Overview
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
Current Appointments & Affiliations
Recent Publications
School-Based Enhanced Hearing Screening and Specialty Telehealth Follow-Up for Hearing Loss Among Children in Rural Alaska: Study Protocol for a Hybrid Effectiveness-Implementation Stepped Wedge, Cluster-Randomized Controlled Trial (North STAR Trial).
Journal Article Res Sq · April 1, 2025 Background Childhood hearing loss has well-known profound implications for language development, school achievement, and future employment opportunities. School-based health programs can provide hearing screening, but access to specialists for follow-up ca ... Full text Link to item CiteAccess to Ear and Hearing Care Globally: A Survey of Stakeholder Perceptions from the Lancet Commission on Global Hearing Loss.
Journal Article Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology · March 2025 ObjectiveCharacterize global access to ear and hearing care (EHC) to inform future policy recommendations.Study designSurvey using convenience sampling.SettingSubjects were surveyed via contact lists of the World Health Organizat ... Full text CiteBarriers to Research for Academic Otologists/Neurotologists in the United States.
Journal Article Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology · February 2025 ObjectiveThe physician-scientist workforce is shrinking in the United States. Academic otologists/neurotologists face a diverse set of barriers to successful careers. We aimed to characterize the factors affecting contemporary otology/neurotology ... Full text CiteRecent Grants
Appalachian STAR Trial
ResearchPrincipal Investigator · Awarded by National Institutes of Health · 2021 - 2022North STAR Trial: Specialty Telemedicine Access for Referrals in Rural Alaska
ResearchPrincipal Investigator · Awarded by National Institutes of Health · 2021 - 2022mHealth Tympanometer: A Digital Innovation to Address Childhood Hearing Loss in Low- and Middle-Income Countries
ResearchPrincipal Investigator · Awarded by National Institutes of Health · 2021 - 2022View All Grants