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.

抽象的 听力损失是全球残疾的主要原因之一，资源有限的燃烧最高 设置（RLS）。鉴于对孩子的神经认知和社会的决心，儿童受到了不成比例的影响 开发，但是如果发现并早点治疗，这些影响可以得到缓解。近60％的听力损失 儿童是由于可预防的因素所致，并且识别是解决听力损失的第一步。高收入 各国已经实施了新生儿听力筛查（UND）计划，其目标是诊断 听力损失和生命的头几个月开始早期干预。很少有可比较的程序 和中等收入国家，鉴于诸如获得受过训练的人员和高昂听力成本的障碍 筛选设备。 我们建议优化一种低成本的智能手机耳声排放（OAE）设备，以进行听力筛查和 在RLS中研究实施。智能手机OAE可与常规听力筛选相媲美 在美国试验中的设备，现在必须评估其影响最大的地方。 R21的目的 将在肯尼亚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，筛选的评估一致性以及比较前线和 外行医疗设施工人，可提供低成本，用户友好的OAE，这是低 - 低 - 可行的工具 资源临床环境。工作将开始直接整合智能手机OAE的听力筛查结果 肯尼亚的电子病历系统。 R33将进一步建立实施成果，并 智能手机OAE设备在UNHS计划中的有效性，并将对 在肯尼亚语境中实施策略和任务转移。同时，R33将部署智能手机 OAE在一项纵向研究（HIV暴露）和已知的（有积液的中耳炎）风险因素的纵向研究中 听力损失。纵向研究将利用其他创新的外行友好智能手机工具 可以用来监视中耳流体，这是儿童听力筛查的重要伴侣 通常依靠昂贵的技能密集型设备。研究团队包括医疗提供者，公众 肯尼亚的健康研究人员，计算机科学家和技术工作组 卫生部，一项合作，将在项目完成后支持计划可持续性。这 项目为UNHS计划，高风险婴儿监视，耳毒性建立了智能手机OAE的基础 监测以及未来的研究，以理解和改善RLS的耳朵和听力护理。结果的结果 与世界卫生组织报告的目标相符 听力损失，可以在2030年之前获得高质量服务而没有经济困难。