Assessing the Feasibility and Acceptance of the Deaf-in-Touch Everywhere (DITE™) Mobile App: Insights from Healthcare Simulations and Stakeholder Discussions (HEARD Project)

Background Deaf individuals confront healthcare disparities from communication barriers, aggravated by Deaf culture ignorance and limitations of lip-reading. While medically-trained sign language interpreters (SLIs) offer solutions, shortages persist. Thus, the Deaf in Touch Everywhere (DITE™) app was developed to provide virtual SLI services through teleconferencing. This study investigates the app's feasibility and factors influencing the adaptation and utilization by the stakeholders. Methods This study adheres to the Consolidated Criteria for Reporting Qualitative Studies (COREQ) guidelines. Participants (≥ 18 years) were purposively sampled and comprised of three stakeholder groups: Malaysian sign language (BIM) users (BNUs), BIM interpreters (JBIMs), and healthcare providers (HCPs). They were involved in simulated medical consultations via video conferencing using the DITE™ app. Following this, three focus group discussions (FGDs) were conducted. Interview questionnaires were designed using the extended Unified Theory of Acceptance and Use of Technology (UTAUT); encompassing performance expectancy, effort expectancy, social influence, facilitating conditions, and behavioural intention. Recorded interviews with JBIMs and HCPs were transcribed verbatim, while transcripts from BNUs were derived from video recordings. Results were imported into NVivo 12 software, and thematic analysis was performed. Results Nineteen participants, comprising six BNUs, six JBIMs, and seven HCPs, participated in three FGDs. The findings were categorized according to the five UTAUT categories and were explored within each participant group. Within the performance expectancy , themes relating to the strengths and limitations of DITE app emerged. Effort expectancy themes encompassed adaptation/adjustment, challenges/setbacks, and navigation/interface of the app. Social influence themes included concerns about data privacy/confidentiality, medicolegal acceptance, and encouragement to use app from relevant stakeholders. Facilitating conditions encompassed themes like confidentiality, support availability, prior relationship with interpreters, previous consultation experiences, and familiarity with telecommunication tools. Regarding behavioural intention , themes that emerged were app usage and promotion and comparing telemedicine and face-to-face consultations with DITE app. In addition, limiting conditions and areas for improvement were discussed. Conclusion The DITE app holds the potential to tackle communication barriers between Deaf individuals and HCPs. However, ongoing research, fine-tuning, and strategic deployment are vital to maximize its effectiveness in enhancing healthcare accessibility and outcomes for the Deaf community in Malaysia.