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

威尔士使用英国手语的聋人社区在获得医疗保健服务（特别是在紧急情况下）、健康信息、精神保健服务和支持以及与家庭有关的服务和培训方面比听力正常的人面临更多挑战。威尔士的聋人在许多医疗保健机构中也面临着不一致的口译服务和沟通不良的问题，因此，他们对慢性病的诊断和治疗不足的风险也更大，而且往往比一般人群的健康状况更差（Sign health, 2019; Shank & Foltz, 2019; Foltz & Shank, 2020； Foltz等人，2022）。聋人的心理健康问题发生率是一般人群的两倍，并且在获得支持服务方面面临障碍（Terry et al., 2021）。研究表明，接触自然和户外活动是一项健康资产（Houlden et al. 2018; Rebar et al. 2015）；然而，威尔士的许多文化和自然资产是无法访问的，因为很少有材料在英国语中可用。该项目的目标是设计、实施和评估由聋人社区主导的解决方案，以解决这些已知和有记录的卫生不公平和不平等现象。我们是一个跨学科的团队，由学术和非学术、听力和聋人合作伙伴组成。我们的项目将使用创新的社交网络技术、社区外展、焦点小组、访谈、定制视频调查问卷和应用程序技术来确定可持续的、社区主导的、文化和语言驱动的解决方案，以改善这个社区的健康和福祉。然后，我们将在五个影响聋人威尔士公民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)公共卫生；(2)心理健康；(3)口译服务；(4)获取自然资源、公园和使用自然环境资源；(5)语言和交流。在(1)公共卫生、(2)心理健康和(3)口译服务领域，我们将与聋人社区以及NHS、卫生委员会、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。解决方案将侧重于获得口译和车贴语服务，提高聋人在语言和文化方面的意识，以及聋人在法律方面的权利。在(4)自然资源领域，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，公园和遗产地。在语言和交流领域，车贴语的威尔士方言，它的词汇和地区变化，仍然没有记录和描述。该项目将开发一个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正在开发的资源的潜在积极影响，并利用该项目获得的结果为当前的地方和国家卫生保健政策、服务、做法和交付提供信息和影响，以帮助遵守2010年《平等法》和2015年《子孙后代福祉法》。

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.