{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:49:07Z","timestamp":1786978147557,"version":"build-2736575974"},"reference-count":32,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T00:00:00Z","timestamp":1669852800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006093","name":"Patient-Centered Outcomes Research Institute","doi-asserted-by":"publisher","award":["AD\u20101602\u201034571"],"award-info":[{"award-number":["AD\u20101602\u201034571"]}],"id":[{"id":"10.13039\/100006093","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006511","name":"Duke Global Health Institute, Duke University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006511","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Laryngoscope Investig Oto"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study evaluated the Hearing Environments and Reflection on Quality of Life (HEAR\u2010QL) questionnaire in rural Alaska, including an addendum crafted through community feedback to reflect the local context. The objectives were to assess whether HEAR\u2010QL score was inversely correlated with hearing loss and middle ear disease in an Alaska Native population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The HEAR\u2010QL questionnaires for children and adolescents were administered as part of a cluster randomized trial in rural Alaska from 2017 to 2019. Enrolled students completed an audiometric evaluation and HEAR\u2010QL questionnaire on the same day. A cross\u2010sectional evaluation of questionnaire data was utilized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 733 children (ages 7\u201312\u2009years) and 440 adolescents (ages \u226513\u2009years) completed the questionnaire. Median HEAR\u2010QL scores were similar among children with and without hearing loss (Kruskal\u2013Wallis,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u2009.39); however, adolescent HEAR\u2010QL scores significantly decreased with increasing hearing loss (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u2009.001). Median HEAR\u2010QL scores were significantly lower in both children (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u2009.02) and adolescents (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u2009.001) with middle ear disease compared with those without. In both children and adolescents, the addendum scores were strongly correlated with total HEAR\u2010QL score (\u03c1\n                      <jats:sub>Spearman<\/jats:sub>\n                      \u00a0=\u20090.72 and 0.69, respectively).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The expected negative association between hearing loss and HEAR\u2010QL score was observed in adolescents. However, there was significant variability that could not be explained by hearing loss, and further investigation is warranted. The expected negative association was not observed in children. HEAR\u2010QL scores were associated with middle ear disease in both children and adolescents, making it potentially valuable in populations where the prevalence of ear infections is high.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level 2<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Clinicaltrials.gov registration numbers<\/jats:bold>\n                      : NCT03309553\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lio2.973","type":"journal-article","created":{"date-parts":[[2022,12,2]],"date-time":"2022-12-02T05:19:53Z","timestamp":1669958393000},"page":"269-278","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["<scp>Hearing\u2010related<\/scp>\n                    quality of life in children and adolescents in rural Alaska"],"prefix":"10.1002","volume":"8","author":[{"given":"Kelli L.","family":"Hicks","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\/Head and Neck Surgery University of North Carolina\u2010Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8768-8084","authenticated-orcid":false,"given":"Samantha Kleindienst","family":"Robler","sequence":"additional","affiliation":[{"name":"Department of Audiology Norton Sound Health Corporation  Nome Alaska USA"},{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of Arkansas for Medical Sciences  Little Rock Arkansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan A.","family":"Simmons","sequence":"additional","affiliation":[{"name":"Department of Biostatistics &amp; Bioinformatics Duke University  Durham North Carolina USA"},{"name":"Duke Global Health Institute  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Ross","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery and Communication Sciences Duke University School of Medicine  Durham North Carolina USA"},{"name":"Center for Health Policy and Inequalities Research, Duke University  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph R.","family":"Egger","sequence":"additional","affiliation":[{"name":"Duke Global Health Institute  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan D.","family":"Emmett","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of Arkansas for Medical Sciences  Little Rock Arkansas USA"},{"name":"Duke Global Health Institute  Durham North Carolina USA"},{"name":"Department of Head and Neck Surgery and Communication Sciences Duke University School of Medicine  Durham North Carolina USA"},{"name":"Center for Health Policy and Inequalities Research, Duke University  Durham North Carolina USA"},{"name":"Department of Epidemiology Fay W. 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