{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T15:49:48Z","timestamp":1775231388080,"version":"3.50.1"},"reference-count":32,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,2,12]],"date-time":"2020-02-12T00:00:00Z","timestamp":1581465600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Laryngoscope Investig Oto"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To establish the feasibility of a systematic, community health worker (CHW)\u2010based hearing screening program that gathers Health Insurance Portability and Accountability Act\u2010compliant electronic data (otoscopic images of tympanic membrane and audiometric evaluation) on a smartphone in an effort to streamline treatment options in resource\u2010limited communities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a cross\u2010sectional study in which four schools were screened in Port\u2010au\u2010Prince, Haiti, during in April 2018. A total of 122 subjects (61% female) aged 5\u201017\u2009years underwent an initial brief audiometric screen followed by a more comprehensive air conduction audiometric evaluation if they failed their initial screen. Participants with more than 35\u2010dB loss in any frequency on their comprehensive audiometric evaluation received endoscopic otoscopy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seventy\u2010five percent of subjects (91\/122) passed their initial screen. Of those who failed, 9% (4\/44 ears) had a severe or profound hearing loss on comprehensive evaluation. Abnormal otoscopic findings (11\/36 ears, 31%) included are cerumen impaction (n = 6), myringosclerosis (n = 3), tympanic membrane perforation (n = 1), and tympanic membrane retraction (n = 1). The average duration of the initial testing was 100\u2009seconds (SD = 74\u2009seconds), whereas the duration of comprehensive testing was 394\u2009seconds (SD = 175\u2009seconds). Extrapolating from these data, we estimate that a group of seven trained CHWs could gather formal audiologic and otologic data points for 100 children per hour using this protocol.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A systematic approach that utilizes local resources (CHWs) and existing infrastructure (cell phones and the Internet) can significantly reduce the burden of hearing healthcare specialists while simultaneously facilitating early diagnosis and management of disabling hearing loss in low\u2010resourced settings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>Level 4.<\/jats:p><\/jats:sec>","DOI":"10.1002\/lio2.361","type":"journal-article","created":{"date-parts":[[2020,2,12]],"date-time":"2020-02-12T15:02:55Z","timestamp":1581519775000},"page":"305-312","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Community health worker\u2010based hearing screening on a mobile platform: A scalable protocol piloted in Haiti"],"prefix":"10.1002","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9932-8748","authenticated-orcid":false,"given":"Asitha D. L.","family":"Jayawardena","sequence":"first","affiliation":[{"name":"Department of Otolaryngology Vanderbilt University Medical Center  Nashville Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9665-1868","authenticated-orcid":false,"given":"Ashley M.","family":"Nassiri","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Vanderbilt University Medical Center  Nashville Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8744-9171","authenticated-orcid":false,"given":"Dylan A.","family":"Levy","sequence":"additional","affiliation":[{"name":"Frank H. Netter MD School of Medicine, Quinnipiac University  North Haven Connecticut"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vienna","family":"Valeriani","sequence":"additional","affiliation":[{"name":"Caris Foundation Haiti  Port\u2010au\u2010Prince Haiti"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alison J.","family":"Kemph","sequence":"additional","affiliation":[{"name":"Department of Hearing and Speech Sciences Vanderbilt University Medical Center  Nashville Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3066-1913","authenticated-orcid":false,"given":"Charissa N.","family":"Kahue","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Vanderbilt University Medical Center  Nashville Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathaniel","family":"Segaren","sequence":"additional","affiliation":[{"name":"Caris Foundation Haiti  Port\u2010au\u2010Prince Haiti"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert F.","family":"Labadie","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Vanderbilt University Medical Center  Nashville Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0756-9772","authenticated-orcid":false,"given":"Marc L.","family":"Bennett","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Vanderbilt University Medical Center  Nashville Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carl A.","family":"Elis\u00e9e","sequence":"additional","affiliation":[{"name":"Department of Otolarhinolaryngology Hopital de L'Universite d'Etat d'Haiti  Port\u2010au\u2010Prince Haiti"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James L.","family":"Netterville","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Vanderbilt University Medical Center  Nashville Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,2,12]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"Prevention of Deafness and Hearing Loss. 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