Erika Sutter

Community Participatory Research With Deaf Sign Language Users to Identify Health Inequities

Deaf people who use American Sign Language (ASL) are medically underserved and often excluded from health research and surveillance. We used a community participatory approach to develop and administer an ASL-accessible health survey. We identified deaf community strengths (e.g., a low prevalence of current smokers) and 3 glaring health inequities: obesity, partner violence, and suicide. This collaborative work represents the first time a deaf community has used its own data to identify health priorities.

Self-reported smoking in online surveys : Prevalence estimate validity and item format effects

Objectives:We assessed validity of self-reported smoking prevalence estimates from an online sample, and explored the impact of different item response formats on estimates. Methods:Self-reported current smoking status was obtained from 110,837 respondents from the Harris Poll Online (HPOL) panel from April 2004 to January 2005. Current smoking prevalence was compared with national estimates from the 2004 Behavioral Risk Factor Surveillance System (BRFSS), 2003 National Health Interview Survey (NHIS), and 2001–2002 National Health and Nutrition Examination Survey (NHANES). All estimates were weighted to reflect the US population. A separate survey section measured smoking prevalence using randomly assigned response formats, including yes/no grid, multiple response, numeric box, category grid, and drop-down box formats. Results:24.0% (95% confidence interval [CI] = 23.7–24.4) of HPOL respondents reported current smoking. BRFSS, NHIS, and NHANES estimates found 20.9%, 21.5% (95% CI = 20.9–22.1), and 24.9% (95% CI = 22.4–27.5), respectively, reporting current smoking. An additional 4.5% of NHANES respondents reporting not smoking had cotinine levels ≥15 ng/mL, indicating current smoking. Estimates of smoking prevalence varied by prevalence period and response format. Conclusions:Prevalence estimates obtained from the HPOL panel are comparable to those from national surveys. Online response format choices result in variation in estimated behavioral prevalence. Online surveys may be useful for public health surveillance of the US population.

Intimate Partner Violence Reported by Two Samples of Deaf Adults via a Computerized American Sign Language Survey

A computerized sign language survey was administered to two large samples of deaf adults. Six questions regarding intimate partner violence (IPV) were included, querying lifetime and past-year experiences of emotional abuse, physical abuse, and forced sex. Comparison data were available from a telephone survey of local households. Deaf respondents reported high rates of emotional abuse and much higher rates of forced sex than general population respondents. Physical abuse rates were comparable between groups. More men than women in both deaf samples reported past-year physical and sexual abuse. Past-year IPV was associated with higher utilization of hospital emergency services. Implications for IPV research, education, and intervention in the Deaf community are discussed.

Higher educational attainment but not higher income is protective for cardiovascular risk in Deaf American Sign Language (ASL) users

BACKGROUND Higher educational attainment and income provide cardiovascular protection in the general population. It is unknown if the same effect is seen among Deaf American Sign Language (ASL) users who face communication barriers in health care settings. OBJECTIVE We sought to examine whether educational attainment and/or annual household income were inversely associated with cardiovascular risk in a sample of Deaf ASL users. METHODS This cross-sectional study included 302 Deaf respondents aged 18-88 years from the Deaf Health Survey (2008), an adapted and translated Behavioral Risk Factor Surveillance System (BRFSS) administered in sign language. Associations between the self-reported cardiovascular disease equivalents (CVDE; any of the following: diabetes, myocardial infarction (MI), cerebral vascular attack (CVA), and angina) with educational attainment (≤high school [low education], some college, and ≥4 year college degree [referent]), and annual household income (<

Considering parental hearing status as a social determinant of deaf population health: Insights from experiences of the "dinner table syndrome"

25,000,

Measuring quality of adolescent preventive services of health plan enrollees and school-based health center users.

25,000-<

Collaboration With Deaf Communities to Conduct Accessible Health Surveillance

50,000, or ≥

SUCCESSFUL RECRUITMENT AND DISTANCE TRAINING OF CLINICIANS IN AN ADOLESCENT SMOKING CESSATION PILOT STUDY IN AAP PROS PRACTICES

50,000 [referent]) were assessed using a multivariate logistic regression adjusting for age, sex, race/ethnicity, and smoking history. RESULTS Deaf respondents who reported ≤high school education were more likely to report the presence of a CVDE (OR = 5.76; 95% CI = 2.04-16.31) compared to Deaf respondents who reported having ≥4 year college degree after adjustment. However, low-income Deaf individuals (i.e., household incomes <

Abstract MP33: The Deaf Weight Wise Study: A Unique Clinical Trial of Health Behavior Modification with Deaf Adults

25,000) were not more likely to report the presence of a CVDE (OR = 2.24; 95% CI = 0.76-6.68) compared to high-income Deaf respondents after adjustment. CONCLUSION Low educational attainment was associated with higher likelihood of reported cardiovascular equivalents among Deaf individuals. Higher income did not appear to provide a cardiovascular protective effect for Deaf respondents.

Abstract P160: Is Higher Educational Attainment or Higher Income Protective for Cardiovascular Risk in Deaf American Sign Language (ASL) Users?

The influence of early language and communication experiences on lifelong health outcomes is receiving increased public health attention. Most deaf children have non-signing hearing parents, and are at risk for not experiencing fully accessible language environments, a possible factor underlying known deaf population health disparities. Childhood indirect family communication–such as spontaneous conversations and listening in the routine family environment (e.g. family meals, recreation, car rides)–is an important source of health-related contextual learning opportunities. The goal of this study was to assess the influence of parental hearing status on deaf people’s recalled access to childhood indirect family communication. We analyzed data from the Rochester Deaf Health Survey–2013 (n = 211 deaf adults) for associations between sociodemographic factors including parental hearing status, and recalled access to childhood indirect family communication. Parental hearing status predicted deaf adults’ recalled access to childhood indirect family communication (χ2 = 31.939, p < .001). The likelihood of deaf adults reporting “sometimes to never” for recalled comprehension of childhood family indirect communication increased by 17.6 times for those with hearing parents. No other sociodemographic or deaf-specific factors in this study predicted deaf adults’ access to childhood indirect family communication. This study finds that deaf people who have hearing parents were more likely to report limited access to contextual learning opportunities during childhood. Parental hearing status and early childhood language experiences, therefore, require further investigation as possible social determinants of health to develop interventions that improve lifelong health and social outcomes of the underserved deaf population.