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APHA Scientific Session and Event Listing

Development of a linguistically accessible health survey for deaf students

Elizabeth G. Finigan, MD, Family Medicine, University of Rochester School of Medicine and Dentistry, 1381 South Avenue, Rochester, NY 14620, 585.271.2409, elizabeth_finigan@urmc.rochester.edu and Erika J. Sutter, MPH, Division of Adolescent Medicine, University of Rochester, 601 Elmwood Ave, Rm 4-6234, Rochester, NY 14642-8690.

Deaf and hard-of-hearing (D/HOH) students have English proficiency scores consistently lower than those of hearing counterparts. Access to health services and information is confounded by communication and literacy barriers. The National Center for Deaf Health Research developed a linguistically accessible instrument to assess health risk behaviors of D/HOH students.

We pooled over 300 questions from youth, college and adult national surveillance survey instruments. Using a consensus-driven process, 71 items were selected. Linguistic consultants guided word/phrase/syntax adaptations to maximize comprehension by D/HOH students while retaining item integrity. We piloted the survey and conducted cognitive interviews with 18 D/HOH college students. After revisions, we administered the survey to 200 D/HOH and 578 hearing first year college students.

Cognitive interviews probed survey language, content, format, and likelihood of response bias. Some limitations of our sentence adaptations were revealed. For example, there was no consensus about the terms 'sex' and 'sexual intercourse' and ‘cholesterol' was an unfamiliar term to several respondents. Most respondents thought critically about their behaviors to arrive at answers. D/HOH students were more likely to choose 'don't know' responses for several items and they reported receiving less preventive testing and communication-based health services.

Our ongoing analyses are revealing important evidence of health disparities between deaf and hearing students. A significant number of D/HOH students had difficulty understanding the modified survey. Researchers should use cognitive interviews to validate results of written surveys. Future D/HOH surveys should include administration via American Sign Language.

Learning Objectives: At the conclusion of the session, participants will be able to

Keywords: Deaf, Health Behavior

Presenting author's disclosure statement:

Any relevant financial relationships? No


The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA