Understanding the role of social connections in the wellbeing and self-efficacy of immigrant families with deaf or hard of hearing children

Abstract Background Immigrant families caring for deaf or hard of hearing (DHH) children face a “double disparity” in accessing healthcare, as demonstrated by existing health disparities in the immigrant and disability communities. Extant literature has revealed that social connections, particularly when culturally concordant, have a positive impact on patients’ health outcomes. Importantly, this model of care has not been explored in the field of otolaryngology, specifically within pediatric hearing care. This study aims to characterize how social connections impact the experiences of immigrant families caring for deaf or hard of hearing children. Methods We conducted semi-structured interviews with 14 immigrant families caring for deaf or hard of hearing children. Parents of participants whose primary language was not English were recruited by audiologists at tertiary children’s hospitals and immigrant identity was confirmed during interviews. All interviews were conducted in the language parents felt comfortable in. Two researchers independently inductively coded four representative interviews to create an initial codebook, which was reiteratively adjusted and applied to subsequent interviews. A final codebook was used to identify impacts of and barriers to social connections in families’ care of their child, as well as recommendations for creating a peer-mentorship program between families with DHH children. Thematic analysis generated main themes. Results Three main themes were identified: challenges faced by immigrant families, benefits of social connections, and peer-mentorship program recommendations and considerations. Within challenges, families reported how resources to support their child were difficult to find due to cultural or linguistic barriers. Additionally, the challenges of cultural and linguistic differences and assimilation made connecting with other DHH families difficult. For benefits, participants noted that social connections improved not only their child’s wellbeing, but also the parents’ wellbeing and self-efficacy. All families viewed the creation of a peer-mentorship program positively and recommendations were provided for its implementation. Conclusion This study provided new insights into the experiences of immigrant families navigating their DHH child’s care in relation to social connections. Successes, barriers, and areas of opportunity in social connections will be useful in guiding future interventions to improve outcomes for families and DHH children.