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Purpose: The Deaf community is an ethnolinguistic minority whose lack of access to mainstream health information limits health literacy. This study describes barriers to teaching high school health education in US K-12 Deaf schools. Methods: An online survey with English and American Sign Language (ASL) instructions were emailed to administrators at sixty schools for the Deaf. Descriptive statistics were conducted to describe study sample, health class curriculum topics and perceived student knowledge of said topics. All statistical analyses were completed using SAS version 9.4 (SAS Institute, Inc., Cary, NC). Results: Twenty-five schools (42%) anonymously responded. Ninety-two percent of schools reported a lack of resources for teaching health education. Only 12% of schools reported having a nationally certified health teacher. Student knowledge was perceived to be poor to satisfactory regarding mental health, self-advocacy, and family medical history. Conclusions: This study found the most notable barriers to health education were difficulty hiring qualified health teachers and severe lack of resources for teaching. The subjects with the greatest lack of resources were also among topics in which students had the poorest perceived knowledge. Recommendations: Additional opportunities for future research could include a comparison to hearing schools in the US, assessing health care knowledge among deaf students in mainstream schools, or completing a similar survey to compare results to comparable schools for the Deaf outside of the United States. Additionally, future research could assess actual student knowledge of the subjects that were queried and compare to existing health disparities in the community. [The volume number (12) shown on the PDF is incorrect. The correct volume number for this article is 13.]

Introduction: To reduce COVID-19 exposure risk, virtual visits became widely adopted as a common form of healthcare delivery for the general population. It is unknown how this affected the deaf population, a sociolinguistic minority group that continues to face communication and healthcare barriers. The survey's objective was to describe the deaf participants' experiences with telehealth visits. Methods: A 28-item online survey, available in American Sign Language and English, was developed and disseminated between November 2020 and January 2021. Ninety-nine deaf participants responded. Descriptive statistics were performed to assess the participant's virtual health care use, experiences, and communication approaches. Results: Seventy-five percent of respondents used telehealth at least once in the past 12 months (n = 74; age = 37.6 ± 14.5 years). Of those who used telehealth, nearly two-thirds experienced communication challenges (65.3%; n = 49). Half of the participants reported having to connect via a video relay service that employs interpreters who maintain general certification instead of a remote interpreter with specialized health care interpreting certifications for video visits with their health care providers (n = 37) and a third of participants reported needing to use their residual hearing to communicate with their providers (n = 25). Conclusion: Standard protocols for health care systems and providers are needed to minimize the burden of access on deaf patients and ensure virtual visits are equitable. It is recommended these visits be offered on Health Insurance Portability and Accountability Act-compliant platforms and include multi-way video to allow for the inclusion of remote medical interpreters and/or real-time captionists to ensure effective communication between the provider and the deaf patient occurs. [ABSTRACT FROM AUTHOR]

Objective: Women who are deaf experience higher rates of reproductive healthcare barriers and adverse birth outcomes compared with their peers who can hear. This study explores the pregnancy experiences of women who are deaf to better understand their barriers to and facilitators of optimal pregnancy‐related health care. Design: Qualitative study using thematic analysis. Setting: Semi‐structured, individual, remote or in‐person interviews conducted in the USA. Sample Forty‐five women who are deaf and communicate using American Sign Language (ASL) and gave birth in the USA within the past 5 years participated in the interviews. Methods: Semi‐structured interviews explored how mothers who are deaf experienced pregnancy and birth, including access to perinatal information and resources, relationships with healthcare providers, communication access and their involvement with the healthcare system throughout pregnancy. A thematic analysis was conducted. Main outcome measures: Barriers and facilitators related to a positive experience of perinatal care access among women who are deaf. Results: Three major themes emerged: (1) communication accessibility; (2) communication satisfaction; and (3) healthcare provider and team support. Common barriers included choosing healthcare providers, inconsistent communication access and difficulty accessing health information. However, when women who are deaf were able to use ASL interpreters, they had more positive pregnancy and birth experiences. Self‐advocacy served as a common facilitator for more positive pregnancy and healthcare experiences. Conclusions: Healthcare providers need to be more aware of the communication and support needs of their patients who are deaf, especially how to communicate effectively. Increased cultural awareness and consistent provision of on‐site interpreters can improve pregnancy and birth experiences for women who are deaf. Linked article: This article is commented on by Moreland et al., pp.522–523 in this issue. To view this mini commentary visit https://doi.org/10.1111/1471-0528.17362 This paper has a Video Abstract presented by Jenna Stewardson, Deaf Health Laboratory Research Program Coordinator at the NTID Research Center on Culture and Language available at: https://vimeo.com/761853406. [ABSTRACT FROM AUTHOR]

Objective: We sought to identify current Emergency Medical Services (EMS) practitioner comfort levels and communication strategies when caring for the Deaf American Sign Language (ASL) user. Additionally, we created and evaluated the effect of an educational intervention and visual communication tool on EMS practitioner comfort levels and communication. Methods: This was a descriptive study assessing communication barriers at baseline and after the implementation of a novel educational intervention with cross-sectional surveys conducted at three time points (pre-, immediate-post, and three months post-intervention). Descriptive statistics characterized the study sample and we quantified responses from the baseline survey and both post-intervention surveys. Results: There were 148 EMS practitioners who responded to the baseline survey. The majority of participants (74%; 109/148) previously responded to a 9-1-1 call for a Deaf patient and 24% (35/148) reported previous training regarding the Deaf community. The majority felt that important details were lost during communication (83%; 90/109), reported that the Deaf patient appeared frustrated during an encounter (72%; 78/109), and felt that communication limited patient care (67%; 73/109). When interacting with a Deaf person, the most common communication strategies included written text (90%; 98/109), friend/family member (90%; 98/109), lip reading (55%; 60/109), and spoken English (50%; 55/109). Immediately after the training, most participants reported that the educational training expanded their knowledge of Deaf culture (93%; 126/135), communication strategies to use (93%; 125/135), and common pitfalls to avoid (96%; 129/135) when caring for Deaf patients. At 3 months, all participants (100%, 79/79) reported that the educational module was helpful. Some participants (19%, 15/79) also reported using the communication tool with other non-English speaking patients. Conclusions: The majority of EMS practitioners reported difficulty communicating with Deaf ASL users and acknowledged a sense of patient frustration. Nearly all participants felt the educational training was beneficial and clinically relevant; three months later, all participants found it to still be helpful. Additionally, the communication tool may be applicable to other populations that use English as a second language. [ABSTRACT FROM AUTHOR]

Background: Users of American Sign Language (ASL) who are deaf often face barriers receiving health information, contributing to significant gaps in health knowledge and health literacy. To reduce the spread of coronavirus disease 2019 (COVID-19) and its risk to the public, the government and health care providers have encouraged social distancing, use of face masks, hand hygiene, and quarantines. Unfortunately, COVID-19 information has rarely been available in ASL, which puts the deaf community at a disadvantage for accessing reliable COVID-19 information., Objective: This study's primary objective was to compare COVID-19-related information access between participants who are deaf and participants who are hearing., Methods: The study included 104 adults who are deaf and 74 adults who are hearing who had participated in a prior health literacy study. Surveys were conducted between April and July 2020 via video conference, smartphone apps, or phone calls. COVID-19 data were linked with preexisting data on demographic and health literacy data as measured by the Newest Vital Sign (NVS) and the ASL-NVS., Key Results: Neither group of participants differed in their ability to identify COVID-19 symptoms. Adults who are deaf were 4.7 times more likely to report difficulty accessing COVID-19 information ( p = .011), yet reported using more preventive strategies overall. Simultaneously, adults who are deaf had 60% lower odds of staying home and calling their doctor versus seeking health care immediately or doing something else compared with participants who are hearing if they suspected that they had COVID-19 ( p = .020)., Conclusions: Additional education on recommended COVID-19 management and guidance on accessible health care navigation strategies are needed for the deaf community and health care providers. Public health officials should ensure that public service announcements are accessible to all audiences and should connect with trusted agents within the deaf community to help disseminate health information online in ASL through their social media channels. [ HLRP: Health Literacy Research and Practice . 2021;5(2):e162-e170.] Plain Language Summary: Compared to participants who are hearing, a higher portion of participants who are deaf reported challenges with accessing, understanding, and trusting COVID-19 information. Although respondents who are deaf had similar knowledge of symptoms compared to participants who are hearing, they used more prevention strategies and were more likely to plan immediate care for suspected symptoms. Improved guidance on COVID-19 management and health care navigation accessible to the deaf community is needed.