Improving Cancer Literacy for the Deaf Using Deaf-Tailored Educational Interventions: a Review of the Literature

  • Tahereh NaseriBooriAbadi
  • Farahnaz Sadoughi
  • Abbas Sheikhtaheri


To date, there have been many strategies, including educational interventions, for cancer prevention and control, but most of them are not deaf-tailored ones. This narrative review aimed to examine cancer educational programs to improve the deaf individuals’ knowledge and attitude toward cancer. The design of this study is a narrative review. We searched ISI Web of Science, Scopus, Science Direct, and MEDLINE/PubMed using the following search strategy: (“cancer education” AND “deaf”) OR (“cancer” AND “deaf” AND literacy). Publication years ranged from 1983 to 2016 for studies on cancer educational interventions for the deaf. Included studies were analyzed regarding research methodologies, types of intervention, and major findings. In total, 12 included studies were classified into three research methodologies. Although short-term and long-term knowledge improvement has been reported, since there is limited evidence on the types of cancer-related educational interventions and there are insufficient studies, longterm effectiveness of educations in improving cancer knowledge of the deaf has to be reported cautiously. Current deaf-tailored education interventions are limited, but included functional features which facilitate communicating cancer health information to the deaf community. In fact, cancer literacy might improve considering deaf community preferences such as using a short open caption, sign language, and plain language in educational interventions, but further research is recommended.


Deaf persons Cancer Health literacy Education Knowledge Sign language 


Compliance with Ethical Standards

Ethical Approval

This narrative review is based on available literature.

Authors’ Statement

This article is a part of a Ph.D. dissertation granted by the Iran University of Medical Sciences (Grant Number: IUMS/SHMIS_2014/294).

Conflict of Interest

The authors declare that they have no conflict of interest.


  1. 1.
    Stewart BW, Wild CP (2015) World cancer report 2014Google Scholar
  2. 2.
    Booker A, Malcarne VL, Sadler GR (2014) Evaluating outcomes of community-basedcancer education interventions: a 10-year review of studies. J Cancer Educ 29:233–240. doi: 10.1007/s13187-013-0578-6 CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Perkins RB, Langrish S, Stern LJ, Simon CJ (2007) A community-based education program about cervical cancer improves knowledge and screening behavior in Honduran women. Rev Panam de Salud Pública 22(3):187–193 CrossRefGoogle Scholar
  4. 4.
    Sadler GR, Beerman PR, Lee K, Hung J, Nguyen H, Cho J et al (2012) Promoting breast cancer screening among Asian American women: the Asian grocery store-based cancer education program. J Cancer Educ 27(4):612–617. doi: 10.1007/s13187-012-0419-z CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Jackson DD, Owens OL, Friedman DB, Dubose-Morris R (2015) Innovative and community-guided evaluation and dissemination of a prostate cancer education program for african-american men and women. J Cancer Educ 30(4):779–785. doi: 10.1007/s13187-014-0774-z CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Al Amoudi SM (2012) Knowledge and attitude of women with special needs towards breast cancer in Saudi Arabia; a cross sectional study. Life Sci J 9:1348–1352Google Scholar
  7. 7.
    Wang R, Aldridge AA, Malcarne VL, Choe S, Branz P, Sadler GR (2010) Health locus of control and assimilation of cervical cancer information in deaf women. J Cancer Educ 25:354–359. doi: 10.1007/s13187-010-0053-6 CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    McKee MM, Barnett SL, Block RC, Pearson TA (2011) Impact of communication on preventive services among deaf American Sign Language users. Am J Prev Med 41:75–79. doi: 10.1016/j.amepre.2011.03.004 CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Tamaskar P, Malia T, Stern C, Gorenflo D, Meador H, Zazove P (2000) Preventive attitudes and beliefs of deaf and hard-of-hearing individuals. Arch Fam Med 9:518. doi: 10.1001/archfami.9.6.518 CrossRefPubMedGoogle Scholar
  10. 10.
    McKee MM, Paasche-Orlow MK, Winters PC, Fiscella K, Zazove P, Sen A et al (2015) Assessing health literacy in deaf american sign language users. J Health Commun Oct 20:92–100. doi: 10.1080/10810730.2015.1066468 CrossRefGoogle Scholar
  11. 11.
    Choe S, Lim RS, Clark K, Wang R, Branz P, Sadler GR (2009) The impact of cervical cancer education for deaf women using a video educational tool employing American sign language, open captioning, and graphics. J Cancer Educ 24:10–15. doi: 10.1080/08858190802665245 CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Pollard RQ, Barnett S (2009) Health-related vocabulary knowledge among deaf adults. Rehabil Psychol 54(2):182. doi: 10.1037/a0015771 CrossRefPubMedGoogle Scholar
  13. 13.
    Kickbusch IS (2001) Health literacy: addressing the health and education divide. Health Promot Int 16(3):289. doi: 10.1093/heapro/16.3.289 CrossRefPubMedGoogle Scholar
  14. 14.
    Zazove P, Meador HE, Reed BD, Sen A, Gorenflo DW (2009) Cancer prevention knowledge of people with profound hearing loss. J Gen Intern Med 24:320–326. doi: 10.1007/s11606-008-0895-3 CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Bukowski PM (2015) Online health information seeking and the deaf: an examination of how the deaf utilize the Internet for healthcare purposes: University of HoustonGoogle Scholar
  16. 16.
    Kuenburg A, Fellinger P, Fellinger J (2016) Health care access among deaf people. JDSDE 21:1–10. doi: 10.1093/deafed/env042 PubMedGoogle Scholar
  17. 17.
    Yao CS, Merz EL, Nakaji M, Harry KM, Malcarne VL, Sadler GR (2012) Cervical cancer control: deaf and hearing women’s response to an educational video. J Cancer Educ 27:62–66. doi: 10.1007/s13187-011-0264-5 CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Berman BA, Jo A, Cumberland WG, Booth H, Britt J, Stern C et al (2013) Breast cancer knowledge and practices among D/deaf women. Disabil Health J 6:303–316. doi: 10.1016/j.dhjo.2013.05.001 CrossRefPubMedGoogle Scholar
  19. 19.
    Sadler GR, Gunsauls DC, Huang J, Padden C, Elion L, Galey T et al (2001) Bringing breast cancer education to deaf women. J Cancer Educ 16:225–228. doi: 10.1080/08858190109528778 PubMedGoogle Scholar
  20. 20.
    Orsi JM, Margellos-Anast H, Perlman TS, Giloth BE, Whitman S (2007) Cancer screening knowledge, attitudes, and behaviors among culturally deaf adults: implications for informed decision making. Cancer Detec Prev 31:474–479. doi: 10.1016/j.cdp.2007.10.008 CrossRefPubMedGoogle Scholar
  21. 21.
    Alse AS, Anandkrishna L, Chandra P, Ramya M, Kamath PS, Shetty AK (2015) Educational intervention on the plaque score among hearing impaired children. Journal of Advanced Clinical & Research Insights 2(1). doi: 10.15713/ins.jcri.37
  22. 22.
    Vejdani-Aram F, Roshanaei G, Hazavehei SMM, Karimi-Shahanjarini A, RezapurShahkolai F (2015) Evaluating a health belief model-based educational program for school injury prevention among hard-of-hearing/deaf high school students. Journal of Education and Community Health 1:32–42CrossRefGoogle Scholar
  23. 23.
    Kaskowitz SR III, Nakaji MC, Clark KL, Gunsauls DC, Sadler GR (2006) Bringing prostate cancer education to deaf men. Cancer Detect Prev 30:439–448. doi: 10.1016/j.cdp.2006.09.001 CrossRefPubMedGoogle Scholar
  24. 24.
    Jones EG, Goldsmith M, Effken J, Button K, Crago M (2010) Creating and testing a deaf-friendly, stop-smoking web site intervention. Am Ann Deaf 155(1):96–102CrossRefPubMedGoogle Scholar
  25. 25.
    Morgan L (2013) Best practice patient teaching strategies to promote health literacy when working with individuals with deafness. Washington State universityGoogle Scholar
  26. 26.
    Steinberg AG, Wiggins EA, Barmada CH, Sullivan VJ (2002) Deaf women: experiences and perceptions of healthcare system access. J Women's Health 11:729–741. doi: 10.1089/15409990260363689 CrossRefGoogle Scholar
  27. 27.
    Gregg AL, Wozar JA, Wessel CB, Epstein BA (2002) Designing a curriculum on Internet health resources for deaf high school students. J Med Lib Assoc 90:431Google Scholar
  28. 28.
    Folkins A, Sadler GR, Ko C, Branz P, Marsh S, Bovee M (2005) Improving the deaf community’s access to prostate and testicular cancer information: a survey study. BMC Public Health. 5.Google Scholar
  29. 29.
    Shabaik S, LaHousse SF, Branz P, Gandhi V, Khan AM, Sadler GR (2010) Colorectal cancer video for the deaf community: a randomized control trial. J Cancer Educ 25:518–523. doi: 10.1007/s13187-010-0113-y CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Harry KM, Malcarne VL, Branz P, Fager M, Garcia BD, Sadler GR (2012) Evaluating a skin cancer education program for the deaf community. J Cancer Educ 27:501–506. doi: 10.1007/s13187-012-0367-7 CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Zazove P, Meador HE, Reed BD, Sen A, Gorenflo DW (2012) Effectiveness of videos improving cancer prevention knowledge in people with profound hearing loss. J Cancer Educ 27:327–337. doi: 10.1007/s13187-011-0292-1 CrossRefPubMedGoogle Scholar
  32. 32.
    Hickey S, Merz EL, Malcarne VL, Gunsauls DC, Huang J, Sadler GR (2013) Breast cancer education for the deaf community in American Sign Language. Oncol Nurs Forum 40:E86–E91. doi: 10.1188/13.ONF.E86-E91 CrossRefPubMedGoogle Scholar
  33. 33.
    Jensen LG, Nakaji M, Harry KM, Gallegos N, Malcarne VL, Sadler GR (2013) Ovarian cancer: deaf and hearing women’s knowledge before and after an educational video. J Cancer Educ 28:647–655. doi: 10.1007/s13187-013-0529-2 CrossRefPubMedGoogle Scholar
  34. 34.
    Sacks L, Nakaji M, Harry KM, Oen M, Malcarne VL, Sadler GR (2013) Testicular cancer knowledge among deaf and hearing men. J Cancer Educ 28:503–508. doi: 10.1007/s13187-013-0493-x CrossRefPubMedPubMedCentralGoogle Scholar
  35. 35.
    Palmer CGS, Boudreault P, Berman BA, Wolfson A, Duarte L, Venne VL et al (2016) 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. Disabil Health J . doi: 10.1016/j.dhjo.2016.07.002Article in pressPubMedGoogle Scholar
  36. 36.
    Kushalnagar P, Smith S, Hopper M, Ryan C, Rinkevich M, Kushalnagar R (2016) Making cancer health text on the internet easier to read for deaf people who use American sign language. J Cancer Educ . doi: 10.1007/s13187-016-1059-5Article in pressPubMedGoogle Scholar
  37. 37.
    Zazove P, Meador HE, Reed BD, Gorenflo DW (2013 Jul) Deaf persons’ English reading levels and associations with epidemiological, educational, and cultural factors. J Health Commun 18(7):760–772CrossRefPubMedGoogle Scholar
  38. 38.
    Hoang L, LaHousse SF, Nakaji MC, Sadler GR (2011) Assessing deaf cultural competency of physicians and medical students. J Cancer Educ 26(1):175–182. doi: 10.1007/s13187-010-0144-4 CrossRefPubMedGoogle Scholar
  39. 39.
    Sheppard K (2014) Deaf adults and health care: giving voice to their stories. Journal of the American Association of Nurse Practitioners 26(9):504–510. doi: 10.1002/2327-6924.12087 CrossRefPubMedGoogle Scholar

Copyright information

© American Association for Cancer Education 2017

Authors and Affiliations

  • Tahereh NaseriBooriAbadi
    • 1
  • Farahnaz Sadoughi
    • 1
  • Abbas Sheikhtaheri
    • 1
  1. 1.Department of Health Information Management, School of Health Management and Information SciencesIran University of Medical SciencesTehranIran

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