A school-based initiative to improve health encounters for deaf teenagers

Background: Individuals deafened before language acquisition commonly receive inferior healthcare and have worse outcomes and less satisfaction with healthcare than hearing patients. This group most commonly does not receive healthcare or media messages in their primary language, American Sign Language. We hypothesized that a targeted intervention for students in a deaf high school would improve health literacy, transition-of-care, and interactions at healthcare encounters.

Methods: We designed and implemented a curriculum innovation at the Rhode Island School for the Deaf targeting transition-of-care and health system interactions for adolescents. Teaching sessions included educational materials and simulated health encounters.

Results: In Phase 1 of the curriculum, a Brown Medical School student mentored a deaf high school senior for her graduation project. They completed a literature survey and visited healthcare sites to identify specific communication issues. For example, they visited a hospital radiology department to experience the process of registration and a simulated imaging procedure, recording potential communication problems throughout the encounter. Phase 2 involved creating teaching materials to educate deaf adolescents on issues encountered in transitioning care, setting up a medical appointment, arranging interpreters, and navigating the encounter. Phase 3 was a mock clinic for graduating seniors to role-play a clinical experience. Students reported greater ease with the medical community, less anxiety, and greater satisfaction after the encounter.

Discussion: Practical experience in transition-of-care and navigating healthcare encounters are vital skills for deaf teenagers. A school-based initiative involving visits to health sites, instructional materials, and a mock medical clinic may improve health outcomes.