Project Overview +

This project aims to adapt an existing interactive multimedia program on cancer prevention for a deaf and hard of hearing audience and evaluate changes in knowledge among 400 profoundly deaf individuals.

Aims +

Aim 1. Assess personal knowledge of and comfort with using computers among deaf and hard of hearing individuals.

Aim 2. Develop interactive software that will allow dissemination of information in the respondent's own language (English or American Contact Sign Language) about preventive medicine recommendations.

Aim 3. Perform post-intervention evaluations to assess the effectiveness of the computer based programs.

Participants +

400 persons with individuals with profound hearing losses.

Intervention +

This project examines whether American Contact Sign Language (ASL) videos are a better method for teaching deaf persons about health care, in particular about cancer prevention behaviors and interventions. To do this, we expand a portion of the Michigan Interactive Health Kiosk content to include captions and a video of a certified interpreter signing the voiced words in ASL. The enhanced video is presented to individuals with severe or profound hearing loss to assess its effectiveness in increasing the efficacy of their cancer prevention efforts and their knowledge about recommended cancer screening interventions.

Participants are asked to complete the video-based computer program and complete a detailed questionnaire including demographic characteristics, hearing loss variables, family hearing loss history, language history, health care utilization history, presence of health problems, and sources of health care information, and their knowledge of cancer prevention and screening recommendations for their age group.

Participants are randomly divided into cases and controls. The cases are given the video program with the ASL interpreter and captions, and the controls are given the standard video program with the information transmitted by voice, text, and graphics. After viewing the program, the study participants get the same questions they had answered before watching the video, assessing their understanding of the current cancer prevention recommendations for their age group.

Follow-up visits at approximately 1 and 6 months are conducted. At each of these, the study participants are asked again to answer questions assessing their knowledge of cancer prevention and screening recommendations for their age group.

Findings +

Two hundred twenty seven respondents self-administered a survey in their preferred language (voice, American Sign Language, captions, or printed English). A small nonparticipant sample was also recruited. Demographics were consistent with those in other studies of deaf people: 63% of respondents reported computer use, mostly at home; 50% of nonparticipants reported computer use. Subjects with hearing loss due to meningitis were less likely to use computers (p = .0004). Computer use was associated with English usage at home (p = .008), with hearing persons (p = .002), and with physicians and nurses (p = .00001). It was also associated with the use of Signed English as a child to communicate (p = .02), teacher use of Signed English (p = .04), and teacher use of ASL (p = .03). Two thirds of respondents reported using computers, though nonresponder data suggested less use among and deaf persons. Computer use was associated with English use and inversely associated with hearing loss due to meningitis.

Participants averaged 22.9% correct answers with no gender difference. Univariate analysis revealed that smoking history, types of medical problems, last physician visit, and women having previous cancer preventive tests did not affect scores. Improved scores occurred with computer use (p=0.05), higher education  (p<0.01) and income (p=0.01), hearing spouses (p<0.01), speaking English in multiple situations (p<0.001), and in men with previous prostate cancer testing (p=0.04). Obtaining health information from books (p=0.05), physicians (p=0.008), nurses (p=0.03) or the internet (p=0.02) and believing that smoking is bad (p<0.001) also improved scores. Multivariate analysis revealed that English use(p=0.01) and believing that smoking was bad (p=0.05)) were associated with improved scores.

Conclusion +


The findings constitute the first sizable report on computer use by persons with profound hearing loss that we aware of. Of those who participated in our video-based computer study, approximately two thirds had used computers previously. This compares favorably with national statistics showing that approximately 70% of Americans were using computers in 2002.

In sum, in our study of persons with profound hearing loss, two thirds of the respondents said they used computers. Use of computers was associated with the use of English in their life, whether currently or during childhood, and losing one's hearing due to meningitis was associated with not using computers. These results should be interpreted with consideration of the specific population that was studied.


Persons with profound hearing loss have poor knowledge of recommended cancer prevention interventions. English use in multiple settings was strongly associated with increased knowledge.

Hearing Disorders

09/01/2000 - 08/31/2002


National Institute on Deafness and Other Communication Disorders

Principal Investigator:

Philip Zazove, MD


Helen E. Meador, PhD