Official websites use .gov

A .gov website belongs to an official government organization in the United States.

Secure .gov websites use HTTPS

A lock ( 🔒 ) or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites.

Need Help

STAR+ Trial: Expanding Access to Hearing Diagnostics and Treatment for Children in Rural Appalachia

Award Number: U01DC024017
ORGANIZATION: NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION DISORDERS
OPDIV: NIH
AWARD CLASS: COOPERATIVE AGREEMENT
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 09/11/2026
PERIOD OF PERFORMANCE END DATE: 08/31/2029

Group Awards By:

View Award Description

STAR+ Trial: Expanding Access to Hearing Diagnostics and Treatment for Children in Rural Appalachia - Untreated childhood hearing loss has profound implications for language development, school achievement, and future employment. In rural and underserved populations where otitis media is common, a staggering 75% of childhood hearing loss is preventable. School health programs often provide the only access to preventive services for rural children. However, school screening has high loss to follow-up, and very few rural-based specialists compound barriers to accessing treatment. We developed the unique Specialty Telehealth Access for Referrals (STAR) model to facilitate follow-up in school hearing screening through prior randomized trials using Tribal health clinic-based infrastructure. The Appalachian STAR Trial, currently in its 5th of 6 years, builds on these trials as the nation’s first study to apply school-based telehealth for preventive hearing screening by connecting rural school staff to specialists for asynchronous follow-up. During implementation evaluations for this trial, we uncovered a key remaining challenge: children still experience significant barriers to needed diagnostic testing and treatment after STAR connects them to the healthcare system for further care. Our objective is to adapt STAR, which includes enhanced hearing screening and specialty telehealth follow-up, into a new STAR+ model that now also includes telehealth diagnostics and treatment. We seek to evaluate the STAR+ model in parallel with the conclusion of the Appalachian STAR Trial to address this critical gap in treatment for rural children with hearing loss. We will conduct the STAR+ expansion to deliver the full continuum of specialty hearing care in rural schools in the Appalachian region of Kentucky, where we already integrate with state data systems and have long-term relationships with communities that have been involved in STAR from the start. A major focus of the trial will be sustainability and scale, laying the groundwork for rural communities across the country to adopt this innovative model of care. We will begin by adapting the STAR model of enhanced screening and specialty telehealth follow-up to include telehealth diagnostics and treatment (STAR+) with our advisory boards and partners using the ADAPT-ITT framework (Aim 1). We will then compare effectiveness and implementation of STAR+ vs. STAR in 63 rural Kentucky schools through a 3-year stepped wedge cluster randomized trial with all kindergarten children in 14 counties (n~9,000) (Aim 2a). The primary outcome will be proportion of referred children who complete the care pathway within 180 days of screening date. We conservatively hypothesize that completion will improve by 20 percentage points with STAR+ compared to STAR. During the trial, we will evaluate implementation determinants and outcomes to guide refinement and promote sustainability of STAR+ (Aim 2b). Lastly, we will conduct an iterative scalability assessment using the ExpandNet framework to support future scale-up of STAR+ in rural communities (Aim 3). By accelerating advancement of STAR+ in one of the nation’s most disadvantaged regions, we are positioned to rapidly transform hearing health access and improve outcomes for rural and underserved children across the country.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $824,459 )
2026	2026	UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES	4301 W MARKHAM ST	LITTLE ROCK	AR	72205	PULASKI	USA	Research Related to Deafness and Communication Disorders	000	1	9/14/2026	NEW	$824,459
														Subtotal = $824,459

Grand Total All Awards = $824,459

Top

All Categories

About

Search

Reports

Data Submission

Award Information

STAR+ Trial: Expanding Access to Hearing Diagnostics and Treatment for Children in Rural Appalachia

Award Number: U01DC024017

ORGANIZATION: NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION DISORDERS

OPDIV: NIH

AWARD CLASS: COOPERATIVE AGREEMENT

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 09/11/2026

PERIOD OF PERFORMANCE END DATE: 08/31/2029

Federal Websites

Department of Health & Human Services

HHS Operating Divisions

HHS Staff Divisions

Download A Document Viewer