1,2,4University of Utah, Salt Lake City, UT
3Disability Research and Translation Consulting, New York
Background/Purpose: American Sign Language (ASL) interpreters can help deaf and hard of hearing persons with diabetes (DHH PWD) access health information. Yet, in medical settings, interpreters are not consistently provided, and some may lack the necessary training to effectively translate health information, potentially leading to mistranslation, reduced understanding of diabetes information, and negative diabetes outcomes in DHH PWD. The lack of ASL vocabulary for common diabetes terms complicates the translation. Diabetes care and education specialists (DCES) can only effectively work with DHH PWD if the diabetes education is adequately interpreted.
Methods: Four focus groups were conducted with individuals representing DHH PWD, DCES, and ASL interpreters. Using a semi-structured guide, participants were asked open-ended questions to understand what concepts are commonly misinterpreted or misunderstood. Each focus group concluded with a debrief by the research team. A qualitative thematic analysis was conducted using data from focus group recordings and the translations/transcriptions along with field notes.
Results: Focus groups included DHH PWD (N = 8), DCES (N = 7), and ASL interpreters (N = 7 hearing, N = 6 CDI). The overarching theme was the ASL interpreter system is lifesaving but broken. Subthemes of contrasting opinions on misunderstood diabetes concepts (ie, DCES rarely identified misunderstandings whereas DHH PWD and ASL interpreters identified many); unequal distribution of power in the relationship of DHH PWD, DCES, and ASL interpreters; challenges obtaining qualified ASL interpreters; ethical boundaries that limit ASL interpreters from actively participating in diabetes education outside of the interpreting role (notifying the DCES that the DHH PWD may not understand); and underuse of certified deaf interpreters to optimize communication between DHH PWD and DCES, also emerged.
Conclusions: Communication between the DHH PWD, DCES, and ASL interpreters is essential for the DHH PWD to understand how to manage their diabetes. However, perceptions differ regarding the effectiveness of communication. Multilevel training is necessary to enhance communication between DHH PWD (interpreterrelated advocacy), DCES (teach-back methods, interpreter-related advocacy, a tip sheet on working with DHH PWD and ASL interpreters), and ASL interpreters (diabetes terminology and concepts).
Disclosures: Funded by the Association of Diabetes Care & Education Specialists Foundation and in part by the Gordon and Betty Moore Foundation through grant GBMF9048.