Activating Deaf healthcare consumers via patient activation group classes: Results and lessons learned

Background:  Over half of deaf persons in the U.S. communicate primarily via American Sign Language (ASL).  Most are not bilingual and hence not fluent in English, thus facing barriers in accessing healthcare, obtaining and comprehending health information, and communicating with physicians. 

Objective: To evaluate the effectiveness of a Patient Activation class series administered in ASL via Deaf educators in empowering Deaf participants to take an active role in their health decisions and to more effectively navigate the healthcare system.    

Methods: Deaf adults were recruited into a four-week class series via six deaf-serving Chicago-area organizations. A train-the-trainer model was utilized in training staff from each organization to implement the class-series. A pretest-posttest design utilized standardized instruments to evaluate changes in participants’ Patient Activation Scores, self-efficacy in interacting with providers, and ability to navigate the healthcare system. Sustained/continued improvements 6-months post-intervention were also assessed.

Results: Two hundred fourteen people enrolled into the program, of which 198 (93%) completed the class series. Results suggest that the intervention approach effectively met the goals.  For example, the median Patient Activation Score increased by 2 points between the pre- and post-test (p<0.05). This increase was sustained through 6-months. Statistically significant improvements were also realized for health service navigation, self-efficacy in communicating with a physician, and behaviors in communicating with a physician.   Qualitative data from 6 month focus groups will also be presented.

Conclusion: Classes in ASL for Deaf adults provide an effective linguistic and culturally appropriate means towards empowering Deaf consumers to be more active patients.