Project Summary This F99/K00 Transition to Aging Research for Predoctoral Students Award application will facilitate the research training of the applicant to launch an independent career in aging research focused on examining the influence of hearing loss on healthcare engagement and health outcomes. The proposed research will examine how hearing loss influences care engagement, health communication and healthcare use for diverse populations of older adults. In the F99 phase of this award, the applicant will examine the role of hearing loss in self-maintenance practices for chronic illness, termed self-care of chronic illness. This study proposes to (1) describe self-care behaviors in older adults with hearing loss and compare self-care behaviors by hearing loss severity, (2) explore the experience of caring for chronic illness while having hearing loss, and how hearing loss impacts self-care, and (3) describe differences in the experiences of self-care of chronic illness by self-care behavior scores and hearing loss severity. This mixed methods study will use a parallel-convergent design to enroll a single diverse sample of community-dwelling hospitalized older adults with a chronic illness and hearing loss. In the K00 phase of this award, the applicant will expand on F99 work to examine (1) how the intersection of hearing loss and social determinants of health influence healthcare use outcomes and (2) how hearing loss and its intersection with race influence the dynamics of patient-provider interaction. K00 research will be conducted using epidemiologic datasets linked with claims data, prospective data collection, and conversation analysis approaches. Research training will occur in resource rich environments with support from a cross-disciplinary mentorship team with expertise in aging, hearing science, chronic illness, epidemiology, and the required methodologies. The applicant proposes a training plan that includes coursework, practical training, seminars, and engagement in ongoing research. Training will focus on methodological skills, ethical research practices, epidemiology, aging, and career development. This proposal aligns with the priorities of the National Institute on Aging by addressing the burden of age-related diseases and disabilities to improve health and function in aging. Having a greater understanding of how hearing loss influences health in diverse populations aging with chronic illness will inform the development of interventions to improve care delivery and maximize health for the millions of adults aging with hearing loss and a chronic illness.