My research focuses on reducing hearing health disparities globally. I work with colleagues around the world to define the global burden of hearing loss and deepen our understanding of its social, economic, and health impact. We apply a public health approach that spans prevention, diagnosis, and treatment.
Fundamental to prevention is evaluating why hearing loss is so much more common in low-resource settings and investigating risk factors that are potentially modifiable. I have focused my prevention efforts on undernutrition, evaluating the contribution of early life malnutrition and micronutrient deficiencies to risk of hearing loss in Nepal. We are currently expanding this work to the Bolivian Amazon.
Diagnosis of hearing loss in remote settings brings unique challenges, including scarcity of audiologists and otolaryngologists, need for portable equipment, and lack of screening programs to identify affected children. I am currently leading a PCORI (Patient-Centered Outcomes Research Institute)-funded community randomized trial with the Norton Sound Health Corporation in Nome, Alaska to evaluate a new protocol for school hearing screening in 15 villages on the Bering Sea. This study utilizes mobile health technology and telemedicine referral to identify previously undiagnosed hearing loss and efficiently connect Alaska Native children to care. The intervention has applicability across the state of Alaska, as well as in other remote, low-resource settings with a high prevalence of hearing loss and ear disease.
My research on treatment of hearing loss is focused on expanding access to cochlear implantation, a treatment for severe-to-profound hearing loss traditionally limited to high-resource settings. I have worked with collaborators in 14 countries to demonstrate that cochlear implantation can be a cost-effective treatment option in Sub-Saharan Africa and Latin America. We are expanding these studies to other regions of the world.
Addressing Childhood Hearing Loss Disparities in an Alaska Native Population: A Community Randomized Trial (AD-1602-34571), PCORI
Research Training in Otolaryngology (5T32DC000027-25), NIDCD/NIH
Global Control of Micronutrient Deficiency (OPPGH 614), Bill and Melinda Gates Foundation
Feed the Future Innovation Lab for Collaborative Research on Nutrition (AID-OAA-L-1-00006), USAID