Community-Based Kiosks for Hearing Screening and Education

描述（由申请人提供）：目前的听力筛查测试在识别听力损失个体方面是有用的，但它们并不是设计用来激励听力学家进行听力评估的随访。对于R21研究的第一个目标，我们将开发一个5个模块的基于社区的自动听力筛查软件套件，目标是提供：1)低成本的听力筛查以及听力和听力损失教育；2)使用听觉灵敏度自动测试法（AMTAS）的简略纯音听力图；3)结果咨询；4)助听器处理语音的演示，旨在激发对治疗的兴趣；5)后续建议。然后，我们将在目标2中增加两个额外的听力筛查测试：固定水平为40 dB HL的纯音筛查；还有一个数字噪声测试。纯音筛选测试将通过对AMTAS程序的简单修改而开发。我们将调整为美国基于电话的听力筛查设计的噪声数字测试（Watson et al. 2010），以便在计算机kiosk中戴着耳机使用。R33研究的主要目标是开展一项基于社区的听力筛查的随机临床试验，分为四组：对照组（未筛查）；5模块软件套件筛选；固定水平的纯音筛选；还有数字噪声测试。共有2400名受试者将在四个地点进行试验筛选：俄勒冈州波特兰和佛罗里达州湾松的社区门诊诊所（CBOCS）；明尼苏达州和威斯康星州的社区中心；以及俄亥俄州哥伦布市的社区中心和健康博览会。据推测，与单纯的纯音筛查或单纯的数字噪声测试相比，5个模块的筛查和教育套件将促使更多的听力学家在6个月时进行听力测试。二次分析将关注助听器的使用情况、基线沟通能力和人口统计数据，如参保或未参保；退伍军人或非退伍军人，城市与农村通过筛查检查获得听力保健的问题。我们还将进行一项试点研究，将5个模块套件装入CD，并与耳机和声卡一起包装，用于家庭听力测试。如果在临床试验中取得成功，这种自动听力筛查方法可以极大地扩大人们获得负担得起的听力筛查的机会，从而激励个人进入这个国家的听力保健系统。最终在互联网上的应用可以真正使自动听力筛查成为负担得起的和有效的现实。

DESCRIPTION (provided by applicant): Current hearing-screening tests are useful in identifying individuals with hearing loss, but they are not designed to motivate follow-up with audiologists for hearing evaluation. For Aim 1 of the R21 study, we will develop a 5-module software suite for community-based automated hearing screening with the goal of providing: 1) low-cost hearing screening with education about hearing and hearing loss; 2) an abbreviated pure-tone audiogram using the Automated Method for Testing Auditory Sensitivity (AMTAS); 3) counseling on the results; 4) a demonstration of hearing-aid processed speech designed to motivate interest in treatment; and 5) recommendations for follow up. We will then add two additional hearing screening tests in Aim 2: a pure-tone screening at a fixed level of 40 dB HL; and a digits-in-noise test. The pure-tone screening test will be developed with a simple modification of the AMTAS program. We will adapt the digits-in-noise test designed for telephone-based hearing screening in the United States (Watson et al. 2010) for use under headphones in a computer kiosk. The main goal of the R33 study is to conduct a randomized clinical trial of community-based hearing screening with 4 arms: control (no screening); screening with the 5-module software suite; a pure-tone screening at a fixed level; and the digits-in-noise test. A total of 2400 subjects will be screened in the trial at four sites: Community-based Outpatient Clinics (CBOCS) in Portland, OR, and Bay Pines, FL; community centers in Minnesota and Wisconsin; and community centers and health fairs in Columbus, OH. It is hypothesized that the 5-module screening and education suite will motivate greater follow up with an audiologist for a hearing test at 6 months than pure-tone screening alone or the digits-in-noise test alone. Secondary analyses will concern hearing aid uptake, baseline communication ability, and demographics such as insured or not insured; VA or non-VA, and urban versus rural to examine issues of access to hearing health care through screening. We will also conduct a pilot study in which the 5-module suite is loaded on a CD and packaged with earphones and a sound card for a Home Hearing Test. If shown successful in a clinical trial, this method of automated hearing screening could greatly expand access to affordable hearing screening that motivates individuals to enter the hearing healthcare system in this country. Eventual application on the internet could truly make automated hearing screening an affordable and effective reality.