RR&D Research Career Scientist Award Application

持续至少6个月的原发(感觉神经性)耳鸣通常是一种无法治愈的永久性疾病。 可用。耳鸣令人烦恼的退伍军人必须依靠旨在减少情绪和 对耳鸣的功能性反应。亨利博士的研究活动集中在以证据为基础的 支持这些方法的研究，并将这些方法传播到退伍军人管理局以及非退伍军人管理局 国内和国际观众。在他30年的退伍军人研究生涯中，包括20份退伍军人研究拨款， 亨利博士领导的一个研究团队开发了进行性耳鸣管理(PTM)，这是一种多用途的 纪律分步护理方法，旨在有效地实施在繁忙的退伍军人管理局诊所。五个层次的 护理包括1级转诊、2级听力学评估、3级技能教育、4级跨学科 评估，以及5级个性化支持。第1级包含针对任何提供商的推荐指南 遇到抱怨耳鸣的病人。2级包括听力测试，短暂的耳鸣评估， 助听器，如果需要的话，还有短暂的耳鸣咨询。亨利博士的团队已经完成了两个随机的 评估助听器和组合仪器使用情况的对照试验(内置助听器) 在声音发生器中)，用于耳鸣治疗。这些RCT验证了这两种类型的耳平设备为 对耳鸣治疗有效-结果与唯一的其他可比RCT和 支持PTM Level 2听力评估，作为任何PTM计划的门户。需要耳鸣的病人 建议2级以上的服务人员参加3级技能培训，包括五个课程(个人或 教育咨询小组)，以学习针对烦人的耳鸣的自我护理技能。其中两个课程是 由一位教授基于声音的治疗原理的听觉学家进行，三次由一位 管理认知-行为疗法(CBT)组成部分的精神健康提供者。在他最近的退伍军人事务部- 在资助的项目中，亨利博士在田纳西州孟菲斯的两个退伍军人医疗中心领导了一项“临床嵌入式”随机对照试验。 和康涅狄格州西黑文-揭示了PTM Level 3技能教育的有效性。然后他领导了第二次RCT， 评估电话管理版本的第三级技能教育(“Tele-PTM”)，它展示了 远程咨询治疗烦扰性耳鸣的疗效观察。加在一起，这四个RCT提供了一个证据 为耳鸣提供有效的临床服务的基地，无论是在临床上还是通过远程医疗，这解决了 耳鸣是绝大多数患有这种无形疾病的退伍军人所需要的。数量非常少的 患者需要4级和5级服务。自2009年以来，退伍军人事务部国家听力和言语病理学 (ASP)服务部门已认可PTM为退伍军人管理局治疗耳鸣的标准，自那以来，Henry博士和 他的团队进行了多次培训，并为数百名临床医生提供了个别咨询 为退伍军人提供耳鸣服务。亨利博士还领导了一项纵向流行病学研究，该研究包括 现场研究包括NCRAR(主站点)和德克萨斯州圣安东尼奥的国防部卓越听证会中心。至 到目前为止，已有近500名退伍军人和现役军人登记在册。除了他的研究 活动，亨利博士一直致力于发展下一代耳鸣和 康复研究人员，支持博士后和博士后研究员的培训，退伍军人管理局职业发展 奖励受赠者和临床医生研究人员，因为他们开发了独立的康复研究路线。这 导师关系产生了许多共同撰写的科学手稿和合作研究拨款 在他的实习生中。亨利博士是公认的耳鸣康复研究和国际专家 发展，为退伍军人事务部和国家卫生研究院国家和国际科学审查小组寻求专业知识 研究合作和咨询，以及培训下一代耳鸣临床医生和 研究人员。最重要的是，他对耳鸣临床治疗的持续贡献将继续 让退伍军人的健康和功能在未来几十年有所不同。

Primary (sensorineural) tinnitus of at least 6 months duration is usually a permanent condition with no cure available. Veterans whose tinnitus is bothersome must rely on methods designed to reduce emotional and functional reactions to tinnitus. Dr. Henry's research activities are focused on producing evidence-based research supporting such methods, and disseminating these methods throughout VA as well as to non-VA national and international audiences. Over his 30-year VA research career, including 20 VA research grants, Dr. Henry has led a research team that has developed Progressive Tinnitus Management (PTM), a multi- disciplinary stepped-care method designed to be efficiently implemented in busy VA clinics. The five levels of care include Level 1 Referral, Level 2 Audiologic Evaluation, Level 3 Skills Education, Level 4 Interdisciplinary Evaluation, and Level 5 Individualized Support. Level 1 consists of referral guidelines for any provider encountering patients who complain of tinnitus. Level 2 involves audiologic testing, brief tinnitus assessment, hearing aids if needed, and brief tinnitus counseling. Dr. Henry's team has completed two randomized controlled trials (RCTs) to evaluate the use of hearing aids and combination instruments (hearing aid with built- in sound generator) for tinnitus management. These RCTs validated both types of ear-level devices as efficacious for tinnitus management—findings that were consistent with the only other comparable RCT and supporting PTM Level 2 Audiologic Evaluation as the gateway of any PTM program. Patients requiring tinnitus services beyond Level 2 are advised to attend Level 3 Skills Education, involving five sessions (individual or group) of educational counseling to learn self-care skills for bothersome tinnitus. Two of the sessions are conducted by an audiologist who teaches the principles of sound-based therapy, and three are taught by a mental health provider who administers components of Cognitive-Behavioral Therapy (CBT). In his recent VA- funded projects, Dr. Henry led a “clinically embedded” RCT at two VA medical centers—Memphis, Tennessee, and West Haven, Connecticut—revealing efficacy of PTM Level 3 Skills Education. He then led a second RCT, evaluating a telephone-administered version of Level 3 Skills Education (“Tele-PTM”), which demonstrated the efficacy of remote counseling for bothersome tinnitus. Combined, these four RCTs have provided an evidence base for providing effective clinical services for tinnitus, either in the clinic or via telehealth, which address the tinnitus needs for the great majority of Veterans suffering from this invisible condition. A very small number of patients require Level 4 and Level 5 services. Since 2009, the VA National Audiology and Speech Pathology (ASP) Service has endorsed PTM as the VA standard of care for tinnitus and, since this time, Dr. Henry and his team have conducted numerous trainings and provided individual consultation to hundreds of clinicians providing tinnitus services to Veterans. Dr. Henry is also leading a longitudinal epidemiology study This multi- site study includes the NCRAR (main site) and the DoD Hearing Center of Excellence in San Antonio, TX. To date, almost 500 Veterans and active Service Members have been enrolled. In addition to his research activities, Dr. Henry has been committed to the development of the next generation of tinnitus and rehabilitation researchers, supporting the training of pre- and postdoctoral fellows, VA career development award grantees, and clinician researchers as they develop independent lines of rehabilitation research. This mentorship has resulted in numerous co-authored scientific manuscripts and collaborative research grants among his trainees. Dr. Henry is recognized as an international expert in tinnitus rehabilitation research and development, whose expertise is sought for VA and NIH scientific review panels, national and international research collaborations and consultations, and training of the next generation of tinnitus clinicians and researchers. Most importantly, his ongoing contributions to the clinical management of tinnitus will continue to make a difference in Veterans' health and functioning for decades to come.