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

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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 ASLproficient 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