School Screening and Telemedicine Specialty Referral to Address Childhood Hearing Loss in Rural Kentucky

Summary

This trial will evaluate a multilevel intervention (STAR model) that combines mobile health (mHealth) hearing screening tools with telemedicine technology for specialty care access in rural Kentucky schools. An initial version of the model was used in rural Alaska where telemedicine-based specialty referral improved both proportion of children receiving follow-up and time to follow-up. The refined STAR model will utilize an enhanced mHealth screening protocol that includes tympanometry for the detection of middle ear disease. The STAR model will also include a specialty telemedicine referral process in schools for children who refer school screening.

Conditions

• Hearing Loss

Interventions

OTHER

Standard School Screening and Referral

Counties in the control condition will use standard hearing screening and standard referral by school district. Standard referral is typically a letter home from the school to parents/caregivers of children who refer screening.

OTHER

Enhanced mHealth Screening

The enhanced screening protocol will consist of an mHealth-based hearing screen combined with tympanometry.

OTHER

Specialty Telemedicine Referral

The specialty telemedicine referral will include a lay-friendly smartphone or tablet that connects to tools necessary for an ear and hearing evaluation. If a child requires referral from hearing screening, a school nurse/teacher will complete the established protocol for the specialty telemedicine referral and send details asynchronously to an audiologist for consultation.

Sponsors & Collaborators

• University of Kentucky

  collaborator OTHER

• Duke University

  collaborator OTHER

• National Institutes of Health (NIH)

  collaborator NIH

• University of Arkansas

  lead OTHER

Principal Investigators

• Matt Bush, MD, PhD, MBA · University of Kentucky

• Susan Emmett, MD, MPH · University of Arkansas Medical Sciences

Study Design

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

SINGLE

Model

CROSSOVER

Eligibility

Min Age

3 Years

Max Age

11 Years

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2022-09-01

Primary Completion

2027-06-30

Completion

2027-06-30

Countries

• United States

Study Locations