Mechanisms of Health Literacy and Information Accessibility in the Deaf

项目概要 美国手语 (ASL) 聋人使用者健康状况不佳的可能性高出近七倍 与听力正常的同龄人相比，识字率更高。该人群是非英语母语的少数群体 医疗机构中沟通不畅的最大风险。聋人健康素养机制 仍然知之甚少，从而限制了解决健康素养差异及其影响的干预措施 关于医疗保健。目前尚不清楚与健康信息相关的态度、知识和技能的差异如何 影响聋人人群的健康素养以及他们如何导致持续的健康不平等。 该提案的两个主要目标是：1）阐明信息边缘化对健康的作用 聋人美国手语 (ASL) 用户的识字能力，2) 更好地了解健康机制 以确定未来健康素养干预发展的可行目标。这个 该提案响应了 PAR-10-133 的要求，即进行评估健康素养基础机制的研究， 包括认知、文化、语言流畅性以及信息查找和解释能力在 聋哑人群，以及他们与听力正常人群有何不同。 为了实现研究目标，我们将采用解释性序贯混合方法设计，使用广泛的 定量数据收集程序，即横断面调查和措施，以确定 三个项目中 450 名聋哑人和 450 名听力受试者的健康素养预测因子和调节因子 地理上不同的地点。这些结果将为后续的定性评估提供信息，这将有助于 解释定量结果，并阐明聋人如何以及为何获得和了解健康 信息。我们将采用尖端技术来评估健康信息的寻求和 除了使用各种经过验证和 ASL 可用的解释模式之外， 评估健康素养和与健康素养相关的其他结构的工具。多元化的团队， 由领先的聋人和听力研究人员组成，提供了关于健康信息如何 以视觉方式分布和传播。这种方法有可能生成丰富的数据来说明如何 为听力损失者制定健康信息和健康素养干预措施。

Project Summary Deaf American Sign Language (ASL) users are nearly seven times more likely to have inadequate health literacy when compared with their hearing peers. This population is the non-English speaking minority group at greatest risk for miscommunication in health care settings. Health literacy mechanisms for Deaf individuals remain poorly understood, thereby limiting interventions to address health literacy disparities and their impact on health care. It is unclear how differences in attitudes, knowledge, and skills related to health information affect health literacy in Deaf populations and how they may contribute to ongoing health inequities. The two primary objectives of this proposal are: 1) to elucidate the role of information marginalization on health literacy in Deaf American Sign Language (ASL) users and 2) to better understand the mechanisms of health literacy in this population so as to identify viable targets for future health literacy intervention development. This proposal is responsive to PAR-10-133's request for studies that assess mechanisms underlying health literacy, including roles of cognition, culture, language fluency, and information-seeking and interpretation ability in the deaf population and, how these may differ from the hearing population. To meet the study objectives, we will employ an explanatory sequential mixed methods design using extensive quantitative data collection procedures, namely, cross-sectional surveys and measures that will identify predictors and moderators of health literacy with 450 Deaf and 450 hearing subjects across three geographically diverse sites. These results will inform the subsequent qualitative assessment that will help explain the quantitative results, and elucidate how and why Deaf individuals access and understand health information. We will incorporate cutting edge technology to assess health information-seeking and interpretation patterns in this population, in addition to using a variety of validated and ASL -accessible instruments to assess health literacy and other constructs related to health literacy. The diverse team, consisting of both leading deaf and hearing researchers, provides a unique insight into how health information is distributed and disseminated visually. This approach has the potential to generate rich data on how to formulate health information and health literacy interventions for individuals with hearing loss.