针对使用美国手语的聋人开展的在线癌症遗传学双语教育方法，比仅使用英文文本能带来更多知识和更强信心：一项随机研究。
Bilingual approach to online cancer genetics education for Deaf American Sign Language users produces greater knowledge and confidence than English text only: A randomized study.
作者信息
Palmer Christina G S, Boudreault Patrick, Berman Barbara A, Wolfson Alicia, Duarte Lionel, Venne Vickie L, Sinsheimer Janet S
机构信息
Department of Psychiatry & Biobehavioral Sciences, UCLA, USA; Department of Human Genetics, UCLA, USA; Institute for Society and Genetics, UCLA, USA.
Gallaudet University, Washington DC, USA.
出版信息
Disabil Health J. 2017 Jan;10(1):23-32. doi: 10.1016/j.dhjo.2016.07.002. Epub 2016 Jul 28.
INTRODUCTION
Deaf American Sign Language-users (ASL) have limited access to cancer genetics information they can readily understand, increasing risk for health disparities. We compared effectiveness of online cancer genetics information presented using a bilingual approach (ASL with English closed captioning) and a monolingual approach (English text).
HYPOTHESIS
Bilingual modality would increase cancer genetics knowledge and confidence to create a family tree; education would interact with modality.
METHODS
We used a parallel 2:1 randomized pre-post study design stratified on education. 150 Deaf ASL-users ≥18 years old with computer and internet access participated online; 100 (70 high, 30 low education) and 50 (35 high, 15 low education) were randomized to the bilingual and monolingual modalities. Modalities provide virtually identical content on creating a family tree, using the family tree to identify inherited cancer risk factors, understanding how cancer predisposition can be inherited, and the role of genetic counseling and testing for prevention or treatment. 25 true/false items assessed knowledge; a Likert scale item assessed confidence. Data were collected within 2 weeks before and after viewing the information.
RESULTS
Significant interaction of language modality, education, and change in knowledge scores was observed (p = .01). High education group increased knowledge regardless of modality (Bilingual: p < .001; d = .56; Monolingual: p < .001; d = 1.08). Low education group increased knowledge with bilingual (p < .001; d = .85), but not monolingual (p = .79; d = .08) modality. Bilingual modality yielded greater confidence creating a family tree (p = .03).
CONCLUSIONS
Bilingual approach provides a better opportunity for lower educated Deaf ASL-users to access cancer genetics information than a monolingual approach.
引言
使用美国手语的美国聋人获取易于理解的癌症遗传学信息的机会有限，这增加了健康差距的风险。我们比较了使用双语方法（带有英文字幕的美国手语）和单语方法（英文文本）呈现的在线癌症遗传学信息的效果。
假设
双语模式会增加癌症遗传学知识和创建家族树的信心；教育会与模式相互作用。
方法
我们采用了一种平行的2:1随机前后研究设计，并按教育程度进行分层。150名年龄≥18岁、可使用计算机和互联网的美国手语聋人在线参与；100名（70名高学历、30名低学历）和50名（35名高学历、15名低学历）被随机分配到双语和单语模式。两种模式提供关于创建家族树、使用家族树识别遗传性癌症风险因素、理解癌症易感性如何遗传以及遗传咨询和检测在预防或治疗中的作用的几乎相同的内容。25道是非题评估知识；一个李克特量表项目评估信心。在查看信息前后2周内收集数据。
结果
观察到语言模式、教育程度和知识得分变化之间存在显著交互作用（p = 0.01）。高学历组无论采用何种模式知识都有所增加（双语：p < 0.001；d = 0.56；单语：p < 0.001；d = 1.08）。低学历组采用双语模式知识增加（p < 0.001；d = 0.85），但采用单语模式知识未增加（p = 0.79；d = 0.08）。双语模式在创建家族树方面产生了更大的信心（p = 0.03）。
结论
与单语方法相比，双语方法为受教育程度较低的美国手语聋人提供了更好的获取癌症遗传学信息的机会。
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