Mechanisms of Health Literacy and Information Accessibility in the Deaf

项目摘要 耳聋的美国手语（ASL）使用者健康状况不佳的可能性高出近7倍 与听力正常的同龄人相比。这一人口是指非英语国家的少数群体， 在医疗保健环境中，沟通不畅的风险最大。聋人健康知识普及机制 对这些问题的了解仍然很少，从而限制了解决卫生知识普及差距及其影响的干预措施 在医疗保健方面。目前还不清楚态度、知识和技能的差异与健康信息的关系 影响聋人的健康素养，以及他们如何可能导致持续的健康不公平。 这一建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）用户的识字率和2）更好地了解健康的机制 在这一人群中进行扫盲，以便确定未来卫生知识普及干预发展的可行目标。这 该提案是对PAR-10-133要求进行评估健康素养机制的研究的回应， 包括认知、文化、语言流利性、信息寻求和解释能力在 聋哑人群，以及这些人群与听力人群的差异。 为了达到研究目的，我们将采用解释性序贯混合方法设计， 定量数据收集程序，即跨部门调查和措施， 健康素养的预测因子和调节因子，其中包括450名聋人和450名听力受试者， 地理位置多样。这些结果将为随后的定性评估提供信息， 解释定量结果，并阐明聋人如何以及为什么获得和理解健康 信息.我们将采用最先进的技术来评估健康信息的寻求， 除了使用各种经过验证的和ASL可访问的解释模式外， 评估卫生知识普及情况的工具和与卫生知识普及有关的其他结构。多样化的团队， 由领先的聋人和听力研究人员组成，提供了一个独特的见解，如何健康信息 是通过视觉传播的。这种方法有可能产生丰富的数据， 为听力损失患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.