Hearing impairment/deafness is the most common sensory limitation in the U.S. An estimated 11 million individuals in the US are deaf or hard-of-hearing. It has been estimated that approximately 1 million Americans use American Sign Language (ASL) as their primary means of communication making it a distinct linguistic minority. This proposal seeks to improve clinical practice by creating a computerized, self-administered depression screener in ASL that is culturally and linguistically accessible to deaf individuals, an at-risk and traditionally underserved population. No current depression screeners have been shown to be valid for the majority of prelingually deaf persons who use ASL as their main communication mode. Studies have shown that depression occurs in higher rates among deaf persons than hearing persons. While the U.S. Preventive Services Task Force recommended systematic screening for depression in primary care clinical settings in 2002, deaf persons have not yet routinely had access to this preventive service. Providing primary care physicians with a depression screener that is culturally and linguistically accurate and can be self-administered via computer and can be used on iPads and iPhones with no further development, can greatly increase the chance that deaf persons with depression will receive proper diagnostic assessment and treatment which can substantially improve their quality of life. The Deaf Depression Screener will also improve scientific knowledge by providing a valid method for estimating the prevalence of depression among deaf persons in primary care which cannot now be accomplished due to the lack of a valid screening instrument.
Screening for depression is recommended for all primary care patients. Deaf persons who use American Sign Language as their main mode of communications are at risk for depression and cannot be screened with existing screeners. This proposal will develop a computerized, self-administered Deaf Depression Screener in American Sign Language that is culturally and linguistically specific and deaf user friendly.