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.

cancer prevention, cancer screening, health care education, health care knowledge, deaf, hearing impaired, sign language, computer use

1. Assess personal knowledge of and comfort with using computers among deaf and hard of hearing individuals.
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.
3. Perform post-intervention evaluations to assess the effectiveness of the computer based programs.

400 persons with individuals with profound hearing losses.

In an attempt to determine if 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, we will 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. This enhanced video will be presented to a larger group of 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.

We will also obtain information about computer use by people who are deaf or hard of hearing. We will also obtain some basic demographic and computer use information from nonrespondents by means of a paper survey.

During the development cycle, two focus groups of four deaf individuals each will be conducted. The first group will view the questionnaire, the pretest, the information program, and the posttest, and provided guidance on further modifying the content to maximize the clarity of understanding for deaf viewers. The second focus group will review the updated version based on any changes made.

For the actual study, participants will be asked to complete the video-based computer program. All study participants will 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 will then be randomly divided into cases and controls. The cases will be given the video program with the ASL interpreter and captions, and the controls will be given the standard video program with the information transmitted by voice, text, and graphics. After viewing the program, the study participants will be given 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 will also be conducted. At each of these, the study participants will be asked again to answer questions assessing their knowledge of cancer prevention and screening recommendations for their age group.

Analysis of the study is still ongoing. One area, computer use, was immediately analyzed, with the following 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.

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.

Zazove P. Meador HE. Derry HA. Gorenflo DW. Burdick SW. Saunders EW. Deaf persons and computer use. American Annals of the Deaf. 148(5):376-84, 2004.