RESEARCH PLAN

I. To take a proven statewide cancer-education program for the Deaf and Hard of Hearing community (DHHC) to national scale. Research has shown that this cancer-education program can increase the DHHC's: 1) knowledge of cancer prevention, detection, and control strategies; 2) knowledge of reliable sources of cancer information and cancer care; and 3) adherence to health-promoting guidelines.

II. To expand the number of cancer topics and address the low level of cancer literacy in American Sign Language (ASL), open caption, and voice overlay that have been specifically designed to make information about cancer prevention, control, survivorship, and clinical trials accessible to the widely diverse members of the DHHC.

III. To demonstrate how this program can be taken to a national scale using overlapping, multimodal dissemination strategies to diffuse the information to the widely dispersed DHHC.

IV. To increase the DHHC's scientific literacy related to clinical trials with the longer-term goal of having members of the community demonstrate receptivity to discussions of clinical-trial opportunities.

V. To demonstrate the model's potential for disseminating a broad array of health and social-welfare information to the DHHC.

VI. To make the library of cancer-education videotapes available to the nation's ASL interpreters to help increase their foundation of cancer knowledge, promote their use of universal signs for specific cancer-relat

r cells, and 64.2% (79/123) knew that a mammogram shows early abnormal changes. While 11.4% (14/123) thought that a mammogram shows abnormalities throughout the upper body, 13% (16/123) thought that a mammogram does a breast biopsy. Tables 3 and 4 contrast the pre- and post-measures used. Five measures showed statistically significant increases in knowledge postintervention. For one measure the trend was toward increased knowledge, which confirmed the program's utility, a key factor in the Health Belief Model and other theoretical paradigms upon which health-education programs are based30, 39-43. Focus-group discussions centered on the barriers to and facilitators of participation in health education (Table 5) and the elements of effective health education for deaf audiences. To be considered important, the issue had to have been raised in more than one focus group. Table 3. Pre- and post-test results related to breast-cancer knowledge Question Pre-Test: % (N) who got answer right Post-Test: % (N) who got answer right How often should BSE be done? (Once a month) 39.2% (47) 74.4% (93)* Age a woman should begin doing BSE? (20 years) 24% (30) 64% (80)* Age a woman should begin having annual CBE? (40