RR&D Research Career Scientist Award Application

原发性（感音神经性）耳鸣至少持续6个月，通常是一个永久性的条件，无法治愈 available.退伍军人的耳鸣是麻烦必须依靠的方法，旨在减少情绪和 耳鸣的症状有哪些？亨利博士的研究活动侧重于产生基于证据的 支持这些方法的研究，并在整个VA以及非VA中传播这些方法 国内和国际观众。在他30年的退伍军人管理局研究生涯中，包括20个退伍军人管理局研究赠款， 博士亨利领导了一个研究小组，开发了渐进式时间管理（PTM），一个多方面的管理方法。 纪律阶梯式护理方法，旨在有效地实施在忙碌VA诊所。的五个层次 护理包括1级转诊，2级听力评估，3级技能教育，4级跨学科 第五级个性化支持。第1级包括任何提供者的转介指南 耳鸣的症状有哪些？2级包括听力测试，简短的耳鸣评估， 助听器，如果需要的话，和简短的耳鸣咨询。亨利博士的团队已经完成了两个随机 对照试验（RCT），以评估助听器和组合仪器（助听器内置， 在声音发生器中）用于耳鸣管理。这些随机对照试验验证了这两种类型的耳位设备， 有效的耳鸣管理-结果与唯一的其他可比RCT一致， 支持PTM 2级听力评估作为任何PTM计划的网关。需要耳鸣的患者 建议2级以上的服务人员参加3级技能教育，包括5个课程（个人或 组）的教育咨询，学习自我护理技能的困扰耳鸣。其中两次会议是 由一位教授声音治疗原理的听力学家主持，三位由一位 管理认知行为疗法（CBT）组成部分的心理健康提供者。在他最近的一次采访中， 资助的项目，亨利博士领导了一个“临床嵌入式”随机对照试验在两个退伍军人医疗中心-孟菲斯，田纳西州， 和康涅狄格州西黑文-揭示PTM 3级技能教育的功效。然后他领导了第二个RCT， 评估电话管理版本的3级技能教育（“电话PTM”），这表明， 远程咨询治疗耳鸣的疗效。结合起来，这四项随机对照试验提供了证据， 为耳鸣提供有效的临床服务的基础，无论是在诊所还是通过远程医疗， 耳鸣需要为绝大多数退伍军人患有这种无形的条件。极少数 患者需要4级和5级服务。自2009年以来，VA国家听力学和言语病理学 (ASP)服务已认可PTM作为护理耳鸣的VA标准，从这个时候起，亨利博士和 他的团队进行了大量的培训，并为数百名临床医生提供了个人咨询 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。 现场研究包括NCRAR（主现场）和位于德克萨斯州圣安东尼奥的国防部听力卓越中心。到 截至目前，已有近500名退伍军人和现役军人报名参加。除了他的研究 活动，亨利博士一直致力于下一代耳鸣的发展， 康复研究人员，支持博士前和博士后研究员的培训，VA职业发展 奖励受资助者和临床研究人员，因为他们开发了独立的康复研究路线。这 导师制产生了许多共同撰写的科学手稿和合作研究赠款 在他的学员中。亨利博士是公认的耳鸣康复研究的国际专家， 发展，其专业知识是寻求VA和NIH科学审查小组，国家和国际 研究合作和咨询，并培训下一代耳鸣临床医生， 研究人员最重要的是，他对耳鸣临床管理的持续贡献将继续， 使退伍军人的健康和功能的几十年来的差异。

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.