Fall Prevention in ASL-Using Deaf Older Adults

Title: Fall Prevention in ASL-Using Deaf Older Adults The overarching goal of this project is to improve the safety, independence, and ability of the older adults who are Deaf, Deaf Blind, Deaf Disabled, and Hard of Hearing (DDBHH) and use American Sign Language (ASL), to participate in daily life, through fall prevention programs that are effective in reducing fall incidences

among older DDBHH adults. The incidence of falls among older adults who report being deaf is significantly higher than among those who deny being deaf (CDC 2020). DDBHH adults who use ASL are diverse, yet unique in that most of them have been deaf congenitally or since childhood, and that they do not share the value of

hearing sensitivity and spoken communication abilities in the same way the rest of the society, particularly the healthcare providers, does. We lack understanding of how cultural, linguistic, and physiological differences impact access to and relevance of resources, information, and support network; nor of the impact of life-long or

near life-long vestibular deficit on balance control and fall risk. The potential inequity for ASL using adults cannot be addressed without gaining further understanding of these factors. An effective fall prevention program design must consider both the physiological factors as well as the cultural

and behavioral factors impacting Deaf adults’ fall incidences; and be able to reach them at different stages of fall prevention, including engaging older DDBHH adults in regular physical activities. Therefore, the specific aims of this project are (1) To identify barriers and opportunities for a successful implementation of a fall prevention

wellness program targeting community-dwelling older DDBHH adults; and (2) To determine feasibility and potential benefits of a balance exercise program delivered in ASL. For the first aim, qualitative data from eligible older DDBHH adults will be collected, through (a) individual interviews which will be analyzed for themes re:

individual experiences with fall incidences, fall-related resources, and access to services; and (b) focus groups to generate ideas and strategies to mitigate fall risks in this population. For the second aim, we will deliver four 8-week exercise programs over a course, each enrolling 10 community-dwelling DDBHH adults 60-years and

older. We will describe the vestibular and physical balance characteristics of the participants, adherence rate, perceived benefits, and improvements in physical fitness among the participants. The results of this culturally informed investigation will inform future design of fall preventative care for older

DDBHH persons, success of which will have a significant impact on older DDBHH adults’ fall incidences, health, and quality of life. The PI, Chizuko Tamaki, AuD, PhD, is a clinician-researcher-educator who has mentored multiple student researchers in vestibular science and serving the DDBHH community as audiologist. Dr. Tamaki

will work with Janis Cole, PhD, a Deaf researcher with background in social work and studies in cultural and gender impact on language use; and Carol Riddick, PhD, Professor of Physical Education & Recreation Program with extensive experience working with older adults and conducting gerontological research.