Patient reported outcomes, COVID-19 knowledge and perceived risks, and healthcare among deaf and hard of hearing adults in the U.S

Current widely used NIH-funded patient reported outcome measurement systems (PROMIS)include domains that assess global, physical, mental, and social health from the patient's perspective.PROMIS is heavily dependent on English, which is a serious barrier to DHH patients who use AmericanSign Language (ASL) and demonstrate low English proficiency. In 2015, PI Kushalnagar was awardedan R01 to address this knowledge gap through 1) linguistic and psychometric validation of PROMIS-Deaf Profile in ASL and 2) cross-sectional analysis of patient reported outcomes (PROs) in an U.S.sample of DHH adults who use ASL. We have added revised aims to address the urgent issues relatedto coronavirus. This revision application addresses an immediate need to create an online ASL/English surveyto quickly deploy and assess an underserved DHH population's knowledge/attitude toward physicaldistancing, self-perceived risk for COVID-19, patient-physician communication, and healthcare accessexperience. This study will also gather new data from key stakeholders that works with this population;and will be used to inform the correct interpretation of the quantitative findings from PROs and COVID-19 data. Together, using mixed methods approach, the team will integrate quantitative PROs andCOVID-19 data with stakeholder qualitative data to enlighten new findings and provide the necessaryfoundation for public health policy and program strategies aimed at improving human communication inDHH population.