Michael McKee, MD is a deaf family physician whose career is centered on healthcare for deaf individuals who communicate in American Sign Language (ASL). Deaf ASL users are considered to be a linguistic minority group that is medically underserved with barriers and characteristics similar to what is found among many other linguistic minority groups. This group is also largely understudied which prevents progress in the Healthy People 2010's goals to reduce health disparities among minorities and disabled persons. Dr. McKee's goal is to become a leading expert and an independent investigator on the topic of health literacy among linguistic minority populations. He is most interested in studying the impact of poor health literacy on cardiovascular disease among Deaf ASL users. The unique environment of the CDC-funded Preventive Research Center: National Center for Deaf Health Research (NCDHR) at the University of Rochester provides a very ideal place for Dr. McKee to accomplish that mission. Rochester, New York, has been anecdotally reported to have the highest per capita deaf population in the United States. The large and active Deaf community in Rochester provides ample opportunities to evaluate and collaborate with to reduce health disparities. In order to achieve the goals outlined in the career development award, Dr. McKee will work closely with expert mentors to undergo a rigorous individualized curriculum plan that will provide further training in the fields of health literacy, deaf health, cardiovascular epidemiology, health disparities, survey methods, and advanced statistical analysis. With the guidance of mentors, consultants and preceptors, Dr. McKee will conduct a research project to further his research skills development and to obtain new and valuable information about the association of health literacy and cardiovascular health on Deaf adult ASL users. To determine the degree of association, a cross- sectional study will be conducted with Deaf ASL users and hearing native English speakers. Multiple tools and questionnaires will be used to compare study between Deaf ASL users and hearing native English speakers to better determine whether health literacy is lower among Deaf ASL users and assess its potential association with increased cardiovascular risk. Since no health literacy assessment tools exist for ASL users, an adaptation and translation of an existing health literacy assessment tool called the """"""""Newest Vital Sign"""""""" (NVS) will take place. The adapted NVS will be the first of its kind assessment tool necessary for evaluating health literacy among Deaf ASL users. Measurements of English proficiency, health care access, and cardiovascular knowledge will be collected to determine its impact on cardiovascular health for both study groups. To determine the association of health literacy with cardiovascular health, we will utilize a non-laboratory based Framingham prediction score to evaluate the risk for cardiovascular disease for both the study and control group. By determining the prevalence and the degree of health literacy and its association with cardiovascular health risk in Deaf ASL users, we can learn how to better develop effective health literacy and cardiovascular health educational programs that are accessible in American Sign Language.

Public Health Relevance

The overarching aim of this proposed Mentored Career Development Award is for Michael McKee, MD to become an independent health services researcher with a career focused on health literacy in linguistic minority populations including Deaf American Sign Language (ASL) users.
The aim of the proposed mentored research project is to assess health literacy and its association with cardiovascular health among Deaf ASL users.

National Institute of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
Research Scientist Development Award - Research & Training (K01)
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Special Emphasis Panel (ZHL1-CSR-H (M1))
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Cook, Nakela L
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University of Rochester
Public Health & Prev Medicine
Schools of Dentistry
United States
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McKee, Michael M; Paasche-Orlow, Michael K; Winters, Paul C et al. (2015) Assessing Health Literacy in Deaf American Sign Language Users. J Health Commun 20 Suppl 2:92-100
Heiman, Erica; Haynes, Sharon; McKee, Michael (2015) Sexual health behaviors of Deaf American Sign Language (ASL) users. Disabil Health J 8:579-85
McKee, Michael M; Winters, Paul C; Sen, Ananda et al. (2015) Emergency Department utilization among Deaf American Sign Language users. Disabil Health J 8:573-8
McKee, Michael M; McKee, Kimberly; Winters, Paul et al. (2014) Higher educational attainment but not higher income is protective for cardiovascular risk in Deaf American Sign Language (ASL) users. Disabil Health J 7:49-55
McKee, Michael; Schlehofer, Deirdre; Thew, Denise (2013) Ethical issues in conducting research with deaf populations. Am J Public Health 103:2174-8
McKee, Michael M (2013) Caring for older patients who have significant hearing loss. Am Fam Physician 87:360-6
McKee, Michael M; Smith, Scott; Barnett, Steven et al. (2013) Commentary: What are the benefits of training deaf and hard-of-hearing doctors? Acad Med 88:158-61
McKee, Michael; Thew, Denise; Starr, Matthew et al. (2012) Engaging the Deaf American sign language community: lessons from a community-based participatory research center. Prog Community Health Partnersh 6:321-9
McKee, Michael M; Winters, Paul C; Fiscella, Kevin (2012) Low education as a risk factor for undiagnosed angina. J Am Board Fam Med 25:416-21
McKee, Michael M; Paasche-Orlow, Michael K (2012) Health literacy and the disenfranchised: the importance of collaboration between limited English proficiency and health literacy researchers. J Health Commun 17 Suppl 3:7-12

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