Perceptions of Cardiovascular Health in an Underserved Community: A Qualitative Study of Deaf Adults through CHIRTN

Surveys of deaf adult users of American Sign Language (ASL) have shown high rates of obesity and poor knowledge of cardiovascular disease (CVD) risks. We used a social marketing framework to conduct 11 focus groups (FGs) among deaf adults over 40 to ascertain their knowledge of CVD risk, their health promoting behaviors, and sources of information about CVD. Barriers and facilitators to those three domains were also noted. 77 ASL-using deaf adults participated in the FGs held in Raleigh, NC; Denver, Colorado; and Rochester, NY. Participants were recruited through deaf social and professional networks. To increase open exchange of information, deaf moderators only used ASL. Participants at all sites were predominately overweight/obese, white, female, and graduates of deaf schools. Average educational achievement in NC and Colorado focus groups participants were much lower than in Rochester. The awareness of heart disease symptoms, risk factors and the importance of exercise varied between regions studied. Limited knowledge about diabetes, stroke, high blood pressure and medications was seen at all FG sites. There was an overreliance on friends and families for health information which led to distorted perceptions of CVD risks. Key facilitators of CVD risk reduction were strong social support among deaf peers and health information exchange. The findings support the need for ASL-accessible cardiovascular health information that can increase CVD knowledge in this under-served group. Risk reduction programs may be especially effective if designed in a group format which takes advantage of the close knit structure of the deaf community.