Expanding stop the bleed to achieve health equity: Inclusion of deaf and hard-of-hearing populations in injury prevention and education.

Abstract

Stop the Bleed (STB) is a program that teaches hemorrhage control techniques to the public. While STB has been taught to 4 million people, it is only widely available in English and Spanish languages. Therefore, vulnerable populations with other language preferences may miss this life-saving training. The purpose of our study is to determine the feasibility and effectiveness of adapting STB for the deaf and hard of hearing (DHH) community. In conjunction with the staff of the Georgia Center for the Deaf and Hard of Hearing, a needs assessment was conducted to identify necessary adaptations of STB. Based on feedback, modifications such as visual aids and community-specific instructions were made in collaboration with the Director of Deaf Studies at Georgia State University. A pilot session was then conducted for high-school aged students who identified as deaf or hard of hearing at the Georgia School for the Deaf using two ASL-certified interpreters and STB-certified instructors. Pre- and post-test surveys were conducted to ascertain knowledge, attitudes, and beliefs about bleeding control. A debriefing focus group was conducted at the conclusion. Content analysis techniques were used to evaluate the focus group. 18 DHH high school students whose primary language is American Sign Language (ASL) participated in the study. 15 completed pre-test and post-test surveys. Post-training assessments showed increased confidence in hemorrhage control techniques and reported value of learning life-saving skills such as tourniquet use. When asked if they would attempt to stop life-threatening bleeding, 27 % of participants said yes in the pre-test compared to 67 % in the post-test. 73 % felt confident stopping life-threatening bleeding in the post-test compared to 40 % in the pre-test. 8 of 9 students (89 %) recommended STB. We found that STB can be successfully adapted for the DHH community to promote life-saving techniques. Through collaborations with community members and language experts, implementation of modifications allowed for accessibility. To our knowledge, we created the first adaptation of STB for the DHH population to address this health disparity. Suggested future adaptations include emphasis on how to contact 911 for the DHH and ASL picture-in-picture adaptation for the video portion.