Abstract P400: Potential Barriers to Cardiovascular Disease Risk Assessment Among Deaf Young Adults

Abstract

Objective: To address a potential barrier to preventing cardiovascular disease (CVD) among people deaf since childhood; the lack of validated health surveys that might be used for risk assessment. Background: CVD impacts the lives of many Americans, including socially or linguistically marginalized persons like those deaf since childhood. CVD risk assessment among young adults, including those who are deaf, is essential for early identification of CVD risk factors and establishment of risk-reduction interventions. Health surveillance approaches like the National College Health Assessment (NCHA) are useful for risk assessment, but young adults must be able to report health information using survey instruments. English literacy among deaf young adults is reportedly poor, and barriers to health surveillance with this group are ill-defined, so risk assessment via health surveillance can be problematic with this group. Methods: The survey response patterns of 191 deaf/hard of hearing (HOH) and 541 hearing college freshmen who completed a written health survey were examined. The survey was adapted from the NCHA and other surveys for use by deaf young adults, and it comprised 71 items covering 10 subject areas including tobacco use, weight, diet, and exercise. Language and literacy were examined as factors associated with students’ response patterns. Measures of reading skill were based on students’ California Achievement Tests and measures of survey readability were based on Flesch/ Flesch-Kincaid readability tests. Students’ responses were tallied to create continuous variables, such as “inconsistent response” scores, “don’t know response” scores, and “non-response” scores. Chi-Square was used to examine response patterns involving categorical variables and t-tests were used to examine patterns involving continuous variables. Results: Fewer deaf/HOH students (42%, n = 75) reported English, versus sign language, as their best language than hearing students (99%, n = 507). Deaf/HOH students who did report English, versus sign language, as their best language were significantly more likely (p = .027) to have estimated reading skills above the 8 th grade level. Thirty-one percent (n = 22) of the survey items had estimated readability above the 5 th grade level; remaining items were at or below 5 th grade. Deaf/HOH students were more likely to have inconsistent responses to related survey items and “don’t know” responses to survey items than hearing students (p < .000 and p < .000, respectively). Conclusion: Study results suggest that language and literacy are potential barriers to CVD assessment among deaf young adults, even high academic achievers like college students. Thus, for health surveillance, the readability of survey instruments and the language and literacy skills of deaf persons must be considered and alternatives to written surveys must be explored.