Tackling Health Inequalities with and for the Deaf BSL-Using Communities in Wales

威尔士使用聋人英国手语(BSL)的社区在获得医疗服务(特别是在紧急情况下)、健康信息、心理健康护理服务和支持以及与家庭相关的服务和培训方面面临着比听力正常人群更多的挑战。威尔士的聋人还在许多保健环境中遭受口译服务不一致和沟通不畅的困扰，因此，他们也面临着更大的被低估和慢性病治疗不足的风险，而且往往比一般人的健康状况更差(Sign Health，2019；Shank&Foltz，2019；Foltz&Shank，2020；Foltz et al.，2022)。聋人的精神健康问题的发生率也是普通人群的两倍，并且面临获得支持服务的障碍(Terry等人，2021年)。研究表明，接触自然和户外活动是一种健康资产(Houlden等人。2018年；力霸等人。然而，威尔士的许多文化和自然资产是无法获得的，因为在BSL中很少有材料可用。该项目的目标是设计、实施和评估聋人社区领导的解决方案，以解决这些已知和有记录的健康不平等和不平等问题。我们是一个由学术和非学术、听力和聋人合作伙伴组成的跨学科团队。我们的项目将使用创新的社交网络技术、社区外联、焦点小组、访谈以及基于视频的定制问卷和应用程序技术，以确定可持续的、社区主导的、文化和语言驱动的解决方案，以改善社区的健康和福祉。然后，我们将在五个影响威尔士聋人健康和福祉的领域开发、实施和评估这些解决方案。这些领域是：(1)公共健康，(2)精神健康，(3)口译服务，(4)获得自然资源，公园，和自然环境资源的使用，(5)语言和交流。在(1)公共健康，(2)精神健康，和(3)口译服务领域，我们将与聋人社区以及NHS，健康委员会，口译员和其他服务提供者合作，制定文化和语言驱动的建议，以改善医疗保健提供过程的每个阶段的服务。解决办法将侧重于获得口译员和BSL语言服务，以及提高对语言和文化方面的聋人意识以及法律方面的聋人权利。在自然资源方面，我们将开发BSL视频指南应用程序，以便更好地访问威尔士三个地点的威尔士自然资源、公园和遗产遗址。在语言和交流方面，BSL的威尔士方言，它的词汇和地区变体，仍然没有记载，也没有描述。该项目将开发在线词典和语料库资源，特别侧重于医学术语，以帮助威尔士的口译员和服务提供者。我们将评估作为该项目一部分而开发的资源的潜在积极影响，并使用从该项目获得的结果来告知和影响当前的地方和国家卫生保健政策、服务、做法和交付，以帮助遵守2010年《平等法案》和2015年《子孙后代福祉法案》。

The Deaf British Sign Language (BSL) using community in Wales have more challenges than hearing populations in accessing healthcare services (especially in emergency situations), health information, mental health care services and support, and family-related services and training. The Deaf in Wales also suffer from inconsistent interpreting services and poor communication in many health-care settings and, as a result, are also at greater risk of underdiagnoses and under-treatment of chronic diseases and tend to have poorer health than the general population (Sign Health, 2019; Shank & Foltz, 2019; Foltz & Shank, 2020; Foltz et al., 2022). Deaf people also have an incidence of mental health problems that is twice as high as the general population and face barriers accessing support services (Terry et al., 2021). Research has shown that access to nature and outdoor activities is a health asset (Houlden et al. 2018; Rebar et al. 2015); however, many of Wales's cultural and natural assets are not accessible because materials are rarely available in BSL.The goal of this project is to design, implement and evaluate Deaf-community-lead solutions for these known and documented health inequities and inequalities. We are a transdisciplinary team of academic and non-academic, hearing, and Deaf partners. Our project will use innovative social networking techniques, community outreach, focus groups, interviews, and custom video-based questionnaires and app technologies to identify sustainable, community-led, culturally, and linguistically driven solutions to improve the health and wellbeing of this community. We will then develop, implement, and evaluate these solutions in five areas that impact Deaf Welsh citizens' health and wellbeing. These areas are: (1) public health, (2) mental health, (3) interpreting services, (4) access to natural resources, parks, and use of natural environment resources and (5) language and communication.In the areas of (1) public health, (2) mental health, and (3) interpreting services we will work with the Deaf community as well as the NHS, Health Boards, interpreters, and other service providers to develop culturally and linguistically driven proposals to improve services at every stage of the healthcare delivery process. Solutions will focus on access to interpreters and BSL language services and improving d/Deaf awareness with respect to language and culture and d/Deaf rights with respect to the law. In the area of (4) natural resources, we will develop BSL video guide apps for better accessibility to Welsh natural resources, parks, and heritage sites at three locations across Wales. In the area of (5) language and communication, the Welsh dialect of BSL, it's lexicon and regional variations, remains undocumented and undescribed. This project will develop an on-line dictionary and corpus resources, with a particular focus on medical terminology, to aid interpreters and service providers in Wales. We will assess the potential positive impact of the resources that we are developing as part of this project and use the results obtained from this project to inform and influence current local and national health care policy, services, practices, and delivery to aid compliance with the 2010 Equality and 2015 Well-being of Future generations Acts.