mHealth OAE: Towards Universal Newborn Hearing Screening in Kenya (mTUNE)

mHealth OAE：迈向肯尼亚全民新生儿听力筛查 (mTUNE)

• 批准号: 10738905
• 负责人: SARAH F. BENKI-NUGENT
• 金额: $ 14.79万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-15 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10738905
• 关键词: 5 year old; Acute; Address; Adopted; Adoption; Affect; Age; Age Months; Audiology; Birth; Caring; Cellular Phone; Child; Childhood; Chronic; Clinical; Collaborations; Community Health Aides; Companions; Computers; Conductive hearing loss; Country; Coupled; Data; Detection; Development; Devices; Diagnosis; Ear; Early Diagnosis; Early Intervention; Early treatment; Economics; Education; Emergency Situation; Environment; Epidemiology; Equipment; Evaluation; Exhibits; Exposure to; Financial Hardship; Foundations; Friends; Goals; HIV; Health; Health care facility; Hearing; Hearing Aids; Hospitals; Human Resources; Incidence; Income; Infant; Infection; Inflammation; Intervention; Kenya; Life; Liquid substance; Location; Longitudinal Studies; Medical; Monitor; Neonatal Screening; Neurocognitive; Newborn Infant; Noise; Nurses; Otitis Media; Otitis Media with Effusion; Otolaryngology; Outcome; Patients; Pediatrics; Penetration; Persons; Population; Program Sustainability; Protocols documentation; Provider; Public Health; Reporting; Research; Research Personnel; Resource-limited setting; Resources; Risk; Risk Factors; School-Age Population; Scientist; Screening Result; Sensitivity and Specificity; Services; Social Development; Surveys; Techniques; Testing; Time; Training; Work; aged; childhood hearing loss; community clinic; computer science; cost; deaf; disability; electronic medical record system; experience; hearing impairment; hearing loss risk; hearing screening; high risk; high risk infant; implementation evaluation; implementation outcomes; implementation science; implementation strategy; improved; innovation; interest; low and middle-income countries; mHealth; middle ear; middle ear fluid; modifiable risk; open source; otoacoustic emission; ototoxicity; permanent hearing loss; preference; prenatal exposure; prevent hearing loss; programs; public health relevance; scale up; screening; screening program; skills; tool; usability; user-friendly; willingness; working group

ABSTRACT Hearing loss is among the leading causes of disability worldwide, with the highest burden in resource limited settings (RLS). Children are disproportionately affected, given the detriment to a child’s neurocognitive and social development, yet the impacts can be mitigated if detected and treated early. Nearly 60% of hearing loss in children is due to preventable factors, and identification is the first step in addressing hearing loss. High income countries have implemented universal newborn hearing screening (UNHS) programs with a goal of diagnosing hearing loss and starting early intervention in the first few months of life. Few comparable programs exist in low and middle income countries, given such barriers as limited access to trained personnel and high cost of hearing screening equipment. We propose to optimize a low-cost smartphone otoacoustic emissions (OAE) device for hearing screening and study the implementation in an RLS. The smartphone OAE is comparable to conventional hearing screening equipment in US trials and now must be evaluated where it can have the greatest impact. The aims of the R21 are to optimize the OAE device in various clinical settings and patient ages in Kenya. We will evaluate potential impact of noisy clinical environments, assess consistency of screening, and compare usability in frontline and lay health facility workers, with a deliverable of a low-cost, user-friendly OAE that is a feasible tool in a low- resource clinical setting. Work will begin to integrate hearing screening results from the smartphone OAE directly with electronic medical records systems in Kenya. The R33 will further establish implementation outcomes and validity of the smartphone OAE device in a UNHS program, and will provide an in-depth evaluation of the implementation strategy and task-shifting in the Kenyan context. In parallel, the R33 will deploy the smartphone OAE in a longitudinal study of suspected (HIV exposure) and known (otitis media with effusion) risk factors for hearing loss. The longitudinal study will leverage an additional innovative lay-person friendly smartphone tool that can be used to monitor for middle ear fluid, an important companion for hearing screening in children that typically relies on expensive, skill intensive equipment. The research team includes medical providers, public health researchers, computer scientists and the Technical Working Group for Ear and Hearing Care in Kenya’s Ministry of Health, a collaboration that will support program sustainability when the project is complete. The project establishes a foundation for smartphone OAE in UNHS programs, high-risk infant surveillance, ototoxicity monitoring, and future research to understand and improve ear and hearing care in RLS. The outcomes of this work align with the goals of the WHO World Report on Hearing, which strives for all people, including those with hearing loss, to have access to high-quality services without experiencing financial hardship by 2030.

摘要 听力损失是全球残疾的主要原因之一，在资源有限的情况下负担最重 设置（RLS）。由于对儿童的神经认知和社交能力的损害， 发展的影响，但如果及早发现和处理，可以减轻影响。近60%的听力损失 儿童听力损失是由于可预防的因素造成的，而识别是解决听力损失的第一步。高收入 许多国家已经实施了普遍的新生儿听力筛查（UNHS）计划，目的是诊断 听力损失，并在生命的最初几个月开始早期干预。在低收入国家， 鉴于获得训练有素人员的机会有限和听证费用高昂等障碍， 筛选设备 我们建议优化一种低成本的智能手机耳声发射（OAE）设备，用于听力筛查， 研究在RLS中的实现。智能手机OAE与传统听力筛查相当 设备在美国的试验，现在必须进行评估，它可以有最大的影响。R21的目标 是在肯尼亚的各种临床环境和患者年龄中优化OAE设备。我们将评估潜力 噪声临床环境的影响，评估筛选的一致性，并比较一线和 非专业卫生设施工作者，提供低成本、用户友好的OAE，这是一个可行的工具， 资源临床设置。将开始直接整合智能手机OAE的听力筛查结果 在肯尼亚建立了电子医疗记录系统R33将进一步确定实施成果， 智能手机OAE设备在UNHS计划中的有效性，并将提供对 在肯尼亚的情况下，执行战略和任务转移。同时，R33将部署智能手机 OAE在疑似（HIV暴露）和已知（渗出性中耳炎）风险因素的纵向研究中的应用 听力损失纵向研究将利用一个额外的创新外行友好的智能手机工具 可用于监测中耳液，这是儿童听力筛查的重要伴侣， 通常依赖于昂贵的、技能密集型的设备。该研究小组包括医疗提供者，公共 健康研究人员，计算机科学家和肯尼亚耳和听力护理技术工作组 卫生部，一个合作，将支持计划的可持续性，当项目完成。的 该项目为UNHS项目中的智能手机OAE、高危婴儿监测、耳毒性奠定了基础 监测和未来的研究，以了解和改善RLS的耳朵和听力护理。这个结果 工作与世卫组织《世界听力报告》的目标保持一致，该报告致力于为所有人服务，包括那些患有 听力损失，到2030年获得高质量的服务，而不会遇到经济困难。