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，在资源有限的情况下造成的负担最大 考虑到儿童的神经认知和社交能力受到损害，儿童受到的影响尤为严重。 发展，但如果及早发现和治疗，近 60% 的听力损失是可以减轻的。 儿童听力损失是由于可预防的因素造成的，识别是解决高收入听力损失的第一步。 各国已实施全民新生儿听力筛查 (UNHS) 计划，目标是诊断 听力损失和在生命最初几个月开始早期干预在低龄儿童中很少有类似的计划。 和中等收入国家，因为获得训练有素的人员的机会有限和听证会成本高昂等障碍 筛选设备。 我们建议优化低成本智能手机耳声发射（OAE）设备，用于听力筛查和 研究 RLS 中的实施情况 智能手机 OAE 与传统听力筛查相当。 R21 的目标是在美国进行试验的设备，现在必须对其能够产生最大影响的地方进行评估。 我们将在肯尼亚的各种临床环境和患者年龄中优化 OAE 设备的潜力。 嘈杂的临床环境的影响，评估筛查的一致性，并比较前线和一线的可用性 为非专业医疗机构工作人员提供低成本、用户友好的 OAE，这是低成本的可行工具。 资源临床环境将开始直接整合智能手机 OAE 的听力筛查结果。 R33 将进一步确定实施成果和肯尼亚的电子病历系统。 UNHS 计划中智能手机 OAE 设备的有效性，并将提供对 与此同时，R33 将部署智能手机。 OAE 对疑似（HIV 暴露）和已知（渗出性中耳炎）危险因素的纵向研究 听力损失纵向研究将利用一个额外的创新的非专业人士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。研究团队包括医疗服务提供者、公众。 健康研究人员、计算机科学家以及肯尼亚耳朵和听力保健技术工作组 卫生部的合作将在项目完成后支持项目的可持续性。 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 监测以及未来的研究，以了解和改善 RLS 中的耳朵和听力护理。 工作与世界卫生组织《世界听力报告》的目标一致，该报告致力于造福所有人，包括患有听力障碍的人 听力损失，到 2030 年在不经历经济困难的情况下获得高质量的服务。