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      Exploring accommodations along the education to employment pathway for deaf and hard of hearing healthcare professionals

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          Abstract

          Background

          Deaf and hard of hearing (DHH) people are an underserved population and underrepresented among healthcare professionals. A major barrier to success for DHH healthcare professionals is obtaining effective accommodations during education and employment. Our objective: describe DHH individuals’ experiences with accommodations in healthcare education.

          Methods

          We used an online survey and multipronged snowball sampling to recruit participants who identify as DHH and who had applied to a U.S. health professional school (regardless of acceptance status). One hundred forty-eight individuals representing multiple professions responded; 51 had completed their training. Over 80% had been accepted to, were currently enrolled, or had completed health professions schools or residency programs, and/or were employed. The survey included questions addressing experiences applying to health professions programs and employment; satisfaction with accommodations in school and training; having worked with a disability resource professional (DRP); and depression screening.

          Results

          Use and type of accommodation varied widely. While in school, respondents reported spending a mean of 2.1 h weekly managing their accommodations. Only 50% were highly satisfied with the accommodations provided by their programs. Use of disability resource providers (DRPs) for accommodations was highest during school (56%) and less frequent during post-graduate training (20%) and employment (14%). Respondents who transitioned directly from school to employment (versus via additional training) were more satisfied with their accommodations during school and were more likely to find employment ( p = 0.02). Seventeen respondents screened positive for risk of depression; a positive screen was statistically associated with lower school accommodation satisfaction.

          Conclusions

          DHH people study and practice across many health professions. While respondents were mostly successful in entering health professions programs, accommodation experiences and satisfaction varied. Satisfaction with accommodations was related to successful employment and wellness. Low satisfaction was associated with higher likelihood of depression symptoms. To increase representation in the workforce, healthcare professional schools, training programs, and employers should enhance support for the learning and working climates for people with disabilities.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s12909-022-03403-w.

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          Most cited references27

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          The Patient Health Questionnaire-2: validity of a two-item depression screener.

          A number of self-administered questionnaires are available for assessing depression severity, including the 9-item Patient Health Questionnaire depression module (PHQ-9). Because even briefer measures might be desirable for use in busy clinical settings or as part of comprehensive health questionnaires, we evaluated a 2-item version of the PHQ depression module, the PHQ-2. The PHQ-2 inquires about the frequency of depressed mood and anhedonia over the past 2 weeks, scoring each as 0 ("not at all") to 3 ("nearly every day"). The PHQ-2 was completed by 6000 patients in 8 primary care clinics and 7 obstetrics-gynecology clinics. Construct validity was assessed using the 20-item Short-Form General Health Survey, self-reported sick days and clinic visits, and symptom-related difficulty. Criterion validity was assessed against an independent structured mental health professional (MHP) interview in a sample of 580 patients. As PHQ-2 depression severity increased from 0 to 6, there was a substantial decrease in functional status on all 6 SF-20 subscales. Also, symptom-related difficulty, sick days, and healthcare utilization increased. Using the MHP reinterview as the criterion standard, a PHQ-2 score > or =3 had a sensitivity of 83% and a specificity of 92% for major depression. Likelihood ratio and receiver operator characteristic analysis identified a PHQ-2 score of 3 as the optimal cutpoint for screening purposes. Results were similar in the primary care and obstetrics-gynecology samples. The construct and criterion validity of the PHQ-2 make it an attractive measure for depression screening.
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            Does Diversity Matter for Health? Experimental Evidence from Oakland

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              Prevalence of hearing loss and differences by demographic characteristics among US adults: data from the National Health and Nutrition Examination Survey, 1999-2004.

              Hearing loss affects health and quality of life. The prevalence of hearing loss may be growing because of an aging population and increasing noise exposure. However, accurate national estimates of hearing loss prevalence based on recent objective criteria are lacking. We determined hearing loss prevalence among US adults and evaluated differences by demographic characteristics and known risk factors for hearing loss (smoking, noise exposure, and cardiovascular risks). A national cross-sectional survey with audiometric testing was performed. Participants were 5742 US adults aged 20 to 69 years who participated in the audiometric component of the National Health and Nutrition Examination Survey 1999-2004. The main outcome measure was 25-dB or higher hearing loss at speech frequencies (0.5, 1, 2, and 4 kHz) and at high frequencies (3, 4, and 6 kHz). In 2003-2004, 16.1% of US adults (29 million Americans) had speech-frequency hearing loss. In the youngest age group (20-29 years), 8.5% exhibited hearing loss, and the prevalence seems to be growing among this age group. Odds of hearing loss were 5.5-fold higher in men vs women and 70% lower in black subjects vs white subjects. Increases in hearing loss prevalence occurred earlier among participants with smoking, noise exposure, and cardiovascular risks. Hearing loss is more prevalent among US adults than previously reported. The prevalence of US hearing loss differs across racial/ethnic groups, and our data demonstrate associations with risk factors identified in prior smaller-cohort studies. Our findings also suggest that hearing loss prevention (through modifiable risk factor reduction) and screening should begin in young adulthood.
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                Author and article information

                Contributors
                chris.moreland@austin.utexas.edu
                meeksli@med.umich.edu
                musarratn.rimi@gmail.com
                kapanzer@med.umich.edu
                tlfancher@ucdavis.edu
                Journal
                BMC Med Educ
                BMC Med Educ
                BMC Medical Education
                BioMed Central (London )
                1472-6920
                6 May 2022
                6 May 2022
                2022
                : 22
                : 345
                Affiliations
                [1 ]GRID grid.89336.37, ISNI 0000 0004 1936 9924, Department of Internal Medicine, , Dell Medical School at the University of Texas at Austin, ; 1601 Trinity St, Bldg B, Austin, TX 78712 USA
                [2 ]GRID grid.27860.3b, ISNI 0000 0004 1936 9684, Center for a Diverse Healthcare Workforce, , University of California, Davis, School of Medicine, ; Sacramento, CA USA
                [3 ]GRID grid.214458.e, ISNI 0000000086837370, Department of Family Medicine, , University of Michigan Medical School, ; 1018 Fuller St., Ann Arbor, MI 48104-1213 USA
                [4 ]General & Internal Medicine, Weil Cornell Medicine, 420 E 70th St., New York, NY 10021 USA
                [5 ]GRID grid.27860.3b, ISNI 0000 0004 1936 9684, Department of Internal Medicine, , UC Davis School of Medicine, ; 4610 X Street, #4101, Sacramento, CA 95817 USA
                Author information
                http://orcid.org/0000-0002-2127-5404
                Article
                3403
                10.1186/s12909-022-03403-w
                9073820
                35524331
                61c38217-95cb-4b26-8e47-373ee25f679a
                © The Author(s) 2022

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 19 August 2021
                : 24 April 2022
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100000102, health resources and services administration;
                Award ID: UH1HP29965
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2022

                Education
                disability,diversity,deafness,medical education
                Education
                disability, diversity, deafness, medical education

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