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  1. Article ; Online: "

    Kushalnagar, Poorna / Ammons, Donalda / Engelman, Alina / Hanumantha, Shilpa / Wilson, Jaime

    Public health reports (Washington, D.C. : 1974)

    2022  Volume 138, Issue 4, Page(s) 573–577

    MeSH term(s) Humans ; Alzheimer Disease ; Persons With Hearing Impairments ; Dementia
    Language English
    Publishing date 2022-08-01
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 120953-x
    ISSN 1468-2877 ; 0033-3549
    ISSN (online) 1468-2877
    ISSN 0033-3549
    DOI 10.1177/00333549221110298
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  2. Article: Limited Diabetes Education and Resources in American Sign Language.

    Litchman, Michelle L / Moreland, Christopher / Fagerlin, Angela / Kushalnagar, Poorna

    Diabetes spectrum : a publication of the American Diabetes Association

    2022  Volume 35, Issue 2, Page(s) 134–135

    Language English
    Publishing date 2022-05-13
    Publishing country United States
    Document type Editorial
    ZDB-ID 2211544-4
    ISSN 1040-9165
    ISSN 1040-9165
    DOI 10.2337/ds21-0091
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  3. Article ; Online: Barriers and facilitators to the inclusion of deaf people in clinical trials.

    Kushalnagar, Poorna / Nicolarakis, Onudeah / Mirus, Gene / Anderson, Melissa / Burke, Teresa / Kushalnagar, Raja

    Clinical trials (London, England)

    2023  Volume 20, Issue 5, Page(s) 576–580

    Abstract: Background/aims: This article discusses the barriers that prevent deaf people from participating in clinical trials and offers recommendations to overcome these barriers and ensure equal access to study participation.: Methods: Between April and May ... ...

    Abstract Background/aims: This article discusses the barriers that prevent deaf people from participating in clinical trials and offers recommendations to overcome these barriers and ensure equal access to study participation.
    Methods: Between April and May 2022, we conducted six focus groups with 20 deaf adults who use American Sign Language, all of whom had previous experience as research study participants. Focus group prompts queried community awareness of clinical trial opportunities, barriers and facilitators to deaf people's participation in clinical trials, and recommended resources to improve clinical trial access. This qualitative focus group data is supplemented by survey data gathered from 40 principal investigators and clinical research coordinators between November 2021 and December 2021. The survey queried researchers' prior experiences with enrolling deaf participants in clinical trials and strategies they endorse for enrollment of deaf participants in future clinical trials.
    Results: Focus group participants unanimously agreed that, compared to the general hearing population, deaf sign language users lack equivalent access to clinical trial participation. Reported barriers included lack of awareness of clinical trial opportunities, mistrust of hearing researchers, and refusal by clinical trial staff to provide accessible communication (e.g. denial of requests for sign language interpreters). Survey data from 40 principal investigators and clinical research coordinators corroborated these barriers. For example, only 2 out of 40 survey respondents had ever enrolled a deaf person in a clinical trial. Respondents indicated that the most helpful strategies for including deaf sign language users in future clinical trials would be assistance with making recruitment information accessible to deaf sign language users and assistance in identifying qualified interpreters to hire to help facilitate the informed consent process.
    Conclusion: The lack of communication accessibility is the most common factor preventing deaf sign language users from participating in clinical trials. This article provides recommendations for hearing researchers to improve deaf people's access to clinical trials moving forward, drawing from mixed-methods data.
    MeSH term(s) Adult ; Humans ; Communication ; Communication Barriers ; Focus Groups ; Persons With Hearing Impairments ; Sign Language ; Clinical Trials as Topic
    Language English
    Publishing date 2023-05-26
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 2138796-5
    ISSN 1740-7753 ; 1740-7745
    ISSN (online) 1740-7753
    ISSN 1740-7745
    DOI 10.1177/17407745231177376
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  4. Article ; Online: Equitable Access to Telehealth and Other Services for Deaf People During the COVID-19 Pandemic.

    Moreland, Christopher J / Rao, Sowmya R / Jacobs, Katja / Kushalnagar, Poorna

    Health equity

    2023  Volume 7, Issue 1, Page(s) 126–136

    Abstract: Introduction: Deaf people who use American Sign Language (ASL) with low self-perceived ability to understand spoken information face inequitable access to health care due to systemic barriers.: Methods: We conducted interviews with 266 deaf ASL users ...

    Abstract Introduction: Deaf people who use American Sign Language (ASL) with low self-perceived ability to understand spoken information face inequitable access to health care due to systemic barriers.
    Methods: We conducted interviews with 266 deaf ASL users at baseline (May-Aug 2020) and 244 deaf ASL users at follow-up (3 months). Questions addressed (1) access to interpretation during in-person visits; (2) whether they visited clinics (3) or emergency departments (EDs); and (4) telehealth use. Analyses involved univariate and multivariable logistic regressions across levels of perceived ability to understand spoken language.
    Results: Less than a third were aged >65 (22.8%); Black, Indigenous, People of Color (28.6%), or LGBTQ+ (31.1%); and had no college degree (30.6%). More respondents reported outpatient visits at follow-up (63.9%) than at baseline (42.3%). Ten more respondents reported going to urgent care or an ED at follow-up than at baseline. At follow-up interviews, 57% of deaf ASL respondents with high perceived ability to understand spoken language reported receiving interpretation at clinic visits compared to 32% of ASL respondents with low perceived ability to understand spoken language (
    Discussion: Our study is the first to explore deaf ASL users' access to telehealth and outpatient encounters over time during the pandemic. The U.S. health care system is designed for people who have high perceived ability to understand spoken information. Systemic access to health care, including telehealth and clinics, must be made consistently equitable for deaf people who require accessible communication.
    Language English
    Publishing date 2023-02-28
    Publishing country United States
    Document type Journal Article
    ISSN 2473-1242
    ISSN (online) 2473-1242
    DOI 10.1089/heq.2022.0115
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  5. Article ; Online: Development and Implementation of a Curriculum for Pediatric Trainees on Caring for Children Who Are Deaf and Hard of Hearing: A Pilot Study.

    Spellun, Arielle / Crume, Bonnie / Kushalnagar, Poorna

    Maternal and child health journal

    2022  Volume 26, Issue 11, Page(s) 2179–2184

    Abstract: Introduction: Children who are deaf or hard of hearing (DHH) are at risk for poor developmental outcomes related to incomplete language access. Evidence based interventions are available to improve early access to language. With a better understanding ... ...

    Abstract Introduction: Children who are deaf or hard of hearing (DHH) are at risk for poor developmental outcomes related to incomplete language access. Evidence based interventions are available to improve early access to language. With a better understanding of caring for DHH children, pediatricians will be more prepared to work with families in improving outcomes for this population. To date, there are no formal curricula on educating pediatric trainees on childhood hearing differences.
    Methods: The authors designed a novel pilot curriculum to educate pediatric trainees on caring for DHH children, including screening, diagnosis, signed languages, and hearing technologies. The curriculum was delivered to pediatric interns in a 1-hour seminar. Pre-lecture, immediate post-lecture, and 6-month post-lecture surveys were developed and conducted to evaluate the effectiveness of the curriculum. Descriptive statistics were used to determine differences in understanding concepts before and after the curricular intervention.
    Results: A total of 55 residents participated in the curriculum over a 14-month study period from 2018 to 2019. There were significant differences in responses between the pre- and post- surveys related to residents' understanding of childhood deafness and their confidence in their ability to care for DHH children.
    Conclusion: Pediatric trainees gained an understanding of the challenges faced by DHH children and of the interventions that aim to provide them with access to language during the critical period of development. As a result, trainees will be in a better position to care for patients and their families after a new diagnosis of a hearing difference and guide them through early language-based interventions.
    MeSH term(s) Child ; Humans ; Persons With Hearing Impairments ; Deafness ; Pilot Projects ; Language Development ; Curriculum
    Language English
    Publishing date 2022-10-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1339905-6
    ISSN 1573-6628 ; 1092-7875
    ISSN (online) 1573-6628
    ISSN 1092-7875
    DOI 10.1007/s10995-022-03514-2
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  6. Article ; Online: Health Disparities Among Mid-to-Older Deaf LGBTQ Adults Compared with Mid-to-Older Deaf Non-LGBTQ Adults in the United States.

    Kushalnagar, Poorna / Miller, Cara A

    Health equity

    2019  Volume 3, Issue 1, Page(s) 541–547

    Abstract: Purpose: ...

    Abstract Purpose:
    Language English
    Publishing date 2019-10-30
    Publishing country United States
    Document type Journal Article
    ISSN 2473-1242
    ISSN (online) 2473-1242
    DOI 10.1089/heq.2019.0009
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  7. Article ; Online: Self-infection with speech aerosol may contribute to COVID-19 severity.

    Kushalnagar, Poorna / Chow, Carson C / Bax, Adriaan

    Journal of internal medicine

    2021  Volume 290, Issue 6, Page(s) 1275–1277

    MeSH term(s) Aerosols ; COVID-19/epidemiology ; COVID-19/prevention & control ; COVID-19/transmission ; Disease Transmission, Infectious/prevention & control ; Exhalation ; Humans ; Masks ; Pandemics ; SARS-CoV-2 ; Saliva/virology ; Speech
    Chemical Substances Aerosols
    Language English
    Publishing date 2021-08-23
    Publishing country England
    Document type Letter ; Research Support, N.I.H., Extramural ; Research Support, N.I.H., Intramural
    ZDB-ID 96274-0
    ISSN 1365-2796 ; 0954-6820
    ISSN (online) 1365-2796
    ISSN 0954-6820
    DOI 10.1111/joim.13370
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  8. Article ; Online: A Mixed Methods Study of Hysterectomy in a U.S. Sample of Deaf Women Who Use American Sign Language.

    Jacobs, Katja / Minakawa, Ai / Rao, Sowmya R / Kushalnagar, Poorna

    Women's health reports (New Rochelle, N.Y.)

    2021  Volume 2, Issue 1, Page(s) 566–575

    Abstract: Background: ...

    Abstract Background:
    Language English
    Publishing date 2021-11-29
    Publishing country United States
    Document type Journal Article
    ISSN 2688-4844
    ISSN (online) 2688-4844
    DOI 10.1089/whr.2021.0081
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  9. Article ; Online: Sign Language for Deaf Infants: A Key Intervention for a Developmental Emergency.

    Spellun, Arielle / Kushalnagar, Poorna

    Clinical pediatrics

    2018  Volume 57, Issue 14, Page(s) 1613–1615

    MeSH term(s) Child ; Deafness/complications ; Female ; Humans ; Language Development Disorders/etiology ; Language Development Disorders/prevention & control ; Sign Language
    Language English
    Publishing date 2018-05-22
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 207678-0
    ISSN 1938-2707 ; 0009-9228
    ISSN (online) 1938-2707
    ISSN 0009-9228
    DOI 10.1177/0009922818778041
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  10. Article: Social Media Use and HIV Screening Uptake Among Deaf Adults in the United States: Cross-Sectional Survey Study.

    Argenyi, Michael / Kushalnagar, Poorna

    JMIR public health and surveillance

    2019  Volume 5, Issue 4, Page(s) e13658

    Abstract: Background: About 46% of US adults obtain recommended HIV screening at least once during their lifetime. There is little knowledge of screening rates among deaf and hard-of-hearing adults who primarily use American Sign Language (ASL), or of social ... ...

    Abstract Background: About 46% of US adults obtain recommended HIV screening at least once during their lifetime. There is little knowledge of screening rates among deaf and hard-of-hearing adults who primarily use American Sign Language (ASL), or of social media as a potentially efficacious route for HIV prevention outreach, despite lower HIV/AIDS-specific health literacy and potentially higher HIV seropositivity rates than hearing peers.
    Objective: We investigated both the likelihood of HIV screening uptake among deaf adults in the past year and over one year ago, and the relationship between social media use and HIV screening uptake among deaf adult ASL users.
    Methods: The Health Information National Trends Survey in ASL was administered to 1340 deaf US adults between 2015-2018. Modified Poisson with robust standard errors was used to assess the relationship between social media usage as a predictor and HIV screening as an outcome (screened more than one year ago, screened within the past year, and never been screened), after adjusting for sociodemographics and sexually transmitted disease (STD) covariates.
    Results: The estimated lifetime prevalence of HIV screening uptake among our sample was 54% (719/1340), with 32% (429/1340) in the past year. Being of younger age, male gender, black, lesbian, gay, bisexual, or queer, or having some college education or a prior STD were associated with HIV screening uptake. Adjusting for correlates, social media use was significantly associated with HIV screening in the past year, compared to either lifetime or never.
    Conclusions: Screening falls well short of universal screening targets, with gaps among heterosexual, female, Caucasian, or older deaf adults. HIV screening outreach may not be effective because of technological or linguistic inaccessibility, rendering ASL users an underrecognized minority group. However, social media is still a powerful tool, particularly among younger deaf adults at risk for HIV.
    Language English
    Publishing date 2019-10-02
    Publishing country Canada
    Document type Journal Article
    ISSN 2369-2960
    ISSN 2369-2960
    DOI 10.2196/13658
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