Considering parental hearing status as a social determinant of deaf population health: Insights from experiences of the "dinner table syndrome".

The influence of early language and communication experiences on lifelong health outcomes is receiving increased public health attention. Most deaf children have non-signing hearing parents, and are at risk for not experiencing fully accessible language environments, a possible factor underlying known deaf population health disparities. Childhood indirect family communication-such as spontaneous conversations and listening in the routine family environment (e.g. family meals, recreation, car rides)-is an important source of health-related contextual learning opportunities. The goal of this study was to assess the influence of parental hearing status on deaf people's recalled access to childhood indirect family communication. We analyzed data from the Rochester Deaf Health Survey-2013 (n = 211 deaf adults) for associations between sociodemographic factors including parental hearing status, and recalled access to childhood indirect family communication. Parental hearing status predicted deaf adults' recalled access to childhood indirect family communication (χ2 = 31.939, p < .001). The likelihood of deaf adults reporting "sometimes to never" for recalled comprehension of childhood family indirect communication increased by 17.6 times for those with hearing parents. No other sociodemographic or deaf-specific factors in this study predicted deaf adults' access to childhood indirect family communication. This study finds that deaf people who have hearing parents were more likely to report limited access to contextual learning opportunities during childhood. Parental hearing status and early childhood language experiences, therefore, require further investigation as possible social determinants of health to develop interventions that improve lifelong health and social outcomes of the underserved deaf population.

Collaboration With Deaf Communities to Conduct Accessible Health Surveillance.

INTRODUCTION: Populations of deaf sign language users experience health disparities unmeasured by current public health surveillance. Population-specific health data are necessary to collaboratively identify health priorities and evaluate interventions. Standardized, reproducible, and language-concordant data collection in sign language is impossible via written or telephone surveys. METHODS: Deaf and hearing researchers, community members, and other stakeholders developed a broad computer-based health survey based on the telephone-administered Behavioral Risk Factor Surveillance System. They translated survey items from English to sign language, evaluated the translations, and filmed the survey items for inclusion in their custom software. They initiated the second Rochester Deaf Health Survey in 2013 (n=211). Analyses (conducted in 2015) compared Rochester Deaf Health Survey 2013 findings with those of the Behavioral Risk Factor Surveillance System with the general adult population in the same community (2012, n=1,816). RESULTS: The Rochester Deaf Health Survey 2013 participants' mean age was 44.7 (range, 18-87) years. Most were deaf since birth or early childhood (87.1%) and highly educated (53.6% with ≥4 years of college). The median household income was <$35,000. The prevalence of current smokers was low (8.1%). Nearly all (93.8%) reported having health insurance, yet barriers to appropriate health care were evident, with high emergency department use (16.2% with two or more past-year visits) and 22.7% forgoing needed health care in the past year because of cost. CONCLUSIONS: Community-engaged research with deaf populations identifies strengths and priorities, providing essential information otherwise missing from existing public health surveillance, and forming a foundation for collaborative dissemination to facilitate broader inclusion of deaf communities.

Self-reported smoking in online surveys: prevalence estimate validity and item format effects.

OBJECTIVES: We assessed validity of self-reported smoking prevalence estimates from an online sample, and explored the impact of different item response formats on estimates. METHODS: Self-reported current smoking status was obtained from 110,837 respondents from the Harris Poll Online (HPOL) panel from April 2004 to January 2005. Current smoking prevalence was compared with national estimates from the 2004 Behavioral Risk Factor Surveillance System (BRFSS), 2003 National Health Interview Survey (NHIS), and 2001-2002 National Health and Nutrition Examination Survey (NHANES). All estimates were weighted to reflect the US population. A separate survey section measured smoking prevalence using randomly assigned response formats, including yes/no grid, multiple response, numeric box, category grid, and drop-down box formats. RESULTS: 24.0% (95% confidence interval [CI] = 23.7-24.4) of HPOL respondents reported current smoking. BRFSS, NHIS, and NHANES estimates found 20.9%, 21.5% (95% CI = 20.9-22.1), and 24.9% (95% CI = 22.4-27.5), respectively, reporting current smoking. An additional 4.5% of NHANES respondents reporting not smoking had cotinine levels > or =15 ng/mL, indicating current smoking. Estimates of smoking prevalence varied by prevalence period and response format. CONCLUSIONS: Prevalence estimates obtained from the HPOL panel are comparable to those from national surveys. Online response format choices result in variation in estimated behavioral prevalence. Online surveys may be useful for public health surveillance of the US population.

History of childhood candy cigarette use is associated with tobacco smoking by adults.

OBJECTIVE: We examined whether childhood candy cigarette use was associated with adult tobacco smoking. METHODS: 25,887 U.S. adults from the Harris Poll Online (HPOL) were surveyed about current smoking status from November 2005 to May 2006. Respondents were randomly assigned to a yes/no item or a dose-response scale to assess candy cigarette use. Data were weighted to reflect the U.S. adult population. RESULTS: 26.4% of respondents reported current smoking and 29.4% reported former smoking. Candy cigarette use was reported by 88% of both current and former smokers and 78% of never smokers (p