RR&D Research Career Scientist Award Application

RR

• 批准号: 10359076
• 负责人: JAMES A HENRY
• 金额: --
• 依托单位: PORTLAND VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-04-01 至 2022-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10359076
• 关键词: Academic advising; Academy; Achievement; Address; Adopted; Adult; American; Annual Reports; Area; Audiology; Auditory; Award; Books; Caring; Chronic; Clinic; Clinical; Clinical Management; Clinical Services; Clinical Trials; Cognitive Therapy; Collaborations; Connecticut; Consultations; Counseling; Development; Devices; Disease; Ear; Education; Educational Background; Emotional; Enrollment; Epidemiology; Evaluation; Exposure to; Family Practice; Funding; Goals; Grant; Guidelines; Head and Neck Surgery; Health; Health Personnel; Healthcare; Hearing; Hearing Aids; Individual; International; Journals; K-Series Research Career Programs; Language; Lead; Learning; Manuscripts; Masks; Measures; Medical center; Mental Health; Mentors; Mentorship; Methodology; Methods; Military Medicine; Military Personnel; Noise; Otolaryngology; Outcome; Pamphlets; Patients; Peer Review; Perception; Postdoctoral Fellow; Prevalence; Provider; Psychoacoustics; Publications; Publishing; Quality of life; Questionnaires; Randomized Controlled Trials; Reaction; Recommendation; Rehabilitation therapy; Research; Research Activity; Research Personnel; Research Project Grants; Research Support; Scientist; Self Care; Services; Site; Speech; Speech Pathology; Symptoms; System; Talents; Telephone; Tennessee; Testing; Time; Tinnitus; Training; Training Support; United States National Institutes of Health; Veterans; Work; active duty; auditory rehabilitation; base; career; clinical care; clinical material; clinical practice; cost effective; design; disability; epidemiology study; evidence base; experience; graduate student; hazard; improved; indexing; instrument; military veteran; multidisciplinary; next generation; programs; rehabilitation research; research and development; self help; service member; skills; sound; standard of care; telecoaching; telehealth; tinnitus retraining therapy; trend

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.

持续时间至少 6 个月的原发性（感音神经性）耳鸣通常是永久性病症，无法治愈 耳鸣困扰的退伍军人必须依靠旨在减少情绪和耳鸣的方法。 亨利博士的研究活动侧重于产生基于证据的功能性反应。 支持此类方法的研究，并将这些方法在整个 VA 以及非 VA 中传播 在他 30 年的 VA 研究生涯中，包括 20 项 VA 研究资助， Henry 博士领导的研究团队开发了渐进式耳鸣管理 (PTM)，这是一种多方 纪律分级护理方法旨在在繁忙的 VA 诊所中有效实施 五个级别。 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 评估和 5 级个性化支持 1 级包括针对任何提供者的推荐指南。 遇到 2 级耳鸣的患者需要进行听力测试、简短的耳鸣评估、 亨利博士的团队已经完成了两次随机的助听器（如果需要）和简短的耳鸣咨询。 对照试验 (RCT) 评估助听器和组合仪器（内置助听器）的使用情况 用于耳鸣管理的随机对照试验验证了两种类型的耳平设备。 对耳鸣管理有效——结果与唯一其他可比较的随机对照试验一致 支持 PTM 2 级听力学评估作为任何需要耳鸣的患者的门户。 建议超过 2 级的服务参加 3 级技能教育，包括五次课程（个人或 小组）的教育咨询，学习针对烦人的耳鸣的自我护理技能，其中两个课程是。 由教授声音治疗原理的听力学家进行，其中三项由一位听力学家教授 在他最近的 VA- 中进行认知行为治疗 (CBT) 的心理健康提供者。 在资助的项目中，亨利博士在两个退伍军人管理局医疗中心（田纳西州孟菲斯、 和康涅狄格州西黑文——揭示了 PTM 3 级技能教育的功效，然后他领导了第二项 RCT， 评估电话管理版本的 3 级技能教育（“Tele-PTM”），该版本展示了 综合起来，这四项随机对照试验提供了远程咨询治疗烦人耳鸣的功效。 为耳鸣提供有效的临床服务的基地，无论是在诊所还是通过远程医疗，解决了 耳鸣需要绝大多数退伍军人患有这种看不见的病症。 患者需要 4 级和 5 级服务 自 2009 年起，VA 国家听力学和言语病理学。 (ASP) Service 已认可 PTM 作为 VA 耳鸣护理标准，从那时起，Henry 博士和 他的团队进行了多次培训并为数百名患者提供了个人咨询 亨利博士还领导了一项纵向流行病学研究，为退伍军人提供耳鸣服务。 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证会卓越中心。 迄今为止，除了他的研究之外，已有近 500 名退伍军人和现役军人加入。 活动中，亨利博士一直致力于开发下一代耳鸣和 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开发独立的康复研究领域。 指导导致了许多共同撰写的科学手稿和合作研究资助 亨利博士在他的学员中被公认为耳鸣康复研究和治疗方面的国际专家。 VA 和 NIH 科学审查小组、国家和国际都寻求其专业知识 研究合作和咨询以及下一代耳鸣和耳鸣治疗的培训 最重要的是，他对耳鸣临床治疗的持续贡献将继续下去。 为退伍军人未来几十年的健康和功能带来影响。