PROSPECTIVE STUDY ON PREVENTION AND TREATMENT OF VOICE PROBLEMS IN TEACHERS

描述（由申请人提供）：拟议的系列讨论教师声音问题的预防和治疗。无论是在美国还是在国际上，文献中的数据都清楚地表明声音障碍是教师的主要职业风险。此外，声音问题是一个全球性的妇女健康问题。直到最近，关于如何治疗教师的这些问题的报道还很少，而关于同样重要的预防问题的报道就更少了。目前的研究是在一个长期目标的背景下进行的，以确定有效的干预方法来预防和治疗教师的语音问题，同时考虑到多元文化和语言因素。本研究将报告围绕两种理论驱动方法的有效性的实用数据，(a)语音卫生教育（VH）和(b)语音卫生教育+“共振语音”的语音生产培训（VH+VP，本质上是Lessac-Madsen共振语音治疗计划）。参与者将是匹兹堡和香港的学生教师，他们将在作为专业教师就业的第二年完成学生教学。中心目标是：b[1]评估VH和VH+VP在协议开始时声音健康的学生教师中预防未来声音问题的有效性，与已经有一定程度声音问题的学生教师的治疗效果相比；b[2]评估美国和中国教师调查结果的普遍性，使用适当的语言和文化适应干预措施；b[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评估他们预测教师未来声音问题风险的不同能力。这些结果在实践层面上应该是有用的，并且应该为未来的研究奠定基础，评估围绕教师声音问题的预防的类似问题，特别是受美国多元文化因素的影响。这些结果也应该对未来调查这些问题干预的因果途径的研究有用。公共卫生相关性：：该项目的相关性在于需要有关预防和治疗教师声音问题的数据。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，教师的声音问题也是妇女的健康问题。虽然已经有一些数据报道了各种方法治疗教师语音障碍的有效性，但迄今为止，尚无前瞻性随机数据报告显示有关预防语音障碍的可靠结果。本系列将通过参与美国和中国的一个合作项目来解决这一差距，评估语音卫生教育（VH）与语音卫生教育+语音生产培训（VH+VP）的价值，对最初健康的学生教师和更关注语音的学生教师进行评估。此外，远程医疗技术将被改进和实施，可能在语音护理或语言病理学的其他领域有更广泛的应用。

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.