182537 A school-based initiative to improve health encounters for deaf teenagers

Monday, October 27, 2008

Leslie A. Herrmann, BS , Warren Alpert Medical School, Brown University, Providence, RI
Edward Feller, MD, FACP , Warren Alpert Medical School, Brown University, Providence, RI
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.

Learning Objectives:
Understand the negative public health implications of poor communication of deaf high school students with the healthcare system. Construct a school-based intervention to increase health literacy of deaf teenagers. Implement a program for deaf teenagers to improve health outcomes.

Keywords: Deaf Patients, Adolescents

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I performed most of the project under the supervision of the other author as part of a community health clerkship. I have over five years of experience working with the Deaf community, including two years of ASL courses and immersion, running a medical school elective on Deaf issues in healthcare, and creating educational materials on Deaf issues.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.