PROSPECTIVE STUDY ON PREVENTION AND TREATMENT OF VOICE PROBLEMS IN TEACHERS

描述（由申请人提供）：建议的系列解决教师的声音问题的预防和治疗。文献中的数据清楚地表明，嗓音障碍不仅在美国，而且在国际上都是教师的主要职业风险。此外，嗓音问题也是全球妇女的健康问题。直到最近，很少有关于教师中这些问题的治疗的报告，更少的报告涉及同样重要的预防问题。本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，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。本研究将报告两种理论驱动的方法来预防和治疗教师的声音问题的有效性，（a）语音卫生教育（VH）和（B）语音卫生教育+语音生产培训“共鸣的声音”（VH+VP，基本上是Lessac-Madsen共鸣语音治疗计划）的实用数据。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的第二个完整的就业年中进行学生教学。中心目标是：[1]评估VH和VH+VP在方案开始时声音健康的实习教师中预防未来声音问题的有效性，以及在已经有一定程度声音问题的实习教师中治疗声音问题的有效性; [2]使用适当的语言和文化适应干预措施，评估美国和中国教师中发现的普遍性;以及[3]评估基于互联网的语音练习和报告程序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为他们的差异能力，以预测未来的教师语音问题的风险。结果应该是有用的，在实践层面上，也应该奠定了基础，为未来的研究评估类似的问题，周围的声音问题的预防教师，特别是在美国的多元文化因素的影响下，结果也应该是有用的，为未来的研究调查因果途径在这些问题的干预措施。公共卫生相关性：该项目的相关性与需要有关的数据，在教师的声音问题的预防和治疗。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，教师的嗓音问题也是妇女的健康问题。虽然一些数据已经报告了各种方法治疗教师嗓音障碍的有效性，但迄今为止，尚未有前瞻性随机数据显示在文献中报告了预防嗓音障碍的有力结果。本系列将通过在美国和中国开展的一个合作项目来解决这一差距，评估声音卫生教育（VH）与声音卫生教育+发声训练（VH+VP）对于最初健康的学生教师与更关注声音的学生教师的价值。此外，远程保健技术将得到完善和实施，可能在语音护理或语音语言病理学的其他领域更普遍的应用。

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.