Center for Deaf Health Equity

The lab's mission is to do research that links accessibility to health outcomes among deaf/hh individuals. The lab's goals are to:

  1. Design and evaluate health research projects
  2. Share results through presentations and publications
  3. Engage in community partnership, training, and education

Our researchers at Deaf Health and Quality of Life are involved in a wide range of biobehavioral and applied research projects. In addition, our faculty, students, and community members - all from a variety of academic backgrounds - contribute to the lab.

Dr. Poorna Kushalnagar, Center Director


HINTS-ASL: Deaf Signers' Experience with Seeking Health Information

ID: 3165
Status: Ongoing
Start date: August 2015
End Date: December 2022

Description

The National Cancer Institute's Health Information National Trends Survey (HINTS) is heavily dependent on English, which presents serious language barriers to Deaf patients who use American Sign Language (ASL). The availability of HINTS and similar surveys in ASL and English that are valid for users of accessible technology and services will provide important insights on understanding the trends in Deaf people's use of the Internet for health-related purposes, therefore improving health communication models that will lead to better personal and public health within this underserved population.

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Products

Argenyi M, Kushalnagar P. Social Media Use and HIV Screening Uptake Among Deaf Adults in the United States: Cross-Sectional Survey Study. JMIR Public Health Surveill. 2019 Oct 2;5(4):e13658. doi: 10.2196/13658. PMID: 31579021; PMCID: PMC6777274.

Harris, R. (2017, June 30). The evolution of graduate sign language teacher preparation programs. American Sign Language Teachers Association national biannual conference, Salt Lake City, Utah.

Harris, R., Kushalnagar, P., & Paludneviciene, R. (2017). Open-Ended Cognitive Interview Approach: Rethinking the Gold Standards for Translating Health Measures to ASL. Paper presented at the second Symposium on Signed Language Interpretation and Translation Research. Washington, DC.

Kushalnagar P, Holcomb J, Sadler GR. Genetic testing and eHealth usage among Deaf women. J Genet Couns. 2019 Oct;28(5):933-939. doi: 10.1002/jgc4.1134. Epub 2019 Jun 10. PMID: 31180177; PMCID: PMC6777990.

Kushalnagar, P, Holcomb, J, & Sadler, G.R. (2019). Genetic testing and eHealth usage among Deaf women. Journal of Genetic Counseling, 00: 1– 7. https://doi.org/10.1002/jgc4.1134

Kushalnagar, P. & Carrizales, S. (2018). Health inequity for shared decision making among deaf males with family history of cancer or of screening-eligible age for PSA tests. Poster presented at the HINTS Data Users Conference, Bethesda, MD.

Kushalnagar, P. & Ryan, C. (2017). Social network sites as accessible health venue for deaf people who use American Sign Language. Paper presentation at the American Public Health Association, Atlanta, GA.

Kushalnagar, P. (2017). HINTS-ASL survey: preliminary findings on deaf people's experience with video relay interpreting and on-site interpreting services in medical settings. Paper presented at the Telecommunications for the Deaf and Hard of Hearing Conference.

Kushalnagar, P. (2018). Health film production as an educational experience for public health students. Presentation at the Undergraduate Public Health and Global Health Education Summit. Arlington, VA.

Kushalnagar, P. (2018). HINTS-ASL: Cultural adaptation and linguistic validation. Paper presented at the HINTS Data Users Conference, Bethesda, MD.

Kushalnagar, P., (2017). Perceived trust and understanding of cancer health information sources among deaf adults who use ASL. Poster presentation at the American Public Health Association, Atlanta, GA.

Kushalnagar, P., Engelman, A., & Sadler, G. (2018). Deaf Patient-Provider Communication and Lung Cancer Screening: Health Information National Trends Survey in American Sign Language (HINTS-ASL). Patient Education and Counseling. DOI:10.1016/j.pec.2018.03.003.

Kushalnagar, P., Harris, R., Paludneviciene, R., & Hoglind, T. (2017). Protocol for Cultural Adaptation and Linguistic Validation of Health Information National Trends Survey in American Sign Language (HINTS-ASL). Journal of Medical Internet Research Protocols. doi:10.2196/jmir.8067

Kushalnagar, P., Hoglind, T., Foreman, D., Lawrence, S., Lena, J., & Miller, J. (2017). Deaf Health Communication Film: Seek, Share, and Connect. American Public Health Association Film Festival, Atlanta, GA.

Kushalnagar, P., Moreland, C., Simons, A., & Holcomb, T. (2018). Perceived communication barrier in family is linked to increased risks for food insecurity among deaf adults who use American Sign Language. Public Health Nutrition. doi: 10.1017/S1368980017002865

Kushalnagar, P., Paludneviciene, R., Bruce, S., Simons, A., & Sadler, G. (2016). HINTS-ASL: Inclusion of Deaf Adults in Cancer Health and Internet Research. Poster presented at the International Cancer Education Conference, Bethesda, MD.

Kushalnagar, P., Ryan, C., Smith, S., & Kushalnagar, R. (2017). Critical Health Literacy in American Deaf College Students. Health Promotion International. doi:10.1093/heapro/dax022.

Kushalnagar, P., Simons, A., & Kushalnagar, R. (2018). Use of Wellness Apps in Deaf American Sign Language Users to Improve Calorie Intake Differs Across Education. Poster presented at the mHealth Technology Showcase, National Institutes of Health, Bethesda, MD.

Kushalnagar,P. and Kushalnagar,R. (2018), Health-Related Information Seeking among Deaf Adults: Findings from the 2017 Health Information National Trends Survey in American Sign Language (HINTS-ASL), in Timothy M. Hale, Wen-Ying Sylvia Chou, Shelia R. Cotten, Aneka Khilnani (ed.) eHealth: Current Evidence, Promises, Perils and Future Directions (Studies in Media and Communications, Volume 15) Emerald Publishing Limited, pp.69 - 91.

Miller, C.A., Biskupiak, A., & Kushalnagar, P. (2019). Deaf LGBTQ Patients' Disclosure of Sexual Orientation and Gender Identity to Health Care Providers. Psychology of Sexual Orientation and Gender Diversity. 62(2), 194-203. doi: 10.1037/sgd0000319

Ryan, C., Kushalnagar, P., & Kushalnagar, R. (2016). Social Network Sites: Comparison of Deaf and Hearing Adult Users of SNSs for Health Related Purposes. Poster presented at the Undergraduate Research Symposium, Rochester, NY.

Simons, Kushalnagar, P. Moreland, C. (2017). Health Disparity and Underdiagnosis of Hypertension in Deaf Signers. Poster presentation at the American Public Health Association, Atlanta, GA.

Spellun, A.H., Moreland, C.J., & Kushalnagar, P. (2019). Young Deaf Adults' Knowledge of Human Papillomavirus and Human Papillomavirus Vaccine's Effectiveness in Preventing Cervical, Anal, Penile, and Oral Cancer. Journal of Pediatric and Adolescent Gynecology. 32(3), 293-299. doi: 10.1016/j.jpag.2018.11.013


PATIENT REPORTED OUTCOMES, COVID-19 KNOWLEDGE AND PERCEIVED RISKS, AND HEALTHCARE AMONG DEAF AND HARD OF HEARING ADULTS IN THE U.S.

ID: 3937
Status: Ongoing
Start date: May 2020
End Date: April 2021

Description

Current widely used NIH-funded patient reported outcome measurement systems (PROMIS) include domains that assess global, physical, mental, and social health from the patient’s perspective. PROMIS is heavily dependent on English, which is a serious barrier to DHH patients who use American Sign Language (ASL) and demonstrate low English proficiency. In 2015, PI Kushalnagar was awarded an R01 to address this knowledge gap through 1) linguistic and psychometric validation of PROMIS- Deaf Profile in ASL and 2) cross-sectional analysis of patient reported outcomes (PROs) in an U.S. sample of DHH adults who use ASL. We have added revised aims to address the urgent issues related to coronavirus. This revision application addresses an immediate need to create an online ASL/English survey to quickly deploy and assess an underserved DHH population’s knowledge/attitude toward physical distancing, self-perceived risk for COVID-19, patient-physician communication, and healthcare access experience. This study will also gather new data from key stakeholders that works with this population; and will be used to inform the correct interpretation of the quantitative findings from PROs and COVID- 19 data. Together, using mixed methods approach, the team will integrate quantitative PROs and COVID-19 data with stakeholder qualitative data to enlighten new findings and provide the necessary foundation for public health policy and program strategies aimed at improving human communication in DHH population.

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