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Addressing Disparities in Emergency Communication with the Deaf and Hard-of-Hearing: Cultural Competence and Preparedness for First Responders


It is critically important to foster a resilient Deaf and hard-of-hearing (Deaf/HH) population empowered to act in a pre-event phase before and respond during and after critical large-scale public health emergencies. Standard all-hazards emergency preparedness risk & response communication efforts don't always reach people with barriers relating to literacy, language, culture or disability. This is a significant problem given that there is a growing body of evidence of higher risk during disasters for injury, death, property loss for 32 million Deaf/HH Americans and for 90 million Americans with low-literacy skills. It is beneficial to use a participatory, community-directed approach to improve all-hazards preparedness capacity for the Deaf/HH.

This dissertation is in a three-paper format. Part I, a literature review, systematically examines all-hazards emergency communication access for the Deaf/HH during large-scale disasters with an eye towards maximizing emergency preparedness capacity within the Deaf community. The literature review does not simply examine lessons learned from any access issues that have been documented in previous disasters but also reviews the peer reviewed and gray literature (non-peer-reviewed literature, often non-published reports) to determine the need for interventions or systemic change on a policy-level. By identifying the scope and magnitude of the problem, this literature review is a stepping stone for Parts II and III, which aim to develop best practices for educational outreach and training for first responders.

Part II is a program evaluation utilizing mixed methods of a training program for law enforcement officers at the scene of domestic violence (DV) emergencies involving the Deaf/HH. A program evaluation of cultural competency training for the Deaf/HH has never been published, to my knowledge, despite several available trainings for first responders or medical professionals and students nationally (Appendix 1). Once trainings are developed, standardized and shown to be beneficial, they can be distributed to Deaf/HH audiences and/or first responders, which can sustain longer-term development efforts that might mitigate the impact of future emergencies or improve the quality of life/infrastructure on broader levels.

Part III is a qualitative exploration of barriers, attitudes, perceptions, and knowledge of law enforcement and first responders regarding working with the Deaf/HH in an emergency. Specific abstracts for each Part can be found in the corresponding section.

The closing section provides a summary of policy and legislative developments on a national level that are informed by Deaf/HH experts in emergency communication; these developments have implications for further research and practice to address disparities in emergency preparedness communication for the Deaf/HH.

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