title: Impact of communication on preventive services among deaf American Sign Language users.
abstract: BACKGROUND
  Deaf American Sign Language (ASL) users face communication and language barriers that limit healthcare communication with their providers. Prior research has not examined preventive services with ASL-skilled clinicians.
  
  
  OBJECTIVE
  The goal of this study was to determine whether provider language concordance is associated with improved receipt of preventive services among deaf respondents.
  
  
  METHODS
  This cross-sectional study included 89 deaf respondents aged 50-75 years from the Deaf Health Survey (2008), a Behavioral Risk Factor Surveillance System survey adapted for use with deaf ASL users. Association between the respondent's communication method with the provider (i.e., categorized as either concordant-doctor signs or discordant-other) and preventive services use was assessed using logistic regression adjusting for race, gender, income, health status, health insurance, and education. Analyses were conducted in 2010.
  
  
  RESULTS
  Deaf respondents who reported having a concordant provider were more likely to report a greater number of preventive services (OR=3.42, 95% CI=1.31, 8.93, p=0.0122) when compared to deaf respondents who reported having a discordant provider even after adjusting for race, gender, income, health status, health insurance, and education. In unadjusted analyses, deaf respondents who reported having a concordant provider were more likely to receive an influenza vaccination in the past year (OR=4.55, p=0.016) when compared to respondents who had a discordant provider.
  
  
  CONCLUSIONS
  Language-concordant patient-provider communication is associated with higher appropriate use of preventive services by deaf ASL users.
authors.affiliation: National Center for Deaf Health Research, Rochester Preventive Research Center, University of Rochester Medical Center, New York, USA. michael_mckee@urmc.rochester.edu
authors.forename: Michael M
authors.initials: MM
authors.lastname: McKee
authors.forename: Steve L
authors.initials: SL
authors.lastname: Barnett
authors.forename: Robert C
authors.initials: RC
authors.lastname: Block
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Pearson
mesh_terms: D000368:Aged; D040343:Behavioral Risk Factor Surveillance System; D003142:Communication; D003430:Cross-Sectional Studies; D003638:Deafness; D005260:Female; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D011314:Preventive Health Services / Q000379:methods / Q000706:statistics & numerical data; D012813:Sign Language
chemical_list: D007252:Influenza Vaccines