JMIR Publications

ABSTRACT

Background:

The primary aim of this research protocol is to implement the first RCT of a virtual DDBHH Community Health Navigator service that is usable and accessible in ASL and English and culturally relevant to the DDBHH community's experiences. The team hypothesizes the collaboration between ASL-fluent CHNs and members of the DDBHH community will result in increased adherence to breast, prostate, cervical, colon, and lung cancer screening protocols.

Objective:

The novel approach of the proposed research is the integration of the CHN model into an ASL context for the purpose of improving cancer screening adherence in a marginalized population (deaf, deafblind, and hard of hearing, henceforth labeled as ‘DDBHH’) that has been poorly served by traditional screening promotion campaigns. The navigation solution provides insights into ASL-CHNs’ knowledge on how to navigate DDBHH patients through the healthcare system for cancer screening and adherence. Literature shows promise that the combination of the patient navigation tool and DDBHH CHNs is the best, low-cost, and rapid approach to reducing the longstanding disparity in cancer health among DDBHH individuals in the U.S.

Methods:

This study will employ a randomized controlled trial design, recruiting participants from the DDBHH community who are eligible for, but have not yet completed, cancer screenings across the United States. 200 non-adherent DDBHH participants will be assigned to either a control group receiving standard care (n=100) or a virtual intervention with ASL-fluent CHNs (n=100). For breast, cervical, colon, and lung cancer, the primary outcome measure is completion of recommended cancer screening. For prostate cancer, the primary outcome measure is participation in shared decision making with the clinician. The follow-up data collection will occur at two weeks, two months, and four months

Results:

For prostate cancer, the expected outcome is strengthened shared decision-making between DDBHH patients who received the virtual intervention from ASL-fluent CHNs and their physicians. For breast, cervical, colon, and lung cancer, the expected outcomes include increased rates of cancer screening among the group of DDBHH participants who received the virtual intervention from ASL-fluent CHNs.

Conclusions:

The availability of a linguistically and culturally-aligned ASL-CHN virtual intervention has the potential to promote the reduction of cancer health disparities by facilitating cancer screening adherence and strengthening shared-decision making between clinicians and the DDBHH community. Clinical Trial: NCT ID: NCT06492993