Date of Doctor of Nursing Practice Project Completion

Spring 4-30-2024

Faculty Advisor

Nancy Crider

Abstract

PURPOSE This quality improvement (QI) project was intended to increase ACP engagement by 25% from baseline by implementing an ASL video intervention. The project was conducted at a Deaf community organization in Houston, Texas.

BACKGROUND Literacy and language barriers negatively impact access to healthcare and health information among the Deaf population. ASL video interventions aimed at improving health equity are supported in the literature.

METHODOLOGY The Plan-Do-Study-Act (PDSA) quality improvement methodology was used to create a video for the Deaf community about ACP using ASL and captioning. The PREPARE™ ACP Engagement Survey measured changes in ACP behavior due to a video intervention among two small groups of volunteers. Satisfaction survey scores (5-point Likert scale), along with feedback from stakeholders, helped drive revisions to the video intervention throughout PDSA cycles.

RESULTS ACP Engagement Survey scores did not reach the target goal; however, project participant (n=8) scores increased by 6.1% and general member (n=15) scores by 14.3%. Satisfaction survey scores were higher among project participants (4.8) who saw up to three video iterations versus general members (4.1) who only saw one.

IMPLICATIONS Collaboration with the Deaf community was critical to the development of an effective ASL video intervention that demonstrated increased ACP engagement among Deaf adults. Need to expand the application of the video to the healthcare setting to assist providers caring for Deaf patients and families. Adaptation of health material should include ASL options to improve health literacy and equitable access to information. Future QI or research with Deaf participants should include ASL translation to assist with accurate and complete data collection.

Keywords

Deaf, literacy, ASL, ACP, advance directives, ASL communication, Deaf health literacy, ASL video, Deaf Interpreter

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Nursing Commons

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