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Deaf and Hard of Hearing (Deaf/HH) youth are a vulnerable minority population at risk for tobacco use. Prevention messages and programs for hearing youth are rarely captioned or available in American Sign Language (ASL) and are not adequate for Deaf/HH children and adolescents. Translation into ASL alone is not the answer as these programs fail to address unique aspects of Deaf/HH culture and experience. Recognizing this, TRDRP funded our prior community-academic partnered research that resulted in “Hands Off Tobacco! An Anti-Tobacco Program for Deaf Youth.” Widely disseminated and still in use today, to our knowledge it is the only comprehensive school-based tobacco prevention program tailored to meet this population’s needs. But since this research took place tobacco use among young people has changed dramatically, with an alarming increase in use of e-cigarettes and tobacco products such as hookah and cigarillos. Programs addressing all tobacco products are badly needed and are underway in the general population. For Deaf/HH youth however, such programs remain unavailable and urgently needed. Building on our prior work, we seek to address this gap in tobacco control and prevention efforts by revising and testing our Hands Off Tobacco! curriculum to include a focus on e-cigarettes and other increasingly popular tobacco products. Working with a Community Advisory Committee of Deaf/HH and hearing experts, a panel of Deaf/HH Youth Champions, and Deaf community members and leaders, our study will reflect attention to the communication requirements and cultural perspectives of the Deaf community. Deaf/HH students from California’s two Schools for the Deaf and from two mainstream school districts will participate. We will conduct focus groups with Deaf/HH middle and high school students and key informant interviews with teachers to learn about the knowledge, misconceptions, and use patterns of this youth population, school policies, programming needs of these students and teachers, and how best to develop an effective and feasible school-based program to prevent all forms of tobacco use. Drawing on what we learn from these groups and interviews, our previous work, and from educators who used the original curriculum, we will modify the curriculum to address current knowledge gaps, beliefs, and use trends. Our research design allows us to examine changes over time and differences between schools that do and do not use the curriculum. A series of ASL-administered surveys completed by 160 Deaf/HH middle school students from four schools will allow us to assess the revised curriculum’s impact on students’ knowledge, use and intention to use e-cigarettes and other tobacco products and, by including Schools for the Deaf and mainstream schools, to compare results for Deaf/HH youth in these two settings. We will talk with students and teachers about the revised program, synthesize and share our findings with educators, community leaders and other researchers, and leverage what we learn to inform future research aimed at more fully assessing and disseminating the curriculum. This study has strong support in the Deaf community and the potential to improve the wellbeing of this underserved and understudied population, and to aid in the fight against e-cigarette and other tobacco use that will only be won if effective prevention programming reaches all youth. |
