As a result of the comprehensive database search, a total of 2834 records were identified, and 847 records were removed. During the title and abstract screening phase, 1987 records were screened, and 1912 records were excluded, leaving 75 full-text articles deemed as eligible. During the full-text article review, 17 studies were included, and 73 studies were excluded, based on the reasons mentioned in Figure 1. This study identified 17 articles that were eligible to be included in this review. Of the 17 included studies, 5 (29%) focused on children (aged <18 y), while 12 (71%) focused on adults (aged >18 y). Tables 1 and 2 summarize the 17 articles [23-39] that met the inclusion criteria.

The studies included in this review employed a diverse array of research designs, reflecting both methodological rigor and adaptability to the research context. Among the 17 studies reviewed, randomized controlled trials (RCTs) emerged as the most frequently used design, with 5 studies adopting this approach [23,25,27,32,34]. Notably, 4 of these were single-blinded RCTs [25,27,32,34], while 1 used an open-blinded format [23]. Beyond RCTs, the studies encompassed descriptive research [38], cross-sectional designs [26,30], group concept mapping [24], pretest-posttest evaluations [31,33], and quasi-experimental studies [39], offering a comprehensive methodological landscape to explore the effectiveness of digital health interventions among Deaf and hard-of-hearing populations. In terms of data collection approaches, the studies predominantly relied on quantitative methodologies, with 13 studies focusing on numerical outcomes and statistical analyses [23,25-27,30-37,39]. Four studies adopted qualitative methods to capture nuanced insights from participants [24,28,29,38]. Notably, Morris et al [28] stood out by employing a mixed methods approach that combined both interviews and questionnaires, providing a more holistic understanding of participant experiences.

Questionnaires were the most commonly used tool for data collection, featured in 13 studies [23,25-27,30-37,39], underscoring their practicality in assessing knowledge, attitudes, and behaviors in digital health interventions. Additionally, 4 studies implemented surveys to collect data [26,29,30,36], while 3 leveraged interviews to gather in-depth qualitative data from Deaf individuals [28,32,39]. This variety in data collection methods highlights the importance of tailoring research tools to ensure accessibility and inclusivity for Deaf individuals. All included studies were published within the past decade, emphasizing the growing interest and ongoing evolution of digital health technologies in this field. Publication years spanned from 2014 to 2023, with notable contributions in 2014 [28], 2015 [29], 2016 [30], 2017 [31], 2019 [32], 2021 [33], 2022 [34], and 2023 [39]. This distribution reflects a consistent and increasing academic focus on leveraging digital communication technologies to promote health prevention and education among Deaf individuals.

The differences and similarities between adult and pediatric groups are synthesized in Figure 2, providing an integrated overview of Tables 1 and 2. Building on this, Table 3 presents a comparative analysis of health promotion outcomes, highlighting distinct trends in how the health needs of Deaf adults and children are addressed. Video-based interventions dominated across both groups due to their flexibility, visual appeal, and accessibility features such as American Sign Language (ASL) interpretation and captions. Among adults, health promotion often focuses on chronic disease prevention and management. For example, SMS text messaging-based interventions aim to improve health knowledge in areas such as hypertension and cancer awareness [30,33]. These interventions underscore the priority of preventive health measures and chronic disease education within adult populations. In contrast, interventions for Deaf children focus on the prevention of common acute childhood illnesses and the development of healthy habits from an early age. Audiovisual media have proven effective in improving oral hygiene and increasing school engagement [31,38].

Despite their differing health priorities, both adult and child populations benefited significantly from digital health interventions, particularly in terms of knowledge acquisition and practical skills. Studies have shown that video-based learning can improve both health awareness and competency in life-saving skills like CPR across age groups. Nonetheless, accessibility remains a concern. A cross-sectional study in Sweden revealed that Deaf individuals, particularly those with deafblindness, were less likely to use eHealth services such as online health care appointment booking [26]. This finding highlights the ongoing challenge of ensuring that digital platforms are inclusive and easy to navigate for Deaf and hard-of-hearing users.

The reviewed studies demonstrated a diverse application of digital technologies as communication interventions aimed at improving health outcomes among Deaf individuals. These technologies included video clips, social media platforms, online courses, and SMS text messaging. Among them, video-based interventions were the most prevalently used, offering a versatile medium that integrates visual, auditory, and textual elements to enhance accessibility and comprehension. For example, Engelberg et al [36] used humorous video clips to deliver cancer awareness messages, effectively increasing cancer-related knowledge among Deaf individuals. Ferguson et al [35] implemented short, interactive videos with subtitles to support auditory rehabilitation for first-time hearing aid users. Koçak Akgün and İldan Çalım [32] developed a breast self-examination (BSE) training video incorporating sign language, providing Deaf women with practical, life-saving skills. Similarly, Muñoz et al [27] introduced an eHealth educational program that combined weekly phone check-ins with a series of instructional videos for parents managing young children’s hearing aids.

Several studies further enhanced accessibility through the integration of sign language, subtitles, and animations. Ahmadi et al [39] created hygiene education videos for Deaf students, while Asogwa et al [38] used video-guided educational clips to foster school engagement. Kurniawati et al [31] promoted oral hygiene among Deaf children through audiovisual media, and Galindo Neto et al [34] developed a CPR training video that improved life-saving competencies. Springer et al [24] created an interactive stroke preparedness video incorporating ASL, which significantly improved stroke symptom recognition among Deaf students. These varied implementations highlight how video-based technologies have become instrumental in bridging communication gaps and addressing health education disparities among Deaf individuals.

The adoption of digital technologies in health promotion has shown substantial benefits for both Deaf adults and children. These tools, especially interactive video interventions, have enhanced health knowledge, practical skills, and engagement levels within these groups. While the overarching goal remains the same, improving health education and inclusivity strategies, areas of focus, and outcomes differ notably between adult and child cohorts.

For Deaf adults, health promotion initiatives tend to address a broader spectrum of health concerns, including chronic conditions, mental health, and preventive care. Digital platforms such as mobile apps, video-based education, social media campaigns, and TMH services are increasingly leveraged to bridge gaps in health care accessibility. Notably, accessible formats such as sign language interpretation, captioning, and subtitles are essential in enhancing the usability of these interventions [19]. Studies indicate that these tailored approaches not only improve health knowledge but also foster greater engagement and more positive mental health outcomes among Deaf adults [40]. Larger sample sizes in many of these studies allow for broader generalizability of findings, strengthening the evidence base for these interventions. Conversely, health promotion efforts targeting Deaf children often emphasize prevention and early health education, with a focus on fostering positive health behaviors from an early age. Interactive content, such as gamified learning, storytelling videos, and visual-rich tutorials, has proven particularly beneficial in capturing and sustaining attention among younger audiences. School-based programs play a crucial role in this demographic, providing a structured and inclusive environment that encourages peer learning and community involvement [41]. Additionally, the involvement of Deaf role models has been identified as a beneficial practice, offering sociolinguistic and cultural perspectives that complement traditional audiological approaches [41]. However, these studies often involve smaller, localized sample groups, which can limit the generalizability of their findings beyond specific contexts.

Despite the promising outcomes, both Deaf adults and children continue to report lower utilization rates and greater difficulties in accessing eHealth services compared to their hearing counterparts. Barriers include limited digital literacy, inadequate internet access, and the scarcity of culturally and linguistically appropriate content. Questionnaires remain the primary tool for evaluating intervention effectiveness in both populations, ensuring consistency in outcome measurement but also underscoring the need for more diverse assessment methodologies in future research. While digital health tools have successfully enhanced health knowledge and practical health-related skills in both groups, their distinct developmental stages and priorities necessitate tailored approaches. Adults benefit from scalable, wide-reaching interventions that address complex health topics, whereas children require engaging, interactive formats that encourage active participation and early adoption of healthy behaviors. Ultimately, the shared success across both groups lies in the strategic use of accessible digital content. Video-guided educational interventions, in particular, have significantly increased engagement levels, especially among Deaf secondary school students, demonstrating that when designed with inclusivity in mind, digital tools can profoundly impact health outcomes.

The findings of this review highlight the transformative potential of digital communication technologies in advancing health education, awareness, and practical skills within these populations, particularly in contexts where conventional, speech-dependent health services remain inaccessible. Unlike hearing populations, who typically benefit from verbally mediated, face-to-face health communication, Deaf individuals often encounter persistent linguistic and communication barriers that limit access to health information. By prioritizing accessible design and tailoring interventions to the distinct needs of both deaf and Deaf adults and children, digital health initiatives can reduce these inequities and promote health equity. This review identifies a wide range of digital technologies, including mobile phones, personal computers, television, and SMS text messaging, delivered through platforms such as online courses, video-based content, email, and social media, that have been effectively used in health promotion and disease prevention. Effectiveness is conceptualized within an implementation science framework as the real-world impact of digital services on reach, acceptability, and user outcomes, with particular relevance to improving health literacy and advancing digital equity [42].

Nevertheless, while digital technologies show considerable promise in improving health outcomes, their successful implementation depends on overcoming several persistent challenges. Accessibility, digital literacy, and cultural relevance remain key concerns that need to be addressed to ensure the sustainability of these interventions. Leveraging digital communication effectively for Deaf children and Deaf adults presents unique challenges. One major challenge is the lack of accessible content in local sign languages. Many health platforms rely on text-based materials or spoken audio, which are not always suitable for Deaf individuals, especially those with limited reading literacy due to delayed language acquisition. Deaf children, in particular, may face language deprivation if they are not exposed to sign language early, affecting their ability to understand health content. Conversely, Deaf adults may carry long-standing gaps in health knowledge due to years of exclusion from accessible education and health care communication [18].

The reviewed studies illustrate the growing use of digital technologies, particularly video-based platforms, to enhance health awareness, education, and skill development among Deaf adults and children. These interventions, which often integrate sign language, captions, and visual storytelling, have shown positive outcomes in improving health-related knowledge and enabling practical health actions such as BSE and CPR. Thus, the dominance of video-based interventions may reflect both user preference and gaps in research on emerging platforms. However, despite these promising results, significant digital health literacy gaps remain. Discrepancies persist due to the lack of inclusive design features, such as sign language options, and usability for Deaf individuals. Literacy development gaps are evident as many interventions are stand-alone with little to no follow-up, particularly for those with limited health knowledge. There is a lack of support where Deaf users are not equipped to assess the digital health content or apply information in decision-making contexts. Together, these gaps underscore the need for digital health interventions to move beyond surface-level accessibility. To be effective and equitable, such interventions must be linguistically aligned, developmentally appropriate, cognitively empowering, and embedded within inclusive health systems that recognize the unique needs of Deaf individuals.

This review highlights important insights into the use of digital technologies for health promotion among Deaf populations; however, several limitations should be acknowledged. First, most of the studies included were conducted in the United States, limiting the generalizability of findings across different cultural, socioeconomic, and health care contexts. Future research should actively include more geographically and culturally diverse Deaf communities to enhance the global applicability and relevance of interventions. Second, only 3 of the 12 studies employed RCT designs. While observational and quasi-experimental studies offer valuable perspectives, the lack of high-quality RCTs reduces the strength of evidence and the effect of interventions. Future research should prioritize well-designed RCTs with double- or triple-blinded methods where feasible, to minimize bias and enhance the validity of outcomes.

Additionally, several studies relied on outdated technologies such as DVDs and CDs, which do not reflect current digital media usage trends. As digital access evolves rapidly, future interventions should focus on contemporary technologies, including mobile apps, video-based platforms, and interactive tools that are more relevant to today’s Deaf populations. Another limitation of this review was the narrow scope of digital technologies considered. While the focus was intentionally placed on broader digital health tools rather than specific social media platforms, this approach may have overlooked the potential impact of emerging platforms like TikTok and Threads. These platforms play an increasingly significant role in health communication, particularly for younger audiences, and warrant further exploration in future research.

Despite these limitations, this review emphasizes the significant potential of digital technologies to reduce health disparities and improve health outcomes. To address these challenges, digital health communication must be co-designed with Deaf communities, prioritize sign language-first content, incorporate Deaf cultural perspectives, and be supported by inclusive policies and trained personnel. This approach can bridge the communication gap and promote equitable health outcomes for both Deaf children and adults. Future research could benefit from explicitly incorporating behavioral and communication theories to better explain why certain interventions succeed or fail, particularly as the evidence base grows. Tailoring interventions to the unique language and modality needs of Deaf individuals is likely to enhance engagement, comprehension, and ultimately health outcomes.