Research

My primary research goal is to improve accessibility, affordability, and outcomes of hearing healthcare services by promoting self-management and also the use of digital technologies. My current research interests can be summarized along with the following four themes:

  1. eHealth (or Telehealth): Applications of the internet and modern information technology in the management of hearing-related disorders, in particular, guided behavioral rehabilitation via the internet (i.e., telerehabilitation or digital therapeutics).
  2. Consumer Health Informatics (CHI): The focus is to understand the health communities, as well as patient-generated data and its uses within and outside healthcare systems. In particular, this line of research focuses on understanding the use of information from various digital mediums (e.g., Internet, social media) in self-assessment and self-management of people with communication disorders.
  3. Psychosocial aspects of hearing loss: This line of research has two distinct areas, which include: (a) understanding the knowledge, attitudes, and behaviors of adolescents and/or young adults towards music-induced hearing loss and developing preventative strategies; and (b) understanding the psychosocial factors related to help-seeking, hearing rehabilitation uptake and use, and to develop appropriate rehabilitative strategies.
  4. Hearing healthcare service delivery model: Developing evidence-base for new service delivery models (i.e., direct-to-consumer model, community-based rehabilitation) to improve accessibility, affordability, and outcomes of hearing healthcare services.

Interests

  • Audiological Rehabilitation
  • Tele-audiology
  • Tinnitus
  • Direct-to-Consumer Healthcare
  • Health Literacy
  • Consumer Health Informatics
  • Music Induced Hearing Loss
  • Social Representations
  • Cross-Cultural Research
  • Big-Data Research

Laboratory Personel

Eldre Beukes

Post-doctoral Researcher and Research Audiologist at the Department of Speech and Hearing Sciences at Lamar University, Beaumont, Texas. Her research focuses on developing and testing Internet-based interventions.

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Marifer Munoz

Doctor of Audiology (AuD) student at the Department of Speech and Hearing Sciences, Lamar University, Beaumont, Texas, USA. She iw working as the Graduate Student Assistant in the Internet-Based Cognitive Behavioral Therapy for tinnitus (ICBT) project.

Collaborators

Gerhard Andersson

Professor of Clinical Psychology at the Department of Behavioural Sciences and Learning, Linköping University, Sweden. His main research is in the development of Internet-based interventions for various behavioral issues. He has published over 630 peer-reviewed manuscripts and 20 books.

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Ilmari Pyykkő

Professor Emeritus of Otolaryngology at the Department of Otolaryngology, University of Tampere, Tampere, Finland. His research focuses on wide range of issues in hearing healthcare. He has published over 500 peer-reviewed manuscripts in scientific journals.

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Current Research Projects

  • Internet-Based Intervention for Tinnitus

    Individuals with tinnitus are severely distressed by this condition, and psychological factors can affect their distress levels. Tinnitus can be very distressing and/or debilitating because of hearing unwanted sounds, such as ringing or buzzing. Many aspects of daily life, such as sleep, mood, and concentration may be affected as a result of having tinnitus. Nearly 50 million people in the U.S. experience tinnitus, and approximately 20 million people struggle with burdensome chronic tinnitus. Ensuring readily accessible, specialized clinical services specific for tinnitus throughout the country is desirable, but difficult to implement due to the burdens on the current healthcare system. Innovative ways to help those with tinnitus and proactively manage the related healthcare burden are required.

    There are several approaches to tinnitus management, but the one with the best evidence—cognitive behavioral therapy (CBT)—is rarely offered (less than 1% in the U.S.). There is a lack of trained audiologists who can deliver this treatment. Psychological management options, such as CBT, are mainly offered in English, and many people who speak other languages such as Spanish, have limited options. One partial solution is to offer CBT via the Internet as a guided self-help program (i.e., Internet-Based Cognitive Behavioral Therapy; ICBT), customizing it to meet individuals’ needs, both in terms of language and time of usage. Evidence from European studies clearly suggests that ICBT is as effective as seeing a clinician with medium to large effects. However, not all patients are suitable, and it is important to assess the medical aspects before starting iCBT.

    The long-term goal of this initiative is to develop an accessible and affordable self-help program that can improve health outcomes in individuals with tinnitus.

  • Consumer Health Informatics in Communication Sciences and Disorders

    Consumer health informatics is a sub-branch of health informatics that helps bridge the gap between patients and health resources. It is defined by the American Medical Informatics Association as “the field devoted to informatics from multiple consumer or patient views”.

    Consumer health informatics examines patient information from points of view such as health literacy, consumer knowledge and education. The goal is to empower patients while giving them the knowledge they need to make their own health decisions. Consumer health informatics couples the consumers’ needs for information with their healthcare preferences to create a tailor-made medical experience. The focus is to understand the health communities, as well as patient-generated data and its uses within and outside healthcare systems. In particular, this line of research focuses on understanding the use of information from various digital mediums (e.g., Internet, social media) in self-assessment and self-management of people with communication disorders.

    Our research is currently focused on examining and defining the types of information present and the communication patterns of people with communication disorders in various me media outlets. The long-term goal of this project is to examine what kind of information is sued by consumers and its influence on outcomes help-seeking, rehabilitation uptake, rehabilitation use, and satisfaction from rehabilitation. We also anticipate that the knowledge developed in this project will help develop effective appropriate communication strategies.

  • Social Representations of Hearing Loss and Hearing Aids

    Over the last decade, there has been a significant shift from body to environment and the relation between the two when understanding the phenomenon of disabilities. The current trend is to view disabilities as the outcome of this interaction, in short from a biopsychosocial perspective. This has called for research based on frameworks that incorporate both the body and the environment. There is a great corpus of knowledge of the functions of a body and a growing corpus of environmental factors such as perceptions among specific groups of persons towards disabilities. However, there is a lack of knowledge of the perception of disabilities from a general population. When this is addressed, it is mainly in terms of stigma and attitudes. Moreover, different professional fields have used different approaches and theoretical framework to understand and describe stigma, attitudes, and behavior of people towards disabilities. However, the concept of attitudes has been heavily criticized of the last decades. The relationship between expressed attitudes and behavior has been critically investigated. More recently another approach, the Social Representations Theory (SRT), has gained increasing popularity with social psychology and other academic areas to understand social perception of disability. This project aims to provide insight into how we can broaden our understanding of hearing disability by using this SRT. Outcome of these studies highlight that attitudes and actions are outcomes of a more fundamental disposition (i.e., social representation), towards a phenomenon like disability.

    In our previous cross-cultural project, we have examined the social representations of ‘hearing loss’ and ‘hearing aids’ as reported by the general public in India, Iran, Portugal, and United Kingdom. Currently, we are studying the social representations of ‘hearing loss’ and ‘hearing aids’ as reported by people with hearing loss and their communication partners in India, Republic of Korea, United Kingdom and United States.

  • Development and Evaluation of Ultra-Low-Cost Hearing Aid

    People with hearing loss can benefit from the use of hearing devices, such as hearing aids, cochlear implants, and other assistive devices. However, global production of hearing aids meets less than 10% of global need and less than 3% of developing countries’ needs. The lack of availability of services for fitting and maintaining these devices, and the lack of batteries are also barriers in many low-income settings.

    The recently passed United States H.R.2430 – FDA Reauthorization Act of 2017 bill highlights the urgent need for accessible and affordable hearing aids that serve mild- to moderate- age-related hearing loss (ARHL), which can be distributed over the counter (OTC). However, current OTC low-cost devices suffer from poor acoustic quality and unknown patient outcomes due to lack of focused instrument design and rigorous clinical evaluation.

    Using the frugal science principles, Dr. Saad Bhamla and his colleagues at Georgia Tech University have developed a self-fitting and ultra-low-cost digital hearing aid (<$1) that provides high frequency amplification needed for individuals with mild- to moderate ARHL. This suggests that ultra-low-cost aids with high acoustic quality are possible. We collaborate in this project to design and clinically validate an innovative ultra-low-cost hearing aid that targets ARHL. This approach is fundamentally different from traditional hearing aids that are expensive and black-box designs. Our long-term vision is to universalize this frugal device to bring hearing aids to the masses.

  • ICF Core Sets for Hearing Loss

    Hearing loss is a highly prevalent health condition in the world and World health organization (WHO) estimates that about 360 million people in the world have hearing loss. Hearing loss may affect social, biological and psychological functions and aspects of health and lead to reduced social engagement and increased risk for isolation, loneliness and decreased health. International classification of functioning, disability and health (ICF) was endorsed by WHO in 2001 and is a classification with a biological, psychological and social approach to functioning used to describe aspects of health. The aim with ICF is to create one common language to describe functioning and disability. This makes it easier describe and compare populations, both on a national and international level.

    In 2010 the project to create two ICF core sets for adults with hearing loss began and the aim of the project was to develop two reliable and valid core sets, a comprehensive- and a brief core set. In 2012 the first comprehensive and brief core sets for hearing loss were created. The comprehensive core set for hearing loss consists of 117 categories and the brief core set consists of 27. The project focus at adults (>18 years). The aim of the first study is to validate the first version of the ICF brief core set for hearing loss.

    The aim of the first study is to validate the first version of the ICF brief core set for hearing loss. The final step in the development of ICF core sets, the validation phase, has not yet been conducted for the ICF core sets for hearing loss. This is an important step to fulfil and it is of importance to keep an international approach similar to the preparatory phases of the ICF core sets for hearing loss.

    Currently, there are a lot of different outcome measurements and instruments, measuring a patient’s functioning, used in hearing research and in clinical practice. This makes study-results and populations hard to compare. Because of the lack of consistency in use of measurements in the audiological field there is a need for an evidence-based instrument to use for hearing loss. Such an instrument, based on the ICF, would be a step closer to a common language for use internationally in both research and clinical practice.