saudi Arabia, to suspend students' attendance at schools and to start distance education. This sudden shift in the educational system has affected students' learning, particularly for d/Deaf and hard-of-hearing (d/Dhh) students, who have unique language and communication needs. AIM: This study explores the challenges and support methods for d/Dhh students during their distance education in Saudi Arabia. METHODS: A qualitative research study using semistructured interviews was conducted with 37 parents of d/Dhh students to answer the research questions. RESULTS: Three themes emerged from the parents' responses: (1) the challenges faced by d/Dhh students in distance education; (2) the specific needs of d/Dhh students in distance education; and (3) the supports provided to d/Dhh students in distance education. CONCLUSIONS: Distance education is a strategic choice, and parents must be informed about how to use the Madrasati e-learning platform effectively by providing solutions and supports. Additionally, d/Dhh students require various forms of ongoing support from both their families and schools to ensure that they succeed and benefit from their experiences.

Deaf Residents With Intellectual Disabilities During the First Covid-19 Associated Lockdown.

Two indicators for stress (mood and aggressive behavior) were evaluated in order to investigate the effect of the restrictions taken against the spread of the coronavirus on people who are deaf and hard of hearing (DHH) and have intellectual disabilities (ID). In three therapeutic living communities, specifically designed for the visual communication needs of people who are DHH and have ID, the mood of the residents is routinely assessed by staff members and every aggressive incident is recorded with the Staff Observation of Aggressions Scale-Revised (SOAS-R). For the 38 residents who were present 8 weeks before the first lockdown (t1) and the following 8 weeks (t2), mood ratings and ratings of aggressive behavior were compared between the two time periods. In contrast to our hypothesis the mood ratings of the residents had a slight significant improvement, whereas the incidents and severity of aggressive behavior did not change significantly. These results suggest that with proper communicative support, individuals who are DHH and have ID can cope effectively with significant restrictions imposed by a pandemic-caused lockdown.

Food Worry in the Deaf and Hard-of-Hearing Population During the COVID-19 Pandemic.

OBJECTIVE: The coronavirus disease 2019 (COVID) pandemic has highlighted preexisting health disparities, including food insecurity, in the deaf and hard-of-hearing (DHH) population. We examined factors associated with food worry during the COVID-19 pandemic. METHODS: We collected survey data on worry about food shortages, worry about contracting COVID-19, and concerns about DHH people staying home and being lonely from April 17 through May 1, 2020, via a bilingual American Sign Language/English online survey platform. The sample consisted of 537 DHH adults living in the United States. We examined the relationship between demographic characteristics and food worry. We used logistic regression and model fitting to predict the likelihood of experiencing food worry. RESULTS: The mean (SD) age of survey respondents was 47 (16), and 25% of the sample identified as people of color. Forty-two percent of survey respondents had a high level of food worry. Increased worry about contracting COVID-19 and concerns about DHH people staying home and being lonely among DHH younger adults or those without a college degree predicted food worry. Gender and race/ethnicity did not contribute to the model for food worry. CONCLUSIONS: Food worry was explained by multiple, intersecting factors, including demographic variables, worry about contracting COVID-19, and concerns about loneliness. Interventions or programs implemented by DHH-serving organizations as well as government programs, social service providers, and food banks should be fully accessible to subgroups of DHH young adults without a college degree who are at risk for food insecurity.

Impacts of face coverings on communication: an indirect impact of COVID-19.

OBJECTIVE: To understand the impact of face coverings on hearing and communication. DESIGN: An online survey consisting of closed-set and open-ended questions distributed within the UK to gain insights into experiences of interactions involving face coverings, and of the impact of face coverings on communication. SAMPLE: Four hundred and sixty members of the general public were recruited via snowball sampling. People with hearing loss were intentionally oversampled to more thoroughly assess the effect of face coverings in this group. RESULTS: With few exceptions, participants reported that face coverings negatively impacted hearing, understanding, engagement, and feelings of connection with the speaker. Impacts were greatest when communicating in medical situations. People with hearing loss were significantly more impacted than those without hearing loss. Face coverings impacted communication content, interpersonal connectedness, and willingness to engage in conversation; they increased anxiety and stress, and made communication fatiguing, frustrating and embarrassing - both as a speaker wearing a face covering, and when listening to someone else who is wearing one. CONCLUSIONS: Face coverings have far-reaching impacts on communication for everyone, but especially for people with hearing loss. These findings illustrate the need for communication-friendly face-coverings, and emphasise the need to be communication-aware when wearing a face covering.

Covid-19 Lockdown Affects Hearing Disability and Handicap in Diverse Ways: A Rapid Online Survey Study.

OBJECTIVES: The aim of this study was to explore the perceived effects of coronavirus disease 2019 (Covid-19) social distancing restrictions and safety measures on people with hearing loss. DESIGN: Participants were 129 adults (48.1% female, mean age 64.4 years) with an audiometric hearing loss, living in Glasgow, Scotland. A rapidly deployed 24-item online questionnaire asked about the effects of certain aspects of lockdown, including face masks, social distancing, and video calling, on participants' behavior, emotions, hearing performance, practical issues, and tinnitus. Data were analyzed descriptively across the entire sample, and with Chi-squared tests for differences between subgroups self-reporting relatively good and relatively poor unaided hearing, respectively. Additional free-text responses provided further perspectives. RESULTS: Behavior: Video calls are used more frequently than prelockdown. The better-hearing group use their hearing aids less. Emotions: There is increased anxiety (especially among the worse hearing group) concerning verbal communication situations and access to audiology services, and greater rumination about one's own hearing loss. Enjoyment of group video calls is mixed. The worse hearing group shows substantial relief at not being obliged to attend challenging social gatherings. Across both groups, a majority would like to see all key workers equipped with transparent face masks. Hearing performance: A large majority finds it hard to converse with people in face masks due to muffled sound and lack of speechreading cues, but conversing at a safe distance is not universally problematic. In the worse hearing group, performance in video calls is generally inferior to face-to-face, but similar to telephone calls. Those who use live subtitling in video calls appreciate their value. TV and radio updates about Covid-19 are easy to follow for most respondents. There is only weak evidence of face mask fixtures interfering with hearing aids on the ear, and of tinnitus having worsened during lockdown. CONCLUSIONS: With due regard for the limitations of this rapid study, we find that there are many negative-and a few positive-effects of Covid-19 restrictions and safety measures on people with hearing loss. From a societal perspective, the widespread adoption of clear face masks may alleviate some of the difficulties and anxieties this population experience. From an individual perspective, one may consider using live subtitles on video calls. Manufacturers of hearing devices should consider developing processing modes and accessories specifically designed for video calls. Finally, repair and maintenance services should be resumed as soon as it is safe to do so.

Deafness and mental health: Clinical challenges during the COVID-19 pandemic.

The current health crisis scenario has exposed the negative impact on mental health. This commentary highlights the main challenges and barriers that the Deaf community faces in access to health care resources and psychological support during the COVID-19 pandemic. (PsycInfo Database Record (c) 2020 APA, all rights reserved).