Using technology-enhanced approaches to advance cancer health equity among diverse deaf, deafblind, and hard of hearing populations.

大约50万人使用美国手语（ASL）。在使用ASL的DDBHH人群中， 在理解印刷的癌症健康信息、获得临床服务方面存在困难的记录报告 进行筛查，并理解和遵循治疗相关的指令，如果筛查结果证明 癌症诊断这些困难导致了我们在DDBHH人群中观察到的健康不平等。 社区卫生工作者已经证明了他们对听力患者的价值，因此有理由期待ASL- 熟练的社区卫生工作者（CHW）将具有相同的识别和解决DDBHH的潜力 人们在接受癌症预防和筛查的最佳护理方面的障碍。我们设想一个精通ASL的 CHW作为癌症健康导航员，能够促进癌症筛查的依从性， DDBHH人群的健康差异。这项研究将建立在该团队目前由NIH资助的研究基础上， 最近开发的技术平台，特别是SNAP（患者导航辅助系统）， 一项支持癌症患者导航的技术，以及REPEAT（通过自适应技术实现增强实践） 辅导），一种工具，以建立虚拟指导实践环境，发展技能，在临床沟通 域.使用SNAP和REPEAT将提供一个高级起点，使我们能够专注于 DDBHH社区的特定培训和社区应用需求，而不是新技术 发展我们有能力满足这些具体需求，并适当地提供和评估 干预措施由一个高度跨学科的团队提供支持，涵盖DDBHH健康差距方面的专业知识， 残疾研究，公共卫生，健康信息学，文化人类学，人因工程，和 计算机科学

About 500,000 use American Sign Language (ASL). Among DDBHH people who use ASL, there are documented reports of difficulties in understanding cancer health information in print, accessing clinical services for screenings, and understanding and following treatment-related directives if the screening results warrant a cancer diagnosis. These difficulties contribute to the health inequity that we observed in the DDBHH populations. Community health workers have proven their value with hearing patients, so it is reasonable to expect that ASL- proficient community health workers (CHW) will have the same potential to identify and resolve DDBHH people’s barriers to receiving optimal care for cancer prevention and screening. We envision an ASL-proficient CHW, functioning as a cancer health navigator, who is able to promote cancer screening adherence and reduce health disparity among DDBHH people. This research will build on the team’s current NIH-funded research and recently developed technology platform, specifically SNAP (the System for Navigational Assistance for Patients), a technology to support cancer patient navigators, and REPEAT (Realizing Enhanced Practice through Adaptive Tutoring), a tool to build virtual guided practice environments for developing skills in clinical communication domains. Use of SNAP and REPEAT will provide an advanced starting point that allows us to focus on the specific training and community application needs of the DDBHH community, rather than new technology development. Our ability to address these specific needs and to appropriately deliver and evaluate the interventions is supported by a highly interdisciplinary team, spanning expertise in DDBHH health disparity, disability studies, public health, health informatics, cultural anthropology, human factors engineering, and computer science