Developing and Evaluating a Picture-Book-Centered Multi-Component Intervention on Empowering Psycho-Emotional Well-Being of Deaf and Hard-of-Hearing (DHH) Children: A Mixed-Methods Feasibility Study

Interventions aimed at improving the psychological well-being of Deaf and Hard-of-Hearing children have been overlooked. This study aimed to develop a targeted picture-book-focused, multi-component psycho-emotional support intervention for Deaf and Hard-of-Hearing children and to evaluate its feasibility and acceptability. A mixed-methods design based on the Successive Approximation Model (SAM) was used. A user-centered picture book was developed and evaluated through a multi-component intervention involving 76 Deaf and Hard-of-Hearing children. Quantitative data were collected at baseline (T0) and one-month follow-up (T1) using the Children’s Loneliness Scale, the General Self-Efficacy Scale, and the Adolescent Mental Resilience Scale. Focus group interviews explored acceptability and appropriateness. Five empowering components were identified, which guided the development of the picture book. The recruitment rate of the study was 92.7% (76/82). A total of 68.4% (52/76) of participants completed the intervention and follow-up. The adherence rate was 92.3% (48/52). Most participants (88.5%, 46/52) reported satisfaction with the intervention. Exploratory changes were observed for loneliness (IQR 41.5 vs. 39.0; 95%CI: 0.275, 0.723) and self-efficacy (IQR 24.0 vs. 25.0; 95%CI: −0.577, −0.027), while resilience showed no significance (IQR 85.0 vs. 87.0; 95%CI: −0.176, 0.435). Most participants rated the picture book as acceptable and were willing to share it. The intervention appears acceptable, feasible, and appropriate, supporting the need for a randomized or implementation study.