Faculty Mentor: Michelle Litchman (College of Nursing, University of Utah)

BACKGROUND AND PURPOSE

There are 1 million deaf or hard of hearing (DHH) individuals in the US who rely on American Sign Language (ASL) to communicate. Amongst this population, it is reported that DHH adult populations report more health problems compared to the general population, including diabetes and cardiovascular disease (CVD). This could be due to major health disparities that exist such as language barriers between DHH individuals and healthcare providers, resulting in inadequate levels of healthcare, and lacking forms of effective health education which results in low health literacy.

An ASL glossary of diabetes terms was previously developed, which improved DHH populations’ understanding of their diabetes and supported diabetes self-management behaviors. An ASL glossary of cardiometabolic/CVD terms is lacking. The purpose of this project is to develop a cardiometabolic/CVD ASL Glossary to improve the health literacy of DHH populations, towards the prevention and self-management of CVD. The development of this educational resource is crucial in addressing the health disparities that exist within the DHH population and to make health education more accessible. Oftentimes, when an ASL interpreter does not understand a medical term, they will finger spell it (ex. v-e-i-n), which doesn’t relay the meaning of the term and can lead to miscommunication of information. The glossary also aims to provide comprehensive training to ASL interpreters with the hopes of preventing this from happening.

METHODOLOGY

The project will be completed in 5-phases with a team of Deaf and hearing members. Phase 1 will have project members gathering common CVD terms with simple definitions and 2-3 accompanying images. In phase 2, Deaf project members will meet to review the terms and determine which ASL signs need to be clarified, developed, or expanded upon. Here, the team will also document which terms do or do not have associated ASL signs. In phase 3, the completed signs will be discussed, and adjustments will be made as needed. In phase 4, all Deaf project members will meet to review and finalize the signs. Phase 5 will have the ASL signs video recorded by a certified deaf interpreter. Once completed, the ASL glossary of cardiometabolic/CVD terms will be used in a virtual chronic disease self-management behavior intervention. Additionally, it will be used to train ASL interpreters who facilitate communication between DHH individuals and their healthcare providers.

RESULTS

Since the project is ongoing, results have yet to be produced. Phase 1 is nearly complete with 59 terms identified. A final review of these terms and pictures is currently being conducted in preparation for phase 2. A grant has been submitted to help support the development of phases 2-5.

CONCLUSIONS

Health education and literacy are critical in supporting the self-management of chronic conditions, such as CVD. The ASL glossary of cardiometabolic/CVD terms has the potential to improve the health disparities that exist within the DHH population by providing accessible health education to DHH individuals to bridge potential gaps in health literacy. As well as providing training materials for ASL interpreters to better understand cardiometabolic/CVD terms and to assist in the communication between DHH individuals and their healthcare providers. This will help close any gaps in communication between DHH individuals and their healthcare providers so that DHH individuals can better understand their health, and for providers to better understand any concerns that an individual may have about their health.

Bibliography

Hommes, Rachel E., et al. “American Sign Language Interpreters Perceptions of Barriers to Healthcare Communication in Deaf and Hard of Hearing Patients.” Journal of Community Health, 2018, pp. 956-961. https://doi.org/10.1007/s10900-018-0511-3.

Kapoor, Ravish, et al. “Disparities Impacting the Deaf and Hard of Hearing: A Narrative and Approaches to Closing Health Care Gaps.” Canadian Journal of Anaesthesia = Journal Canadien D’Anesthesie, 2023, pp. 975-977. https://doi/org/10.1007/s12630-023-02453-y.

Lloyd-Jones, Donald M., et al. “Life’s Essential 8: Updating and Enhancing the American Heart Association’s Construct of Cardiovascular Health: A Presidential Advisory From the American Heart Association.” Circulation, 2022, e18-e43. https://doi/org/10.1161/CIR.0000000000001078.

McKee, Michael M., et al. “Assessing Health Literacy in Deaf American Sign Language Users.” Journal of Health Communication, 2015, pp. 92-100. https://doi/org/10.1080/10810730.2015.1066468.

Mitchell, Ross E., and Young, Travas A. “How Many People Use Sign Language? A National Health Survey-Based Estimate.” Journal of Deaf Studies and Deaf Education, 2022, pp. 1-6. https://doi/org/10.1093/deafed/enac031.