Jason Rotoli, MD

University of Rochester

"Prehospital Communication Barriers and the Deaf ASL User"
SAEMF/ADIEM Diversity and Inclusion in EM Research Grant




Individuals with limited English proficiency (LEP) face frequent communication difficulties within the health care setting. Particularly among the Deaf American Sign Language (ASL) user, there are clear disparities within the delivery of care due to these language and communication barriers. Research has suggested that Deaf ASL users have lower utilization of primary and preventive care services, low health literacy, and limited access to health information. Many of these individuals have increased ED visits to fulfill their medical needs. This project specifically aims to understand the nature of communication among Deaf ASL users within the prehospital setting by assessing EMS provider’s comfort level and communication strategies in communicating with Deaf ASL users. Specifically, this study aims to refine and pilot an educational intervention to improve knowledge and comfort treating Deaf ASL users as well as provide communication tools to EMS providers. We will compare these domains at three time points to evaluate the effect of our educational interval.

Despite the disparities in care, access and utilization of health care resources among Deaf ASL users, there is very limited research regarding communication among this population in the prehospital setting. By initiating focus within the prehospital setting and EMS providers, effective and appropriate care can be delivered to these patients, from the very beginning. Establishing proper communication between patient and EMS can ultimately influence the overall clinical trajectory of the patient. Assessments and interventions conducted by EMS providers can, thus, be performed and relayed effectively, thereby avoiding the potentially harmful consequences of under-delivered or inappropriate care. With the education intervention and communication tool development, EMS providers and Deaf patients will have improved ability to express their concerns and health care needs without fear or confusion. This proposed study would not only provide valuable insight into a marginalized population, but would also provide a means to reduce the aforementioned disparate healthcare needs of Deaf ASL users.

Research Results

Dr. Rotoli is still completing the project.