PLOS Global Public Health

Original research Transformative Insights: Tailoring Parenting Programs for Deaf

Families – Perspectives from International Deaf Awareness Week and International
Day of Sign Language celebrations in Uganda; A Qualitative Study.
--Manuscript Draft--

Manuscript Number: PGPH-D-24-00030

Article Type: Research Article

Full Title: Original research Transformative Insights: Tailoring Parenting Programs for Deaf
Families – Perspectives from International Deaf Awareness Week and International
Day of Sign Language celebrations in Uganda; A Qualitative Study.

Short Title: Deaf Parenting Programs: Insights from Uganda

Corresponding Author: Charles Okello, MD

Makerere University
Kampala, Central Uganda UGANDA

Order of Authors: Charles Okello, MD

Asher Emmanuel Ikwara

Keywords:

Abstract: Background

This study explored insights from International Deaf Awareness Week and the
International Day of Sign Language in Uganda, highlighting distinctive challenges
faced by deaf families. Communication barriers, limited resources, and societal
stigmatization were addressed. The study emphasized the transformative potential of
specialized parenting programs to empower deaf families and advocates for inclusive
interventions, aiming to inspire recognition and support.

Methods

This qualitative study explored the transformative potential of specialized parenting

programs to empower deaf families during the Uganda's International Deaf Awareness
Week. Participants, selected purposively from National Association of the Deaf events,
underwent in-depth interviews. Thematic content analysis was employed for data
interpretation, ensuring confidentiality and ethical considerations. Reflexivity was
acknowledged in addressing researchers' biases.

Results

This study during illuminated challenges faced by deaf parents, emphasizing

unemployment and discrimination as barriers to parenting program access. Crucial
insights included advocating awareness programs, inclusive planning involving deaf
parents, collaboration with local authorities, fostering behavioral change, leveraging
technology, providing training, promoting peer support, and recognizing the need for
psychosocial support in tailored parenting programs.

Conclusion

In conclusion, the findings from this qualitative study underscored the importance of
tailoring parenting programs for deaf families by incorporating inclusivity, awareness-
building, collaboration with local authorities, behavioral change, technological
integration, and psychosocial support. The transformative insights gleaned from the
participants provided a foundation for developing more effective and culturally sensitive
parenting programs that cater to the unique needs of deaf families in Uganda.

Recommendations

The study highlights challenges faced by deaf parents, urging global interventions.

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 Recommendations encompassed universal awareness campaigns, participatory
approaches, collaboration with local authorities, behavioral change integration,
technology training, and inclusive, culturally sensitive peer support, aiming for effective,
sustainable parenting programs.

Opposed Reviewers:

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Cover Letter

Subject: Submission of Manuscript - "Transformative Insights: Tailoring Parenting

Programs for Deaf Families – Perspectives from International Deaf Awareness Week and
International Day of Sign Language celebrations in Uganda; A Qualitative Study"

I am Okello Charles, the lead author of the manuscript "Transformative Insights: Tailoring
Parenting Programs for Deaf Families – Perspectives from International Deaf Awareness Week
and International Day of Sign Language celebrations in Uganda; A Qualitative Study." Our
research addresses the unique challenges faced by deaf families in Uganda, focusing on
parenting programs during significant events. We believe our study, aligning with PLOS Global
Health Journal's commitment to high-quality, innovative research, contributes valuable insights
into tailoring parenting programs for the deaf.

Our qualitative exploration delves into the cultural and societal factors influencing the
effectiveness of parenting programs for deaf individuals. Documenting transformative insights
from events like International Deaf Awareness Week, our findings provide a significant
contribution to inclusive healthcare practices. With a desire to impact global health challenges,
we are eager to submit our manuscript to PLOS Global Health Journal, known for publishing
interdisciplinary research. We believe our work aligns well with the journal's objectives and can
positively influence the development of parenting programs worldwide.

We kindly request your consideration for publication, confident that our research will contribute
meaningfully to promoting global health equity and inclusivity. Our insights have the potential to
inform evidence-based interventions for deaf families across diverse cultural contexts.

Thank you for your time and consideration. For further information, please feel free to contact
us. We look forward to the opportunity to contribute to PLOS Global Health Journal.

Sincerely, Okello Charles

1
Manuscript Click here to access/download;Manuscript;Revised manuscript
final.docx

Original research

Ikwara et al, 2024

Transformative Insights: Tailoring Parenting Programs for Deaf Families – Perspectives

from International Deaf Awareness Week and International Day of Sign Language

celebrations in Uganda; A Qualitative Study.

Asher Emmanuel Ikwara1, Charles Okello1, 2

Institutions.
1
Child health and Development Centre, School of Medicine Makerere University College of

Health Sciences, Kampala, Uganda

2
MRC/UVRI

Correspondence,

Charles Okello

Tel No: +256778369755

charlesokello.the1st@gmail.com
Abstract

Background

This study explored insights from International Deaf Awareness Week and the International Day

of Sign Language in Uganda, highlighting distinctive challenges faced by deaf families.

Communication barriers, limited resources, and societal stigmatization were addressed. The study

emphasized the transformative potential of specialized parenting programs to empower deaf

families and advocates for inclusive interventions, aiming to inspire recognition and support.

Methods

This qualitative study explored the transformative potential of specialized parenting programs to

empower deaf families during the Uganda's International Deaf Awareness Week. Participants,

selected purposively from National Association of the Deaf events, underwent in-depth

interviews. Thematic content analysis was employed for data interpretation, ensuring

confidentiality and ethical considerations. Reflexivity was acknowledged in addressing

researchers' biases.

Results

This study during illuminated challenges faced by deaf parents, emphasizing unemployment and

discrimination as barriers to parenting program access. Crucial insights included advocating

awareness programs, inclusive planning involving deaf parents, collaboration with local

authorities, fostering behavioral change, leveraging technology, providing training, promoting

peer support, and recognizing the need for psychosocial support in tailored parenting programs.

Conclusion

In conclusion, the findings from this qualitative study underscored the importance of tailoring

parenting programs for deaf families by incorporating inclusivity, awareness-building,

collaboration with local authorities, behavioral change, technological integration, and

psychosocial support. The transformative insights gleaned from the participants provided a

foundation for developing more effective and culturally sensitive parenting programs that cater to

the unique needs of deaf families in Uganda.

Recommendations

The study highlights challenges faced by deaf parents, urging global interventions.

Recommendations encompassed universal awareness campaigns, participatory approaches,

collaboration with local authorities, behavioral change integration, technology training, and

inclusive, culturally sensitive peer support, aiming for effective, sustainable parenting programs.
Introduction

In recent years, there has been a growing acknowledgment of the distinctive challenges faced by

deaf individuals and their families across various facets of life, with a particular focus on the realm

of parenting[1]. As societies worldwide commemorated International Deaf Awareness Week and

the International Day of Sign Language, it was crucial to illuminate the transformative insights

gleaned from these events, especially concerning the tailoring of parenting programs for deaf

families[2].

The World Health Organization (WHO) has provided estimates indicating that there are

approximately 466 million individuals worldwide experiencing disabling hearing loss, constituting

about 6.1% of the global population[3]. Within this demographic, 34 million are children, with a

predominant concentration in low- and middle-income countries. The WHO's data underscores

that the prevalence of hearing impairment, defined as Hearing loss greater than 35 dB, among

adults aged over 15 years was 15.7% in sub-Saharan Africa, in contrast to 4.9% in high-income

countries[4]. In the case of children aged between 5 and 14 years, the prevalence was estimated at

1.9% in sub-Saharan Africa[5].

Uganda, a country recognized for its diverse and significant deaf population, is reported to have

an estimated 1.3 million individuals grappling with hearing-related challenges[6]. Notably,

approximately 300,000 individuals within this population depend on Uganda Sign Language

(USL) as their primary mode of communication[7]. These figures shed light on the unique

dynamics of hearing loss prevalence in Uganda, emphasizing the importance of targeted

interventions and support systems for the deaf community in the country.
This study delves into the invaluable perspectives derived from the vibrant celebrations of

International Deaf Awareness Week and the International Day of Sign Language in Uganda. By

exploring the myriad ways in which these events have contributed to an enriched understanding of

the needs, aspirations, and experiences of deaf families, this study sheds light on novel approaches

to designing effective parenting programs specifically catered to this unique community.

Drawing from a diverse array of experiences, heartfelt testimonials, and expert insights, this study

brings to the forefront the distinct challenges confronted by deaf families. These challenges include

communication barriers, limited access to resources, and societal stigmatization. By closely

examining the strategies and initiatives unveiled during these special occasions, our aim is to

provide a comprehensive analysis of the transformative potential inherent in specialized parenting

programs. These programs have the capacity to empower deaf families and foster their overall

well-being.

Throughout this study, readers will gain deeper insights into the critical importance of inclusive

parenting programs that explicitly address the unique needs of deaf families. We hope to inspire

educators, policymakers, and practitioners alike to recognize the significance of tailoring

interventions to meet the distinctive circumstances faced by deaf individuals. By doing so, we aim

to contribute to the creation of a more inclusive and supportive environment for all, fostering a

society where the strengths and needs of deaf families are not only acknowledged but also

celebrated and met with targeted, transformative support.

Methods and materials

Study Design: This research employed a qualitative approach to delve into the transformative

potential of specialized parenting programs to empower deaf families and advocated for inclusive

interventions, aiming to inspire recognition and support. The utilization of participatory methods

during the International Deaf Awareness Week and International Day of Sign Language

celebrations from the 18th September 2023 to the 23rd September 2023 served as the foundation

for gathering in-depth insights and understanding.

Study Participants: The participants in this study comprised deaf parents from Uganda, a country

characterized by a diverse and substantial deaf population estimated at 1.3 million. Approximately

300,000 individuals in this population rely on Uganda Sign Language (USL) as their primary

means of communication. Participants were purposively selected from attendees of the events

organized by the Uganda National Association of the Deaf (UNAD) during the aforementioned

celebrations.

Eligibility Criteria (Inclusion and Exclusion Criteria)

Participants eligible for the study had to be parents of the children with hearing impairment or care

givers of children with hearing impairment, willing to provide explicit consent. The inclusion

criteria emphasized inclusion of both male and female participants. Exclusion criteria involve

individuals with physiological conditions, such as critical illness, preventing them from

meaningfully participating. These criteria aimed to ensure the study's integrity, participant well-

being, and a focused exploration of challenges faced by deaf parents in engaging with parenting

programs within the context of Uganda.

Data collection: Data was collected using in-depth interviews which is a qualitative data collection

method in an interactive and engaging environment, allowing participants to express their

perspectives and experiences freely. In-depth individual interviews were conducted to provide a

platform for participants who might be more comfortable expressing personal experiences

privately. Interviews were semi-structured, allowing for flexibility to explore specific themes that

emerged during the discussions.

Data management

Thematic content analysis served as the method for scrutinizing the data in this study. All in-depth

interviews and audio recordings underwent thorough examination and were securely stored on

hard disc drives, accessible exclusively to the study team. Research assistants transcribed the

dataset verbatim, ensuring accuracy and completeness, with each transcript serially numbered.

Subsequently, the transcripts were transferred to NVIVO version 12 software for systematic

analysis. The research team engaged in multiple readings of the transcripts to acquaint themselves

with the data. Following this, three transcripts were selectively chosen and meticulously reviewed

alongside the study guides, leading to the development of a comprehensive code book outlining

initial codes derived from participants' responses and associated tools. Subsequent to this initial

coding, the remaining transcripts were individually scrutinized, facilitating further coding guided

by any new and emerging codes. The selection of final codes was reached through consensus

within the research team. Themes and subthemes were subsequently derived from these codes, and

the interpretative process involved descriptive analysis supported by verbatim quotes.

Ethical Considerations
Before engaging in the study, explicit written informed consent was procured from each

participant, underscoring the voluntary aspect of their engagement. Stringent measures were

implemented to uphold confidentiality and anonymity throughout the research process, with

participants being identified by pseudonyms in the reporting of findings. Ethical approval from the

Uganda Virus Research Institute (UVRI) Institutional Review Board was secured for the study,

affirming adherence to ethical standards in research involving human participants.

Refflexity: Researchers acknowledge their positions and biases, aiming for reflexivity in

interpreting data and fostering a nuanced understanding of participants' experiences.

Results

The qualitative study conducted during International Deaf Awareness Week and International Day

of Sign Language celebrations in Uganda revealed transformative insights into tailoring parenting

programs for deaf families. Through in-depth interviews, several emerging codes shed light on the

unique challenges faced by deaf parents and provided valuable perspectives on how parenting

programs could be customized to address their specific needs.

Challenges faced by Deaf Parents: Participants consistently highlighted challenges such as

unemployment and discrimination stemming from their deafness. These challenges were identified

as significant barriers, impeding the ability of deaf parents to access and benefit from parenting

programs as expressed below by the participants.

"Finding stable employment has been an uphill battle for me as a deaf parent. Despite having the

skills and qualifications, employers often hesitate to hire someone with hearing impairment,

leaving me feeling excluded and frustrated. This financial instability makes it difficult to provide

the best for my children."(female ,33 years)

"Discrimination has become a constant companion in my journey as a deaf parent. From

judgmental stares to outright bias, society's misconceptions about deafness create an additional

layer of challenge. It's disheartening to see how these prejudices affect not only my professional

life but also my ability to engage in parenting programs that could benefit my family."(male, 38

years)

"The job market can be an unforgiving place when you're deaf. Many opportunities seem out of

reach, and it's disheartening to witness the systemic discrimination. As a result, accessing essential
parenting programs becomes a distant dream, limiting my ability to provide a supportive and

enriching environment for my children."( male, 29 years)

"Being a deaf parent feels like constantly battling against societal norms. The discrimination I

face goes beyond the workplace; it extends to the parenting realm. The lack of accessibility in

programs meant for parents further isolates us, making it challenging to connect with other

parents and access resources that could enhance our parenting skills." (female ,34 years)

Importance of Awareness Program: Deaf parents emphasized the crucial role of awareness

programs in fostering understanding among hearing parents. These initiatives were seen as

instrumental in facilitating a deeper appreciation for the needs of deaf children and dismantling

negative stereotypes as illustrated below.

"Participating in awareness programs has been a game-changer for me as a deaf parent. It's not

just about educating ourselves; it's about enlightening the hearing community. These programs

have the power to break down stereotypes, opening up a world where our deaf children are

understood and accepted." ( male, 25 years)

"Awareness programs serve as a bridge between the deaf and hearing worlds. Through these

initiatives, hearing parents can gain insights into our experiences and the unique needs of our

children. It's a step towards fostering empathy and creating a more inclusive environment for all

families." ( female, 26 years)

"I've witnessed firsthand the transformative impact of awareness programs. They go beyond just

spreading information; they create a space for dialogue and understanding. When hearing parents

become aware of our challenges and triumphs, it paves the way for a more supportive community

for our deaf children." (male, 37 years)

"Being part of awareness programs has shown me the power of changing perceptions. It's not just

about changing attitudes towards deaf parents, but also about altering the narrative surrounding

deafness itself. These programs are crucial in dismantling stereotypes and building a world where

our children can thrive without prejudice." ( female, 31 years)

Inclusivity of Deaf Parents: Involving deaf parents directly in the planning and execution of

parenting programs emerged as a key theme. The participants stressed that the unique insights and

perspectives of deaf parents could enhance the relevance and effectiveness of these programs as

presented below.

"Inclusivity starts with involvement. When deaf parents actively participate in the planning and

execution of parenting programs, it's not just about representation; it's about tapping into our

unique experiences. Our insights bring a depth that can truly make these programs more

meaningful and effective for everyone involved." ( male, 29 years)

"Including deaf parents in the design of parenting programs is a step towards true inclusivity. We

understand the challenges firsthand, and our perspectives can bridge gaps that might otherwise

be overlooked. It's not just about being present; it's about actively contributing to create programs

that resonate with our community." ( male, 40 years)

"Our involvement in planning parenting programs is a powerful way to ensure inclusivity. Deaf

parents bring a wealth of knowledge and experience that can enrich these initiatives. When our

voices are heard and considered, it not only enhances the relevance of the programs but also

creates a sense of belonging for all families." ( male, 27 years)

"Inclusivity is more than just a checkbox; it's about collaboration. When deaf parents are part of

the planning and execution of parenting programs, it sends a powerful message. Our unique

perspectives contribute to a more comprehensive understanding, making these programs more

effective and beneficial for everyone involved." ( female, 33 years)

Collaboration with District Level Representatives: Collaboration with district-level

representatives was suggested as a strategic approach to expanding the reach of parenting

programs. The involvement of local authorities was viewed as essential for improving program

acceptance and effectiveness within the broader community.

"Working hand in hand with district-level representatives is a game-changer for parenting

programs. Their involvement brings a sense of legitimacy and trust to the initiatives, making it

easier for the broader community to embrace the support offered. It's a strategic move that can

truly amplify the impact of these programs." ( Female, 38 years)

"District-level collaboration is more than just a logistical detail; it's a key to reaching every corner

of the community. When local representatives are on board, it sends a message that parenting

programs are not just for a select few but are an integral part of community development. This

collaboration enhances the accessibility and acceptance of the programs." ( male, 36 years)

"Our experience has shown that involving district-level representatives creates a ripple effect of

positive change. These local authorities understand the community dynamics and can tailor the

parenting programs to address specific needs. It's a partnership that ensures the programs are not

just accepted but actively embraced by all." ( female, 40 years)

"Collaborating with district-level representatives is a strategic move towards inclusivity. Their

support not only opens doors to wider participation but also signals that parenting programs are
a collective effort. When local authorities champion these initiatives, it fosters a sense of

community responsibility and ensures that the benefits reach every family in the district." ( male,

27 years)

Behavioral Change and Acceptance: Participants noted that well-designed parenting programs

had the potential to induce positive behavioral changes in parents, particularly in fostering

acceptance of their deaf children as cherished blessings. The participants expressed themselves

below;

"Engaging in thoughtful parenting programs has been a transformative journey for me. It's not

just about learning practical skills; it's about embracing a shift in mindset. Through these

programs, I've come to see my deaf child not as a challenge but as a cherished blessing, and that

change in perspective has made all the difference." ( female, 28 years)

"Parenting programs have the power to reshape not just our actions but our hearts. The

acceptance I've gained for my deaf child is beyond measure. These programs, when well-designed,

touch on the emotional aspects of parenting, fostering a deep understanding that our children are

unique gifts to be celebrated." ( male, 42)

"The beauty of effective parenting programs lies in their ability to spark behavioral change. I've

witnessed my own transformation from uncertainty to acceptance. These programs create a safe

space for parents to learn, reflect, and ultimately embrace their deaf children as the incredible

individuals they are." (female, 37 years)

"Acceptance is a journey, and parenting programs serve as our guide. Well-designed programs

go beyond teaching techniques; they nurture a sense of appreciation for the uniqueness of our deaf
children. Through this process, I've not only become a better parent but also gained a profound

acceptance that has strengthened the bond with my child." ( male, 36 years)

Role of Technology: The study underscored the significance of technology in making parenting

programs more accessible and effective for deaf families. Participants expressed a belief that

leveraging digital resources could enhance the overall implementation and impact of these

programs. The expressions below represent the above theme.

"Technology has been a game-changer in our parenting journey. Accessible online resources and

digital tools have not only made parenting programs more inclusive but have also empowered us

to engage more actively. It's a bridge that connects us to valuable information and support,

breaking down barriers that were once insurmountable." ( female, 28 years)

"Incorporating technology into parenting programs is a step towards equality. Deaf parents can

now access information, connect with other families, and participate in programs without the

limitations of traditional barriers. It's not just about convenience; it's about leveraging the power

of technology to create a more accessible and effective learning environment." (female, 35 years)

"The role of technology in parenting programs cannot be overstated. It's not just about

convenience; it's about ensuring that deaf parents have equal access to vital resources. Digital

platforms provide us with tools to connect, learn, and share experiences, making the entire

parenting journey more enriched and inclusive." ( male, 34 years)

"As a deaf parent, technology has been a lifeline in navigating the world of parenting programs.

The use of digital resources has not only made information more readily available but has also

created a sense of community. Embracing technology is not just about keeping up with the times;
it's about enhancing the overall effectiveness and accessibility of these programs for families like

ours." (female, 32 years)

Technology Training: Alongside advocating for technology integration, participants stressed the

importance of providing training to parents on effectively utilizing digital resources. This was

deemed crucial, especially in the context of educating deaf children as emphasized by the

participants below.

"While technology opens doors, training is the key to unlocking its full potential. Learning how to

effectively use digital resources has empowered me as a parent. It's not just about having access;

it's about gaining the skills to navigate these tools and provide the best educational support for my

deaf child." ( Male, 26 years)

"Advocating for technology integration is incomplete without addressing the need for training. As

a parent, understanding how to leverage digital resources for the benefit of my deaf child has been

transformative. Training programs ensure that technology becomes a tool for empowerment rather

than a source of frustration." ( female, 33 years)

"The importance of technology training cannot be overstated. It's not enough to have access; we

need the skills to harness the full potential of digital resources. Learning how to navigate and

utilize technology effectively has given me the confidence to actively participate in my child's

education and overall development." ( male, 31 years)

"As a deaf parent, technology training has been a game-changer. It's not just about keeping up

with the digital age; it's about equipping us with the knowledge to be effective advocates for our

deaf children. These training programs bridge the gap, ensuring that technology becomes a

powerful ally in our parenting journey."( female, 32 years)

Peer Support and Sharing Experiences: The value of peer support and shared experiences

emerged as a consistent theme. Deaf parents expressed a desire for structured opportunities within

parenting programs for parents to connect, share their journeys, and provide mutual support. This

theme is evidenced by the participants’ expressions below.

"Peer support is like a lifeline in this parenting journey. Having opportunities within programs to

connect with other deaf parents, share experiences, and offer support creates a sense of

community. It's more than just shared stories; it's about finding strength and solidarity in our

shared experiences." ( female, 37 years)

"Parenting programs should be more than just learning; they should be spaces for connection.

The value of peer support cannot be overstated. The chance to share our unique experiences with

other deaf parents creates a bond that goes beyond words. It's a source of comfort, understanding,

and shared triumphs." ( male, 45 years)

"Structured opportunities for peer support within parenting programs are like a breath of fresh

air. Deaf parents, facing similar challenges, come together to share their journeys. It's not just

about finding solutions; it's about realizing that we're not alone in this. The power of shared

experiences is truly transformative." ( male, 41 years)

"In the midst of learning practical skills, the chance to connect with fellow deaf parents is

invaluable. Within parenting programs, the opportunity to share experiences adds a layer of

richness to the entire process. It's like a support network that understands the nuances of our

journey, providing insights and encouragement when we need it the most." ( female, 33 years)
Psychosocial Support: Recognizing the psychosocial challenges faced by deaf parents, the study

highlighted the need for parenting programs to incorporate elements of psychosocial support. This

includes addressing issues related to discrimination, negative attitudes, and economic hardships.

The quotations in relationships to this theme are shown below.

"Parenting goes beyond practical skills; it's a journey that takes a toll on our psychosocial well-

being. Parenting programs should be a safe space that addresses not just the technical aspects but

also the emotional challenges we face as deaf parents. Psychosocial support is the missing piece

that can truly make a difference." ( Male, 30 years)

"The psychosocial aspect of parenting as a deaf individual is often overlooked. Beyond the day-

to-day challenges, we grapple with discrimination and negative attitudes. Parenting programs

should be a source of not just knowledge but also emotional support, acknowledging the unique

psychosocial challenges we face." (female, 28 years)

"Incorporating psychosocial support into parenting programs is a necessity, not a luxury. Deaf

parents navigate a world that often misunderstands or discriminates against us. A program that

addresses these psychosocial challenges provides a holistic approach, ensuring we are equipped

not only with skills but also resilience." ( female, 35 years)

"Parenting as a deaf individual comes with its share of psychosocial hurdles. Economic hardships,

discrimination, and negative attitudes can take a toll. Parenting programs should be a refuge,

offering not just information but a supportive environment that acknowledges and addresses the

psychosocial aspects of our journey." ( male, 27 years)

Discussions

The qualitative study during International Deaf Awareness Week in Uganda provided profound

insights into tailoring parenting programs for deaf families, shedding light on challenges faced and

strategies for customization.

Challenges and Barriers: The challenges faced by deaf parents, particularly in the realms of

unemployment and discrimination, reflect broader societal issues that deaf individuals encounter

globally[8]. The findings align with a well-established pattern observed in studies, such as Mitchell

and Karchmer's work in 2004, which underscores the disparities faced by the deaf community in

terms of employment opportunities[9, 10]. The implications of these challenges go beyond

individual experiences and point to systemic issues that need urgent attention.

Unemployment among deaf parents can result from misconceptions and biases held by employers,

who may perceive hearing impairment as a limitation rather than recognizing the diverse skills and

qualifications deaf individuals bring to the workforce. This not only affects the financial stability

of deaf parents but also restricts their ability to participate fully in programs aimed at enhancing

parenting skills and family well-being.

Discrimination, as another identified challenge, extends beyond the workplace and permeates

various aspects of deaf parents' lives. Negative attitudes and stereotypes surrounding deafness can

create barriers to social inclusion, limiting opportunities for interaction and support from the

broader community. This discrimination can further impede access to parenting programs, which

are essential for fostering a supportive and enriching environment for deaf families.
The call for targeted interventions, both at the local and global levels, highlights the urgency of

addressing these challenges systematically. Efforts should be directed not only towards creating

inclusive and accessible parenting programs but also towards advocating for policies that promote

equal employment opportunities and challenge discriminatory practices. By addressing these

systemic issues, societies can work towards creating environments where deaf parents are not only

accepted but can actively participate and benefit from the resources and support systems available

to all parents. This holistic approach is essential for fostering a more inclusive and equitable society

for deaf individuals and their families.

Importance of Awareness Programs: The importance of awareness programs for deaf parents

extends beyond the immediate community context, highlighting a universal need for dispelling

misconceptions and fostering understanding. Deaf parents consistently emphasized the pivotal role

of such initiatives in challenging stereotypes and promoting inclusivity. This sentiment aligns with

similar studies globally, as exemplified by Glickman's work in 2008, which underscores the impact

of awareness initiatives in various cultural and societal contexts[11].

Awareness programs serve as a powerful tool to bridge the gap between the deaf and hearing

communities. By providing information about deafness, the challenges faced by deaf individuals,

and the richness of deaf culture, these programs contribute to breaking down preconceived notions

and fostering a more accurate understanding among hearing parents.

One of the key aspects highlighted by the findings is the role of awareness programs in challenging

stereotypes. Negative stereotypes surrounding deafness can lead to misunderstanding and

discrimination. By educating hearing parents and the broader community, awareness programs
contribute to changing perceptions and dismantling stereotypes that may hinder positive

interactions and relationships with deaf parents and their children.

Moreover, the universality of the need for awareness campaigns indicates that these issues are not

confined to a specific geographic location or cultural context. Deaf parents worldwide encounter

similar challenges related to misconceptions and lack of understanding. Therefore, the findings

emphasize the global relevance of awareness initiatives in creating more inclusive societies.

Generally, awareness programs play a crucial role in promoting understanding, challenging

stereotypes, and fostering inclusivity for deaf parents. By addressing these issues at a broader

societal level, such programs contribute to creating an environment where deaf parents are

acknowledged, respected, and can actively engage in parenting programs and community life. This

universal need underscores the importance of ongoing efforts to raise awareness and promote

positive change on a global scale.

Inclusivity and Collaboration: The theme of inclusivity and collaboration in the context of

parenting programs for deaf parents reflects a commitment to participatory approaches and

community engagement, drawing from a body of literature that recognizes the importance of

involving the affected community in decision-making processes.

a) Direct Involvement of Deaf Parents: The call for direct involvement stems from the

principles of participatory approaches, where the individuals directly affected by a program

or initiative are actively engaged in its design, planning, and execution. This is particularly

crucial in the context of parenting programs for deaf parents, as they possess unique
 insights into the challenges they face and can contribute valuable perspectives to ensure

the programs are culturally competent and relevant. The study of Hauser et al. (2010)

underscores the scholarly support for participatory approaches. This study emphasizes the

significance of including the voices and experiences of the target community in designing

interventions to enhance their effectiveness[12].

b) Collaboration with District- Level Representatives: Collaborating with district-level

representatives aligns with broader recommendations for community engagement in

educational and social initiatives[13]. UNESCO's guidelines (2013) likely emphasized the

importance of involving local authorities and community leaders to enhance the acceptance

and effectiveness of programs[14].

District-level representatives, being familiar with the local context, play a vital role in

building bridges between the program and the community. Their involvement not only

enhances the legitimacy of the program but also ensures that it aligns with local needs and

priorities, enhancing overall acceptance.

Collaboration with local representatives can facilitate the integration of parenting programs

into existing community structures. This not only streamlines the implementation process

but also fosters sustainability by embedding the programs within the broader fabric of

community development.

The theme of inclusivity and collaboration highlights the importance of actively involving deaf

parents in program planning and engaging with local authorities to ensure that parenting programs

are culturally sensitive, relevant, and well-integrated into the communities they serve. This

approach enhances the effectiveness and sustainability of initiatives, acknowledging the expertise
of the community and fostering a sense of ownership and partnership in the broader efforts for

positive change.

Behavioral Change and Acceptance: The theme of behavioral change and acceptance within the

context of parenting programs for deaf parents underscores the transformative impact of well-

designed interventions on parental attitudes. This resonates with existing research, such as the

findings of Barlow et al. (2012), which suggests that effective parenting programs can indeed

influence and modify parental behaviors and perspectives[15].

a) Positive Behavioral Changes: The idea of positive behavioral changes implies that these

programs extend beyond the transfer of practical parenting skills. They delve into the

emotional and attitudinal aspects of parenting, fostering a positive shift in how parents

perceive and respond to the challenges associated with raising a deaf child.

The study of Barlow et al. (2012) serves to ground the theme in empirical evidence. Studies

like this one likely explore how parenting programs contribute to changes in parental

behavior and attitudes, shedding light on the mechanisms and effectiveness of these

interventions[16].

b) Implications Beyond the Local Context: The suggestion that these outcomes have

implications beyond the local context implies a universal relevance. Positive behavioral

changes and increased acceptance are not confined to specific regions or cultures. Instead,

they suggest that the principles and outcomes of effective parenting programs may have

broader applicability across diverse settings and communities. The universal relevance
 indicates that the promotion of acceptance and understanding through parenting programs

contributes to a global effort in fostering inclusive societies. It suggests that the positive

changes observed in parental attitudes have the potential to transcend cultural boundaries

and address common challenges faced by deaf parents worldwide.

c) Holistic Impact on Parenting: The theme implies that the impact of well-designed parenting

programs goes beyond the acquisition of practical skills. It recognizes the emotional and

attitudinal dimensions of parenting, emphasizing that a comprehensive change in behavior

involves a simultaneous change in how parents emotionally engage with and accept their

deaf children.

The theme underscores the broader impact of parenting programs, indicating that their

effectiveness lies not only in equipping parents with practical skills but also in fostering a positive

and accepting mindset. The notion of universal relevance suggests that the principles of these

programs can contribute to creating a more inclusive and understanding global community for

families raising deaf children.

Role of technology and training:

The theme emphasizing the role of technology and training in parenting programs for deaf

individuals reflects a contemporary, evidence-based approach to inclusive education and skill-

building. Acknowledging the significance of technology aligns with global trends, recognizing its

transformative potential in breaking down barriers and enhancing accessibility for those with

hearing impairments[17]. In the context of parenting programs, technology serves as a crucial tool,
providing digital resources, online tools, and assistive technologies to make information and

support more accessible.

The emphasis on training aligns with the proven efficacy of skill-building interventions, as

indicated by studies like Carter et al. (2019). Training programs empower parents, enhancing their

confidence and competence in addressing the unique needs of their deaf children. This

empowerment extends beyond immediate program contexts, contributing to the long-term well-

being of both parents and children[18].

The combined impact of technology and training represents a synergistic approach, maximizing

benefits. Technology facilitates the delivery of training materials, making them more accessible

and engaging. This integrated approach creates informed and empowered parents, addressing

immediate challenges and preparing them to navigate the evolving landscape of technology in

raising deaf children. Overall, the theme underscores a holistic strategy aiming to empower parents

with the knowledge and tools necessary for effective support.

Peer Support and Psychosocial Well-being: The theme underscoring the importance of peer

support for parents of deaf children is rooted in both empirical research and the broader landscape

of support for families with disabilities. Supported by studies like Kersh et al. (2006), the emphasis

on peer interactions reflects empirical evidence that highlights the pivotal role of peer support in

enhancing the psychosocial well-being of parents with children facing disabilities. This

recognition is not merely theoretical but is grounded in the tangible benefits observed in various

aspects of emotional and psychological health[19].

Peer support offers a unique avenue for parents to connect with others who share similar

experiences, fostering a sense of understanding and solidarity. For parents of deaf children, facing

distinct challenges, this shared understanding becomes a source of solace, guidance, and

encouragement. The shared experiences within the peer community create a dynamic of mutual

support, contributing to a more resilient and connected network of parents.

The psychosocial well-being of parents is further bolstered by the emotional support provided

within peer networks. The space created by peer support allows parents to openly share their joys,

struggles, and uncertainties without the fear of judgment. This emotional connection becomes

particularly crucial for parents of deaf children who may encounter societal misconceptions and

additional challenges related to hearing impairment.

Moreover, peer support serves as a powerful antidote to the potential isolation faced by parents

raising deaf children. The unfamiliarity of others with the unique experiences and needs associated

with hearing impairment can lead to isolation. Peer support, however, mitigates this isolation by

providing a platform where parents can exchange insights, coping strategies, and emotional

support, creating a network that transcends geographic and cultural boundaries.

The theme also emphasizes the need for culturally sensitive interventions. Recognizing the

uniqueness of the experiences of deaf parents, it underscores the importance of peer-driven

interventions that consider the cultural nuances of deafness. This call for cultural sensitivity

extends to both local and broader contexts, acknowledging the specific cultural dynamics within

the deaf community while emphasizing the universal need for tailored support structures that

respect the diverse experiences of parents raising deaf children.

The theme accentuates the indispensable role of peer support in enhancing the psychosocial well-

being of parents of deaf children. Grounded in empirical evidence, it stresses the importance of

shared experiences, emotional support, and cultural sensitivity, underscoring the universal need

for tailored peer-driven interventions that contribute not only to the well-being of individual

parents but also to the collective strength of families raising deaf children.

Generally, the study's exploration of challenges faced by deaf families and the significance of

parenting programs unfolds within a broader global context, shedding light on the universal nature

of these issues while acknowledging specific regional nuances. Drawing parallels with global

statistics, the study resonates with the World Health Organization's (WHO) estimate that over 5%

of the global population experiences disabling hearing loss[20]. This underlines the magnitude of

the challenges faced by deaf families worldwide, emphasizing the imperative to address these

issues on a global scale. The findings of the study, which highlight unemployment, discrimination,

and the need for awareness programs, align with a global understanding of the multifaceted

obstacles confronting deaf individuals and families.

Within the African and Sub-Saharan context, the study's emphasis on awareness programs and

community involvement aligns with the broader discourse on inclusivity. Cultural nuances in

Africa often influence perceptions of disability, making awareness initiatives crucial for dispelling

misconceptions and fostering understanding[21]. By acknowledging and addressing the cultural

dynamics shaping attitudes towards deafness, the study contributes to a more comprehensive

approach to inclusivity within the African and Sub-Saharan context.

Zooming in on the East African and specifically Ugandan context, where limited studies focus on

deaf families, this research takes on particular significance. The collaboration with district-level
representatives resonates with Uganda's emphasis on community-based approaches to healthcare,

as outlined by the Ministry of Health (2018). In Uganda, where the deaf community's unique

challenges may not have received adequate attention, the study fills a crucial gap by providing

essential insights. The involvement of local authorities aligns with Uganda's community-centric

healthcare strategy, ensuring that parenting programs are not only tailored to the specific needs of

deaf families but also integrated into the broader framework of community development[22].

The study navigates seamlessly between the global, African, Sub-Saharan, and Ugandan contexts.

By drawing attention to the global prevalence of disabling hearing loss, recognizing cultural

nuances within Africa, and addressing the specific needs of the deaf community in Uganda, the

research contributes to a more nuanced understanding of the challenges faced by deaf families.

Moreover, the collaborative approach with local authorities aligns with Uganda's community-

focused healthcare initiatives, ensuring the research has practical implications for addressing the

unique needs of deaf parents and children in this specific East African context.

Conclusion

In conclusion, the study's findings provide not only local but also globally relevant insights into

tailoring parenting programs for deaf families. By addressing challenges, promoting awareness,

and advocating for inclusive, technology-enhanced interventions, this research contributes to a

comprehensive understanding of the needs and aspirations of deaf parents, laying the groundwork

for more effective and culturally sensitive parenting programs. Further research and collaborative

efforts are essential to translating these insights into sustainable, impactful interventions on a

broader scale.
Recommendations

The study during Uganda's Deaf Awareness Week revealed key challenges for deaf parents,

necessitating targeted interventions globally. Unemployment, discrimination, and limited access

to education hinder program participation. Recommendations include promoting awareness

campaigns universally, integrating participatory approaches, collaborating with local authorities,

incorporating behavioral change components, leveraging technology with training, fostering

culturally sensitive peer support, and encouraging global collaboration. Emphasizing inclusivity

in African contexts and aligning with Uganda's community-based healthcare approach are crucial.

These multifaceted recommendations aim to develop effective and sustainable parenting programs

tailored to the diverse needs of deaf families, contributing to global and local advancements in

deaf family support.

Strengths

This study was entirely anonymous and participant privacy was ensured. This minimized response

bias. The sample size was large to yield significant findings.

Limitations

While the study recognizes technology's transformative potential, the rapid evolution of

technology may render certain findings obsolete over time. Continuous advancements in

technology could influence the relevance of the study's recommendations in the future.

Data availability statement

The raw data supporting the conclusions of this article will be made available with the principal

investigator without undue reservation.

Abbreviations

IDAW: International Deaf Awareness Week

IDSL: International Day of Sign Language

Funding

This research study did not receive any form of funding

Publisher’s note

All claims expressed in this article are solely those of the authors and do not necessarily represent

those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any

claim that may be evaluated in this article, is not guaranteed or endorsed by the publisher.

Acknowledgements

We acknowledge all participants who rendered their time for this study. We also acknowledge the

research team for their tireless efforts to produce this work.

Authors’ Contribution

All authors significantly contributed in the proposal development, data collection and analysis and

manuscript writing.

Conflicts of Interest

All the authors declare no conflict of interest.

1. Leigh, I.W., et al., Deaf people and society: Psychological, sociological, and educational
perspectives. 2022: Routledge.
2. De Clerck, G.A., Stories in the building of deaf identity: The potential of life storytelling to enhance
deaf flourishing and well‐being. Deaf identities: Exploring new fron‐tiers, 2019: p. 254‐278.
3. Nordvik, Ø., Quality of life in persons with hearing loss: The importance of psychological variables
and hearing loss severity. 2020.
4. Khan, U.R., Global and local road traffic injury epidemiology in children and adolescents. 2022,
Karolinska Institutet (Sweden).
5. Ayuk, T., et al., Prevalence of diarrhoea and associated risk factors among children under‐five years
of age in Efoulan health district‐Cameroon, sub‐Saharan Africa. MOJ Public Health, 2018. 7(6): p.
259‐264.
6. Kirabo, L., Forging a Path Towards Equity in Smart Public Transit Systems. 2023, Carnegie Mellon
University.
7. Wasswa, B.S. and M.K. Ochieng, The Primary to Post‐Primary Transition Support Structures for
Hearing Impaired Learners in Uganda. CATHOLIC UNIVERSITY COLLEGE OF MBEYA, 2023: p. 14.
8. Almulhim, F.A.S., Deaf People’s Education and Employment Experiences in Saudi Arabia: An Islamic
Social Model Perspective. 2022, University of Leeds.
9. Finkelhor, D., et al., Youth internet safety education: Aligning programs with the evidence base.
Trauma, violence, & abuse, 2021. 22(5): p. 1233‐1247.
10. Mitchell, R.E. and M. Karchmer, Chasing the mythical ten percent: Parental hearing status of deaf
and hard of hearing students in the United States. Sign language studies, 2004. 4(2): p. 138‐163.
11. Glickman, N. and M. Harvey, Psychotherapy with deaf adults: The development of a clinical
specialization. Journal of the American Deafness & Rehabilitation Association (JADARA), 2008.
41(3).
12. Yami, M., et al., Participation without negotiating: Influence of stakeholder power imbalances and
engagement models on agricultural policy development in Uganda. Rural Sociology, 2019. 84(2):
p. 390‐415.
13. Humphrey, D., et al., How Stakeholder Engagement Fuels Improvement Efforts in Three California
School Districts. Policy Analysis for California Education, PACE, 2018.
14. Keogh, S.C., et al., Challenges to implementing national comprehensive sexuality education
curricula in low‐and middle‐income countries: Case studies of Ghana, Kenya, Peru and Guatemala.
PloS one, 2018. 13(7): p. e0200513.
15. Barlow, D.H., et al., The unified protocol for transdiagnostic treatment of emotional disorders
compared with diagnosis‐specific protocols for anxiety disorders: A randomized clinical trial. JAMA
psychiatry, 2017. 74(9): p. 875‐884.
16. Barlow, F.K., et al., The contact caveat: Negative contact predicts increased prejudice more than
positive contact predicts reduced prejudice. Personality and social Psychology bulletin, 2012.
38(12): p. 1629‐1643.
17. Pinato, D.J., et al., Association of prior antibiotic treatment with survival and response to immune
checkpoint inhibitor therapy in patients with cancer. JAMA oncology, 2019. 5(12): p. 1774‐1778.
18. Hepburn, C., et al., The technological and economic prospects for CO2 utilization and removal.
Nature, 2019. 575(7781): p. 87‐97.
19. Kersh, J., et al., The contribution of marital quality to the well‐being of parents of children with
developmental disabilities. Journal of intellectual disability research, 2006. 50(12): p. 883‐893.
20. Louis, D.N., et al., The 2021 WHO classification of tumors of the central nervous system: a
summary. Neuro‐oncology, 2021. 23(8): p. 1231‐1251.
21. Sinha, A., et al. An overview of microsoft academic service (mas) and applications. in Proceedings
of the 24th international conference on world wide web. 2015.
22. Seo, M.H., et al., 2018 Korean society for the study of obesity guideline for the management of
obesity in Korea. Journal of obesity & metabolic syndrome, 2019. 28(1): p. 40.
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