Appalachian STAR Trial – Diversity Supplement - Diversity Supplement for Appalachian STAR Trial M-PI: Susan Emmett, MD, MPH and Matthew Bush, MD, PhD, MBA Project Summary/Abstract Health disparities begin early in life, and schools often offer the only access to preventive services for rural children; however, preventive screening programs are variably implemented, plagued by loss to follow-up, and frequently compounded by limited access to specialists in rural areas. The goal of the Appalachian STAR Trial is to establish a novel, generalizable model of school-based telehealth-driven preventive care that can be disseminated to rural populations across America. The Appalachian STAR Trial is currently wrapping up its third year, and valuable feedback from participating school staff members and the Community Advisory Board (CAB) has led to the need for supplemental research activities. The STAR model was adapted based on community member feedback (Aim 1), and the enhanced hearing screening component of the stepped-wedge trial (Aim 2) was rolled out in year three. An implementation evaluation (Aim 3) was conducted with 24 participants who used the STAR model. Based on overwhelming feedback, the intervention was significantly redesigned, and a second year of the enhanced hearing screening component will be conducted, including another implementation evaluation to assess the impact of modifications. While iteratively adapting the STAR model, the CAB highlighted the need to concentrate efforts on reaching historically marginalized communities, specifically Hispanic and Black communities, with the goal of ensuring the STAR model intervention is accessible to families that are linguistically and culturally diverse. To be responsive to the CAB’s directives, Aim 3 will be expanded to include an increased emphasis on recruitment of those who are Hispanic and/or Black. Based on community feedback, the specialty telemedicine component of the STAR model will be iteratively evaluated with both groups to strengthen potential adoption of telehealth and similar healthcare services for all eligible Kindergarten children. This supplemental research activity will be conducted by a bilingual Hispanic research audiologist who is a recent graduate of the University of Arkansas for Medical Sciences Audiology Program and joined the Center for Hearing Health Equity as a postdoctoral fellow. Born and raised in Mexico with an interest in advancing culturally and linguistically sound clinical and research initiatives within audiology, this candidate is well-positioned to lead this project. Through this Diversity Supplement, the candidate will receive mentorship in conducting community-based research in audiology, from design to dissemination, with the goal of teaching the necessary skills to bring diverse perspective to clinical research within the hearing sciences.
