PROSPECTIVE STUDY ON PREVENTION AND TREATMENT OF VOICE PROBLEMS IN TEACHERS

描述（由申请人提供）：拟议的系列解决了教师声音问题的预防和治疗问题。文献中的数据清楚地表明，不仅在美国，而且在国际上，嗓音障碍都是教师的主要职业风险。此外，声音问题构成了全球女性健康问题。直到最近，关于教师这些问题的处理的报告还很少，而涉及同样重要的预防问题的报告就更少了。本研究的长期目标是确定有效的干预方法，以预防和治疗教师的声音问题，同时考虑到多元文化和语言因素。目前的研究将报告关于预防和治疗教师声音问题的两种理论驱动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“共振声音”发声培训（VH VP，本质上是Lessac-Madsen共振声音治疗计划）。参与者将是匹兹堡和香港的见习教师，他们将在作为专业教师就业的第二年中对学生教学进行跟踪。中心目标是：[1] 评估 VH 和 VH VP 在预防方案开始时声音健康的见习教师中未来出现嗓音问题的有效性，以及治疗已经达到一定水平的见习教师的嗓音问题； [2] 通过对干预措施进行适当的语言和文化调整，评估美国和中国教师研究结果的普遍性； [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。还将评估人体工程学和个人因素的不同能力，以预测教师未来声音问题的风险。研究结果应该在实践层面上有用，并且还应该为未来研究评估围绕预防教师声音问题的类似问题奠定基础，特别是受美国境内多元文化因素影响的问题。这些结果也应该对未来研究围绕这些问题进行干预的因果路径的研究有用。公共卫生相关性：：该项目的相关性与对预防和治疗教师声音问题的数据的需求有关。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妇女健康问题。尽管已经报道了一些关于治疗教师嗓音障碍的各种方法的有效性的数据，但迄今为止，文献中尚未报道有关预防嗓音障碍的前瞻性随机数据显示出可靠的结果。本系列将通过在美国和中国开展一个合作项目来解决这一差距，该项目评估声音卫生教育 (VH) 与声音卫生教育发声培训 (VH VP) 对于最初健康的学生教师和对声音问题更大的学生教师的价值。此外，远程医疗技术将得到完善和实施，可能在语音护理或言语病理学的其他领域得到更广泛的应用。

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.