Primary (sensorineural) tinnitus of at least 6 months duration is usually a permanent condition with no cure available. Veterans whose tinnitus is bothersome must rely on methods designed to reduce emotional and functional reactions to tinnitus. Dr. Henry's research activities are focused on producing evidence-based research supporting such methods, and disseminating these methods throughout VA as well as to non-VA national and international audiences. Over his 30-year VA research career, including 20 VA research grants, Dr. Henry has led a research team that has developed Progressive Tinnitus Management (PTM), a multi- disciplinary stepped-care method designed to be efficiently implemented in busy VA clinics. The five levels of care include Level 1 Referral, Level 2 Audiologic Evaluation, Level 3 Skills Education, Level 4 Interdisciplinary Evaluation, and Level 5 Individualized Support. Level 1 consists of referral guidelines for any provider encountering patients who complain of tinnitus. Level 2 involves audiologic testing, brief tinnitus assessment, hearing aids if needed, and brief tinnitus counseling. Dr. Henry's team has completed two randomized controlled trials (RCTs) to evaluate the use of hearing aids and combination instruments (hearing aid with built- in sound generator) for tinnitus management. These RCTs validated both types of ear-level devices as efficacious for tinnitus management?findings that were consistent with the only other comparable RCT and supporting PTM Level 2 Audiologic Evaluation as the gateway of any PTM program. Patients requiring tinnitus services beyond Level 2 are advised to attend Level 3 Skills Education, involving five sessions (individual or group) of educational counseling to learn self-care skills for bothersome tinnitus. Two of the sessions are conducted by an audiologist who teaches the principles of sound-based therapy, and three are taught by a mental health provider who administers components of Cognitive-Behavioral Therapy (CBT). In his recent VA- funded projects, Dr. Henry led a ?clinically embedded? RCT at two VA medical centers?Memphis, Tennessee, and West Haven, Connecticut?revealing efficacy of PTM Level 3 Skills Education. He then led a second RCT, evaluating a telephone-administered version of Level 3 Skills Education (?Tele-PTM?), which demonstrated the efficacy of remote counseling for bothersome tinnitus. Combined, these four RCTs have provided an evidence base for providing effective clinical services for tinnitus, either in the clinic or via telehealth, which address the tinnitus needs for the great majority of Veterans suffering from this invisible condition. A very small number of patients require Level 4 and Level 5 services. Since 2009, the VA National Audiology and Speech Pathology (ASP) Service has endorsed PTM as the VA standard of care for tinnitus and, since this time, Dr. Henry and his team have conducted numerous trainings and provided individual consultation to hundreds of clinicians providing tinnitus services to Veterans. Dr. Henry is also leading a longitudinal epidemiology study This multi- site study includes the NCRAR (main site) and the DoD Hearing Center of Excellence in San Antonio, TX. To date, almost 500 Veterans and active Service Members have been enrolled. In addition to his research activities, Dr. Henry has been committed to the development of the next generation of tinnitus and rehabilitation researchers, supporting the training of pre- and postdoctoral fellows, VA career development award grantees, and clinician researchers as they develop independent lines of rehabilitation research. This mentorship has resulted in numerous co-authored scientific manuscripts and collaborative research grants among his trainees. Dr. Henry is recognized as an international expert in tinnitus rehabilitation research and development, whose expertise is sought for VA and NIH scientific review panels, national and international research collaborations and consultations, and training of the next generation of tinnitus clinicians and researchers. Most importantly, his ongoing contributions to the clinical management of tinnitus will continue to make a difference in Veterans' health and functioning for decades to come.

Public Health Relevance

Tinnitus is the chronic perception of ringing, buzzing, hissing, or other noises and can be functionally debilitating for those who experience it. Military personnel are exposed to numerous hazards that cause tinnitus, and Veterans frequently seek assistance from the VA for the condition. Dr. Henry's research focuses on providing evidence-based methods of tinnitus management. His work has led to the development of Progressive Tinnitus Management (PTM), considered the standard of tinnitus care in the VA. Dr. Henry has completed four controlled trials demonstrating that PTM improves quality of life for the great majority of Veterans in need. He has disseminated results of this work through publications in top scientific journals and keynote speeches to national and international audiences; he has also trained numerous clinicians and fellows in PTM and research. Dr. Henry's contributions to tinnitus research, healthcare, and training were recognized in 2016 with the VA's Paul B. Magnuson Award for outstanding achievement in rehabilitation research.

Agency
National Institute of Health (NIH)
Institute
Veterans Affairs (VA)
Project #
1IK6RX002990-01
Application #
9613155
Study Section
Rehabilitation Engineering & Prosthetics/Orthotics (RRD7)
Project Start
2019-04-01
Project End
2026-03-31
Budget Start
2019-04-01
Budget End
2020-03-31
Support Year
1
Fiscal Year
2019
Total Cost
Indirect Cost
Name
Portland VA Medical Center
Department
Type
DUNS #
089461255
City
Portland
State
OR
Country
United States
Zip Code
97239