This is an application for a K23 Mentored Patient-Oriented Career Development Award for Dr. Nicholas Reed who recently joined the faculty of the Department of Otolaryngology-Head & Neck Surgery at the Johns Hopkins University School of Medicine as an Assistant Professor. The goal of the proposed project is to provide the candidate with the advanced training and skills to launch an independent research program examining hearing loss and health care outcomes among older adults. To facilitate this goal, the candidate has assembled a multidisciplinary mentorship and collaboration team with expertise that spans epidemiology, biostatistics, implementation science, gerontology, health systems and policy, nursing, delirium, and hearing loss. He proposes a comprehensive training plan that consists of coursework, observation, practical training, engagement in seminars, workshops, and working groups, and constructive research meetings across clinical and academic centers at Johns Hopkins University, Harvard University, Indiana University, University California, San Francisco, and University of Pittsburgh. The specific training and development goals of this Award include: (1) instruction in trial design, epidemiology, and biostatistics methodology to apply in the proposed research, (2) training in aging research and gerontologic care considerations with specific emphasis on understanding conceptual models, measurement of, and interventions for delirium, (3) guidance in implementation science methodology, process evaluation, and outcomes research as they apply to health systems initiatives to improve quality of care among older adults, (4) continued training in the responsible conduct of research with emphasis on considerations for clinical practice-based research, and (5) development and submission of an R01 grant application that builds upon the methodologic foundation, preliminary evidence, publications, and collaborations from this Career Development Award. The proposed research of this Career Development Award addresses the overlooked influence of hearing loss on health care outcomes and seeks to refine methods to address hearing loss in the health care system. The specific goals are to (1) investigate the association between hearing loss, communication impairment, and hearing aid use with health care outcomes such as 30-day readmission, length of stay, and hospitalization in older adults, (2) characterize incidence of delirium among hospitalized older adults with and without hearing loss, and (3) refine and assess the feasibility and acceptability of implementing a comprehensive hearing loss screening and intervention program to improve care outcomes in the inpatient setting. At the conclusion of this Career Development Award, the candidate will have the skills, expertise, and preliminary evidence to be competitive for independent research funding and design and execute translational research addressing hearing loss throughout the health care system that could shape patient-care for the millions of older adults with hearing loss.
The role of hearing loss in health care outcomes such as delirium and health care utilization, possibly mediated via poor patient-provider communication and sensory deprivation pathways, is poorly understood. This study characterizes these associations in epidemiologic datasets and clinical samples and explores a low-cost, low- risk sustainable solution to address hearing loss in the inpatient setting. This Award lays the groundwork for large clinical trials that investigate systematically addressing hearing loss to improve health care outcomes and potential translation of research to improve patient-care for the millions of older adults with hearing loss.
