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Table 2 Characteristics of study included

From: Exploring the health literacy status of people with hearing impairment: a systematic review

Study(year)

Country

Title

Methodology

N

Population

Measurement tool

Gregg [14] (2002)

United States

Designing a Curriculum on Internet Health Resources for Deaf High School Students

Survey (qualitative)

22

Deaf high school students

Questionnaire to investigate the level of Internet skills

Steinberg [15] (2006)

United States

Health Care System Accessibility: Experiences and Perceptions of Deaf People

Focus group (qualitative)

91

91 adults with hearing disabilities (aged 24–83 years) who predominantly communicate in American Sign Language

None

Groce [16] (2006)

Swaziland

HIV/AIDS and Disability: A Pilot Survey of HIV/AIDS Knowledge Among a Deaf Population in Swaziland

Survey (quantitative)

191

91 hearing impaired and 100 hearing adults

Questionnaire related to HIV/AIDS

Groce [17] (2007)

Nigeria

HIV/AIDS and Disability: Differences in HIV/AIDS Knowledge Between Deaf and Hearing People in Nigeria

Survey (quantitative)

100

50 teenagers with hearing impairment and 50 hearing adults

Questionnaire related to HIV/AIDS

Choe [18] (2009)

United States

The Impact of Cervical Cancer Education for Deaf Women Using a Video Educational Tool Employing American Sign Language, Open Captioning, and Graphics

Survey (quantitative)

130

Women with hearing impairment (aged 19–93)

Questionnaire related to cervical cancer

Pollard [19] (2009)

United States

Health-Related Vocabulary Knowledge Among Deaf Adults

Survey (quantitative)

57

People with hearing loss (aged 21–67 years) participated, with 27 women and 29 men

REALM

Hoang [20] (2011)

United States

Assessing Deaf Cultural Competency of Physicians and Medical Students

Survey (qualitative)

1445

640 non-DCT students, 25 DCT students, and 780 medical school instructors

Questionnaires related to deaf culture and clinical dilemmas of deaf people

Convery [21] (2011)

Australia

Management of Hearing Aid Assembly by Urban-Dwelling Hearing-Impaired Adults in a Developed Country: Implications for a Self-Fitting Hearing Aid

Survey (quantitative)

80

80 participants aged 45–90 years with hearing impairment

S-TOFHLA

Maddalena [22] (2012)

Canada

Palliative and End-of-Life Care in Newfoundland’s Deaf Community

Interview (qualitative)

7

Members of the Deaf community, residents of the Northeast Avalon Region, and the caregiver of a deceased person with disabilities (aged 40–65 years)

None

Yao [23] (2012)

United States

Cervical Cancer Control: Deaf and Hearing Women’s Response to an Educational Video

Survey (quantitative)

133

127 hearing loss women (aged 19–93 years) and 106 hearing women (aged 18–85 years)

Questionnaire related to cervical cancer

Berman [24] (2013)

United States

Breast Cancer Knowledge and Practices Among Deaf Women

Interview (quantitative)

209

209 hearing loss women (aged 40 years and up) with poor levels of education

Selected questions from questionnaires previously applied to people with hearing impairment and from a standard survey instrument, as well as from a pool of items used in other cancer prevention and control studies in low-literacy, cultural, and linguistic populations

Jensen [25] (2013)

United States

Ovarian Cancer: Deaf and Hearing Women’s Knowledge Before and After an Educational Video

Survey (quantitative)

107

55 hearing loss women (aged 18 years and up) and 52 hearing women (aged 18 years and up)

Questionnaire related to ovarian cancer

Convery [26] (2013)

South Africa, China

Hearing-aid Assembly Management Among Adults from Culturally and Linguistically Diverse Backgrounds: Toward the Feasibility of Self-Fitting Hearing Aids

Survey (quantitative)

80

40 hearing-impaired South Africans and 40 Chinese individuals (aged 32–92 years)

S-TOFHLA

Mckee [27] (2015)

United States

Assessing Health Literacy in Deaf American Sign Language Users

Interview (quantitative)

405

166 adults with hearing loss (aged 40–70 years) and 239 hearing people (aged 40–70 years)

Transform the New Vital Sign (NVS) tool into a sign language interface

Ferguson [28] (2015)

United States

Communication Needs of Patients with Altered Hearing Ability: Informing Pharmacists’ Patient Care Services Through Focus Groups

Focus group (qualitative)

20

Patients with hearing loss (aged 18 years and up) using American Sign Language who have more than two long-term prescription medications

None

Smith [29] (2015)

United States

Deaf Adolescents’ Learning of Cardiovascular Health Information: Sources and Access Challenges

Interview (qualitative)

20

Teenagers with hearing impairment using sign language (aged 9–12 years) from Rochester, New York

None

Kushalnagar [30] (2015)

United States

Health Websites: Accessibility and Usability for American Sign Language Users

Survey (quantitative)

32

Students with hearing impairment (aged 18 years and older) who know ASL

S-TOFHLA

Smith [31] (2016)

United States

Dimensions of Deaf/Hard-of-Hearing and Hearing Adolescents’ Health Literacy and Health Knowledge

Survey (quantitative)

281

187 D/HH and 94 hearing college-bound high school students

HLSI-SF

S-TOFHLA

CHDKQ

Haricharan [32] (2017)

South Africa

Health Promotion via SMS Improves Hypertension Knowledge for Deaf South Africans

Focus group (quantitative)

41

People with hearing disabilities in Cape Town (aged 18 years and up)

30 objective questionnaires to measure the effectiveness of SMS campaigns

Palmer [33] (2017)

United States

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

Survey (quantitative)

150

ASL users with hearing impairment (aged 18 years and up) with computer and internet access took part

Added items to the existing cancer genetics knowledge questionnaire

Kushalnagar [34] (2017)

United States

Critical Health Literacy in American Deaf College Students

Survey (quantitative)

38

Undergraduate students with hearing loss who use ASL (aged 22–38 years)

S-TOFHLA

Pinilla [35] (2019)

Germany

Primary Non-Communicable Disease Prevention and Communication Barriers of Deaf Sign Language Users: A Qualitative Study

Interview (qualitative)

15

Two had a history of diabetes, whereas 13 did not. All were members of the deaf community located in Germany

None

Stevens [36] (2019)

United States

Communication and Healthcare: Self-Reports of People with Hearing Loss in Primary Care Settings

Survey (quantitative)

1581

The survey information was distributed to the Hearing Loss Association of America email listserv; 1,682 people visited the survey link and 1,581 people responded

Survey questions developed by subject matter experts in hearing health

Gur [37] (2020)

Turkey

Health Literacy of Hearing-Impaired Adolescents, Barriers, and Misunderstandings they Encounter, and their Expectations

Survey (quantitative)

88

Students enrolling in a deaf or hard of hearing (D/HoH) vocational high school (aged 15–18 years)

TSY-32 based on HLS-EU

Tolisano [38] (2020)

United States

Can You Hear Me Now? The Impact of Hearing Loss on Patient Health Literacy

Survey (quantitative)

300

Adult patients (aged 18 years and up)

BHLS

Wells [39] (2020)

United States

Limited Health Literacy and Hearing Loss Among Older Adults

Telephone survey (quantitative)

19,223

Adults (aged 65 years and up)

The following question was used to test health literacy: “How confident are you filling out medical forms by yourself?”

Willink [40] (2020)

United States

Understanding Medicare: Hearing Loss and Health Literacy

Survey (quantitative)

10,510

With survey weights applied, the studied Medicare beneficiaries represented 50,084,169 beneficiaries

8 questions about health literacy

Almusawi [41] (2021)

Kuwait, Saudi Arabia

Disparities in Health Literacy During the COVID-19 Pandemic Between the Hearing and Deaf Communities

Survey (quantitative)

110

40 individuals with hearing impairment and 70 hearing adults

Questionnaire developed in relation to COVID-19

Tran [42] (2021)

United States

Health Literacy and Hearing Healthcare Use

Survey (quantitative)

1376

Between August 2018 and October 2019; adult patients (aged 18 years and older) who received hearing testing and finished a health literacy survey

BHLS