Interventions aimed at improving health care equity for d/Deaf patients: a systematic review

Abstract

Abstract Background d/Deaf people suffer from inequitable access to care and health information, which results in worse health literacy and poorer mental and physical health compared to hearing populations. Various interventions aimed at improving health equity for d/Deaf people exist in the scientific literature but have to be systematically analysed. The purpose of this systematic literature review was to obtain a global overview of what we know about these interventions. Methods Medline Ovid SP, Embase, CINAHL EBSCO, PsycINFO Ovid SP, Central - Cochrane Library Wiley and Web of Science were searched for relevant studies on access to health care, interventions and health education for d/Deaf people following PRISMA-equity guidelines. The outcomes of interest were interventions aimed at achieving equitable care access to health information for d/Deaf people. Results Forty-eight studies were analysed. Four main categories of interventions emerged: 1) interventions addressing direct clinical care, 2) health technology-based interventions, 3) interventions focused on patient education, and 4) interventions focused on health care provider education. Among them, access to sign language interpretation or to culturally and linguistically adapted means of communication, use of communication media such as sign language video for the dissemination of medical information, and increasing use of technology (telemedicine, videoconferencing) were effective to strengthen equity in the care of d/Deaf people. Moreover, involving d/Deaf individuals in the conceptualization, creation, implementation and evaluation of interventions seemed to be imperative. Conclusions A multi-pronged approach, using a combination of interventions that improve health literacy among d/Deaf patients and promote health care providers' awareness of communication barriers and cultural sensitivity show promise in achieving more equitable care for d/Deaf patients, but more widespread research is needed. Key messages The scientific literature has identified and analysed many tools for improving health care equity for d/Deaf people, but their implementation is lacking. The involvement of d/Deaf people in research and implementation processes is crucial for the development of appropriate interventions.