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的个人方面很有用，但它们的设计并不是为了激励听力专家进行听力评估的后续行动。对于R21研究的目标1，我们将开发一个基于社区的自动听力筛查的5模块软件套件，目的是提供：1)低成本的听力筛查，提供有关听力和听力损失的教育；2)使用自动听力敏感度测试方法(AMTAS)的简明纯音听力图；3)结果咨询；4)旨在激发治疗兴趣的助听器处理语音演示；以及5)后续建议。然后，我们将在AIM 2中增加两个额外的听力筛查测试：40分贝HL固定水平的纯音筛查；以及数字噪声测试。纯音筛选测试将通过对AMTAS程序的简单修改来开发。我们将采用为美国基于电话的听力筛查而设计的噪声中数字测试(Watson等人)。2010)，用于在电脑亭的耳机下面使用。R33研究的主要目标是进行一项基于社区的听力筛查的随机临床试验，共4组：对照(无筛查)；使用5模块软件套件进行筛查；固定水平的纯音筛查；以及数字噪声测试。共有2400名受试者将在四个地点进行筛查：俄勒冈州波特兰市的社区门诊诊所(CBOCS)和佛罗里达州的Bay Pines；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，5个模块的筛查和教育套件将促使听力专家在6个月后进行听力测试，而不是单纯的纯音筛查或噪声中的数字测试。二次分析将涉及助听器摄入量、基线沟通能力和人口统计数据，如参保或未参保；退伍军人管理局或非退伍军人管理局，以及城市与农村，以检查通过筛查获得听力保健的问题。我们还将进行一项试点研究，将5个模块的套装在CD上，并与耳机和声卡打包，用于家庭听力测试。如果在临床试验中被证明是成功的，这种自动化听力筛查方法可以极大地扩大获得负担得起的听力筛查的机会，从而激励个人进入美国的听力保健系统。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.