Journal of Community Health

, Volume 43, Issue 5, pp 956–961 | Cite as

American Sign Language Interpreters Perceptions of Barriers to Healthcare Communication in Deaf and Hard of Hearing Patients

  • Rachel E. Hommes
  • Amy I. Borash
  • Kari HartwigEmail author
  • Donna DeGracia
Original Paper


Communication barriers between healthcare providers and patients contribute to health disparities and the effectiveness of health promotion messages. This is especially true regarding communication between providers and deaf and hard of hearing (HOH) patients due to lack of understanding of cultural and linguistic differences, ineffectiveness of various means of communication and level of health literacy within that population. This research aimed to identify American Sign Language (ASL) interpreters’ perceptions of barriers to effective communication between deaf and HOH patients and healthcare providers. We conducted a survey of ASL interpreters attending the 2015 National Symposium on Healthcare Interpreting with an overall response rate of 25%. Results indicated a significant difference (p < 0.05) in all areas of preferred communication between providers and deaf/HOH patients as perceived by interpreters. ASL interpreters observed that patients did not understand provider instructions in nearly half of appointments. Eighty-one percent of interpreters said that providers “hardly ever” use “teach-back” methods with patients to ensure understanding. A focus on improving health care and health promotion efforts in the deaf/HOH community depends on improving communication, health literacy, and patient empowerment and involves holding health care organizations accountable for assuring adequate staffing of ASL interpreters and communication resources in order to reduce health disparities in this population.


Deaf and hard of hearing Health communication American Sign Language (ASL) interpreters Health disparities 



We would like to thank the St. Catherine University CATIE Center, Richard Laurion, and Erica Alley for their aid in coordination and inspiration for this research.

Compliance with Ethical Standards

Conflict of interest

The authors declare they have no conflict of interest.

Ethical Approval

This study was reviewed and approved by the St. Catherine University Institutional Review Board. All participants read a consent form before participating in the survey.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Rachel E. Hommes
    • 2
  • Amy I. Borash
    • 3
  • Kari Hartwig
    • 1
    Email author
  • Donna DeGracia
    • 1
  1. 1.Master of Physician Assistant Studies Program, #4227St. Catherine UniversitySt. PaulUSA
  2. 2.MinneapolisUSA
  3. 3.St. CloudUSA

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