Cancer screening knowledge, attitudes, and behaviors among culturally Deaf adults: implications for informed decision making.

BACKGROUND: Previous studies show that Deaf persons tend to have lower health status, lack health knowledge, have differing health attitudes, and decreased health care utilization when compared to the general population. The authors sought to examine knowledge, attitudes, and behaviors surrounding age- and gender-specific cancer screening tests amongst a sample of Deaf adults who were patients of Deaf-friendly medical organizations. The authors also sought to compare age- and gender-specific cancer screening rates amongst this sample to that of the general US population. METHODS: A sample of 203 adult Deaf patients participated in a comprehensive, face-to-face health survey conducted between November 2002 and March 2003. The survey was administered in American Sign Language by Deaf interviewers and included age- and gender-specific cancer knowledge, attitude, and behavior questions. RESULTS: Knowledge pertaining to Pap smear among females was low, while the proportion having ever had a Pap smear was comparable to the general population. Mammography knowledge amongst females age 50 and older was comparatively higher, although it remained lower than the proportion of females in this age group who reported ever receiving a mammogram. Overall, screening rates for breast, cervical, and colorectal cancer were similar to rates in the general US population. Attitudes toward specific cancer screening tests were also favorable. CONCLUSIONS: Persons within the Deaf community can have cancer screening rates similar to those of the general US population. However, utilization in the absence of knowledge regarding these tests is worrisome and brings about ethical, health care quality and health education concerns.

A co-twin control study of physical function in elderly African America women.

OBJECTIVE: This study investigated variables associated with physical functioning limitations among elderly African American women, controlling for genetics and common family environment. METHOD: Activities of daily living limitations (ADL) and instrumental activities of daily living limitations (IADL) are examined in 180 pairs of African American elderly twins using a co-twin control design. The association of chronic disease, other physical problems, lifestyle, and demographic factors with both measures are investigated. RESULTS: Arthritis, hypertension, and more than 1 chronic disease are associated with ADL limitations and arthritis; diabetes, heart attack, and more than 1 chronic disease are associated with IADL limitations in univariate analyses. In multivariate analyses, a different set of additional variables is associated with the two measures. DISCUSSION: Among elderly African American women, physical functioning limitations are influenced by the presence of chronic diseases, other physical problems, lifestyle, and demographics. These associations are not due to genetics or common family environment effects.