Tailoring a Healthy Living Intervention to Deaf Adults: Sociocultural Data from the Target Group

Deaf persons are an understudied linguistic minority/cultural group. To date, there is no evidence-based weight loss interventions tailored to their needs. Behavioral interventions cannot be deployed from one cultural group to another without some adaptation to the practices and social context of the target group. The National Center for Deaf Health Research (NCDHR) is conducting a randomized-controlled trial of a healthy lifestyle intervention for deaf adults who use American Sign Language (ASL). NCDHR will adapt an intervention that was proven efficacious in a population of hearing African-American women (Samuel-Hodge et al., 2009). To inform the adaptation of this intervention for use with deaf participants, a team of deaf and hearing investigators and community members developed an interview guide within the theoretical framework of the social ecological model and self-determination theory. ASL-fluent team members conducted in-depth interviews over videophone with 13 participants. Socio-cultural data was gathered about their dietary and physical activity practices. Among participants, aged 40-69, nine had BMI above 25. Major findings that will be incorporated into the tailored curriculum included: 1) difficulties in maintaining healthy lifestyle due to: social isolation, depression related to past traumatic events, and daily stressors which were perceived as greater than hearing people; 2) distorted body image in which overweight was seen as healthy; 3) a low-fund of knowledge about diet and exercise; 4) preference for individual counseling among those who were embarrassed by their weight. These findings have implications for the adaptation of materials for other linguistic-minority groups.