According to the Table 2, poor health literacy and limited access to health information and health care services have been affected by communication and language barriers. Given the literature, communication barrier is common among known obstacles such as language barrier and interpersonal factors. Table 2: a summary of studies on difficulties in access to health information as a start point of health literacy process
3- Facilitators
Researchers have recommended four facilitators for the improving health literacy, including legal activities to reduce health disparities, providing sign language interpreter services, training health care providers about effective communication …show more content…
. Health information availability is the starting point of the health literacy. According to the literature, deaf individuals have not accessed to health information because of the lack of deaf-tailored health information resources (Kushalnagar et al., 2015), and limited access to the current health information (Jones et al., 2005). Deaf community has another problem in health-related cognition as the complexity of medical terms (Pollard Jr & Barnett, 2009) and low literacy and limited readability skills (Neuhauser et al., 2013). In fact, low health literacy means the limited knowledge of health-related issues. For instance, limited knowledge of medical conditions and symptoms of diseases has been demonstrated in the previous studies (Berman et al., 2013; Goldstein et al., 2010; Hanass-Hancock & Satande, 2010; Margellos-Anast et al., 2006; Sacks et al., 2013) . Besides, inadequate knowledge of disease prevention (Zazove et al., 2012), medical screening tests (Orsi et al., 2007) and preventive health services (McKee, Barnett, Block, & Pearson, 2011) have been indicated in the literature. The impact of higher education, English proficiency and obtaining health information from the book, the Internet and health care providers in the deaf health knowledge promotion has been revealed in the previous study (Zazove et al., 2009). Hence, it is necessary to identify the barriers to access to health information for the deaf, as unless the removal of these obstacles, deaf people may not become health literate individuals. Common barriers deaf community face in health care environment have discussed