Mechanisms of Health Literacy and Information Accessibility in the Deaf

项目摘要 失聪的美国手语(ASL)使用者健康状况不佳的可能性几乎是后者的7倍 与听力正常的同龄人相比，他们的识字能力更强。这一群体是非英语少数群体， 在卫生保健环境中沟通不畅的最大风险。聋人的健康素养机制 仍然知之甚少，从而限制了解决卫生知识差距及其影响的干预措施 在医疗保健方面。目前尚不清楚态度、知识和技能的差异如何与健康信息相关 影响聋人的健康素养，以及它们可能如何造成持续的健康不平等。 这项提议的两个主要目标是：1)阐明信息边缘化对健康的作用 聋人美国手语(ASL)使用者的识字能力和2)更好地了解健康机制 提高这一人群的识字率，以便为今后的健康识字干预发展确定可行的目标。这 该提案是对S关于评估健康素养潜在机制的研究的要求的回应， 包括认知能力、文化能力、语言流利性、信息寻求能力和口译能力在翻译中的作用 聋人人口，以及这些人口与听力人口有何不同。 为了达到研究目标，我们将采用解释性的顺序混合方法设计，使用广泛的 定量数据收集程序，即横断面调查和将确定 450名聋人和450名听力受试者健康素养的预测和调节 地理位置不同的地点。这些结果将为后续的定性评估提供帮助 解释量化结果，并阐明聋人如何以及为什么获得和理解健康 信息。我们将采用尖端技术来评估健康信息寻求和 这一群体中的口译模式，除了使用各种经过验证的和ASL可访问的 评估健康素养的工具和与健康素养有关的其他结构。多样化的团队， 由领先的聋人和听力研究人员组成，提供了对健康信息如何 以可视方式分发和传播。这种方法有可能生成丰富的数据，说明如何 为听力损失个体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.