PROSPECTIVE STUDY ON PREVENTION AND TREATMENT OF VOICE PROBLEMS IN TEACHERS

简介(申请者提供)：建议的系列内容涉及教师发声问题的预防和治疗。文献中的数据清楚地将嗓音障碍视为教师的主要职业风险，不仅在美国，在国际上也是如此。此外，声音问题构成了全球妇女健康问题。直到最近，关于教师这些问题的治疗的报告还很少，而同样重要的预防问题的报告就更少了。目前的研究是在一个长期目标的背景下进行的，目的是确定有效的干预方法，以预防和治疗教师的声音问题，同时考虑到多种文化和语言因素。本研究将报告两种预防和治疗教师声音问题的理论驱动的方法的有效性的实用数据，(A)声音卫生教育(VH)和(B)声音卫生教育“共鸣声音”发声培训(VH VP，实质上是Lessac-Madsen共鸣声音治疗计划)。参与者将是匹兹堡和香港的实习教师，他们将在受聘为专业教师的第二个完整年中跟踪学生教学。中心目标是：[1]评估VH和VH VP对预防在协议开始时嗓音健康的实习教师中未来嗓音问题的有效性，与对已有嗓音问题的实习教师的治疗进行比较；[2]评估研究结果在美国和中国教师中的普遍性，使用对干预措施的适当的语言和文化调整；以及[3]评估基于互联网的语音练习和报告计划作为面对面干预的补充的可行性。人体工程学和个人因素也将被评估，以区分它们预测教师未来声音问题的风险的能力。这些结果在实践层面上应该是有用的，也应该为未来评估关于预防教师嗓音问题的类似问题的研究奠定基础，特别是在美国国内受到多元文化因素影响的情况下。这些结果也应该有助于未来研究围绕这些问题进行干预的因果路径。公共卫生相关性：该项目的相关性与需要有关预防和治疗教师发声问题的数据有关。这些问题是教师的主要职业危害，影响着美国乃至全球的教师。此外，教师的声音问题构成了对女性健康的担忧。虽然已经有一些关于各种方法治疗教师发声障碍的有效性的数据报道，但到目前为止，还没有关于预防发声障碍的文献报道显示出强有力的结果的前瞻性随机数据。本系列将通过参与一个美国和中国的合作项目来解决这一差距，评估语音卫生教育(VH)和语音卫生教育(VH VP)对最初健康的实习教师和对语音问题更关注的实习教师的价值。此外，还将改进和实施一项远程医疗技术，该技术可能会应用于其他领域的语音护理或更广泛的语言病理学。

DESCRIPTION (provided by applicant): The proposed series addresses the prevention and treatment of voice problems in teachers. Data in the literature clearly identify voice disorders as teachers' primary occupational risk not only in the U.S. but also internationally. Moreover, voice problems constitute a global women's health concern. Until recently, few reports have been available around the treatment of these problems in teachers, and even fewer have addressed the equally important question of prevention. The present studies are conducted within the context of a long-range goal to identify effective intervention methodologies for both the prevention and treatment of voice problems in teachers taking into consideration multicultural and linguistic factors. The present studies will report pragmatic data around the effectiveness of two theoretically-driven approaches to the prevention and treatment of voice problems in teachers, (a) voice hygiene education (VH) and (b) voice hygiene education + voice production training in "resonant voice" (VH+VP, essentially the Lessac-Madsen Resonant Voice Therapy program). Participants will be student teachers in Pittsburgh and Hong Kong, who will be followed from student teaching across their second full year of employment as a professional teacher. The central aims are: [1] to evaluate the effectiveness of VH and VH+VP for the prevention of future voice problems in student teachers who are vocally healthy at the outset of the protocol, versus the treatment of voice problems in student teachers who already have them at some level; [2] to evaluate the generality of the findings across teachers in the U.S. and China, using appropriate linguistic and cultural adaptations of the interventions; and [3] to evaluate the feasibility of an internet-based voice exercise and reporting program as a supplement to face-to-face interventions. Ergonomic and personal factors will also be evaluated for their differential ability to predict the risk for future voice problems in teachers. The results should be useful at a practical level, and should also lay the groundwork for future studies assessing similar issues around the prevention of voice problems in teachers, in particular as influenced by multicultural factors within the U.S. The results should also be useful for future studies investigating causal pathways in interventions around these problems. PUBLIC HEALTH RELEVANCE:: The relevance of the project has to do with the need for data around the prevention and treatment of voice problems in teachers. Such problems are teachers' primary occupational hazard, and affect teachers within the U.S. and also globally. Moreover, voice problems in teachers constitute a women's health concern. Although some data have been reported about the effectiveness of various approaches to the treatment of voice disorders in teachers, thus far no prospective randomized data showing robust results have been reported in the literature around the prevention of them. This present series will address this gap by engaging in a collaborative project across the U.S. and China assessing the value of voice hygiene education (VH) versus voice hygiene education + voice production training (VH+VP) for initially healthy student teachers versus student teachers who greater voice concerns. Also, a telehealth technology will be refined and implemented that may have applications in other domains of voice care or speech-language pathology more generally.