Duke School of Medicine professor Susan Emmett has been awarded a grant that is projected to be $5.5 million over five years to study a school-based hearing screening model in western Kentucky.
The study will involve the implementation and assessment of the Specialty Telemedicine Access for Referrals (STAR) program at 66 schools in rural Kentucky. STAR aims to use telehealth services to directly connect children in schools with local hearing loss specialists.
Children identified in screening programs typically aren't connected with the appropriate healthcare providers to receive the care that they need, Emmett explained.
"This was incredibly exciting. Our goal is to transform access to health care for rural children across the [United States]. Grants like this can greatly facilitate our ability to create that transformation," said Emmett, Medical School '10 and associate professor of head and neck surgery and communication sciences.
The grant was delivered through the National Institute of Health Common Fund’s Transformative Research to Address Health Disparities and Advance Health Equity initiative. The grants were awarded to scholars whose studies feature a unique or innovative intervention and focus on one of the populations that experience health disparities in the U.S., as defined by the NIH.
Emmett and Matthew Bush, professor of otolaryngology, head and neck surgery at the University of Kentucky, will lead the study. STAR, which involves school-based hearing screening facilitated by teachers and nurses, was originally tested in rural Alaska.
Emmett explained that rural Alaska, where she has been working for the past five years, has a high burden of infection-related hearing loss as well as significant barriers to care because of the state's low population density. While Emmett's work in Alaska will continue, the aim for the study in western Kentucky is to create a model that can be generalized across rural America.
Teachers and school nurses will screen children in schools for hearing loss using low-cost cell phone-based technology. If a child is identified as having possible hearing loss or middle ear disease, the screener will collect additional data. The results of the screen, along with pictures of the child's ear drums, will be sent directly to an audiologist.
Emmett is also working to implement a second STAR study in Alaska, which will involve thirty schools and run at the same time as the Kentucky study. After both trials conclude, Emmett and her collaborator hope to work with the HEAR-USA research network she leads to begin scale-up of the STAR model across the rural United States.
All of Emmett's research is focused on addressing health disparities in hearing loss, which currently affects 1.5 billion people worldwide. An estimated 80% of individuals with hearing loss live in low or middle income countries or are members of underserved populations in high income countries, Emmett said.
The WHO estimates that 60% of worldwide childhood hearing loss, and 75% in low- and middle-income countries, is preventable, Emmett continued.
"The reason for this is that the vast majority of childhood hearing loss is due to ear infections. If we identify and treat those promptly, we can greatly reduce the burden of childhood hearing loss worldwide," she said.
Emmett became passionate about hearing loss disparities when living and working in Tanzania for a year as a medical student at Duke. She was doing pediatric HIV research but noticed that many of the children she was treating for HIV also had hearing loss.
"[Hearing loss] was greatly affecting children's quality of life and ability to do well in school, but it wasn't being addressed at all. It wasn't even being discussed. I started to question why, and wonder why this important issue wasn't being paid attention to," Emmett said.
That ultimately led her to go into otolaryngology and bring her interest in policy and public health together with the surgical field.
Emmett said that she is excited about the grant and hopeful about the long-term potential of the STAR model.
"We do anticipate that this will ultimately transform access for kids across the country," she said.
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Anna Zolotor is a Trinity senior and recruitment chair for The Chronicle's 118th volume. She was previously news editor for Volume 117.