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，但它们的设计并不能激励听力学家进行听力评估。对于R21研究的目标1，我们将开发一个用于基于社区的自动听力筛查的5个模块的软件套件，其目标是提供：1）低成本的听力筛查，并提供有关听力和听力损失的教育; 2）使用自动方法测试听觉灵敏度（AMTAS）的简化纯音听力图; 3）结果咨询; 4）助听器处理语音的演示，旨在激发治疗的兴趣;和5）后续建议。然后，我们将在目标2中增加两项额外的听力筛查测试：40 dB HL固定水平的纯音筛查;以及噪声中数字测试。纯音筛选试验将通过对AMTAS程序的简单修改来开发。我们将在美国（沃森et al. 2010）调整设计用于基于电话的听力筛查的噪声数字测试，以在计算机亭的耳机下使用。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，分为4组：对照组（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;以及噪声中数字测试。本试验将在4个研究中心共筛选2400例受试者：波特兰，OR和Bay Pines，FL的社区门诊（CBOCS）;明尼苏达州和威斯康星州的社区中心;以及哥伦布，OH的社区中心和健康博览会。据推测，5模块筛查和教育套件将激励更多的后续与听力学家在6个月的听力测试比纯音筛查单独或数字噪声测试单独。二次分析将涉及助听器使用率、基线沟通能力和人口统计学，如投保或未投保; VA或非VA，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，其中5个模块的套件加载在CD上，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，从而激励人们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一个负担得起的和有效的现实。 公共卫生相关性：我们将开发一个5个模块的自动听力筛查亭，旨在鼓励那些未能通过筛查的人进行听力测试。这将在一项随机临床试验中进行测试，该试验分为四组：对照组（无筛查）; 5模块自动筛查;简单纯音筛查;和噪声中数字筛查。我们还将研究来自不同地理和人口背景的参与者的结果如何不同。

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. PUBLIC HEALTH RELEVANCE: We will develop a 5-module automated hearing screening kiosk designed to motivate those who fail screening to follow up with a hearing test. This will be tested in a randomized clinical trial with four arms: control (no screening); 5-module automated screening; simple pure-tone screening; and digits-in-noise screening. We also will examine how results vary for participants from different geographical and demographic backgrounds.