Training and Reinforcement on HPD Use

产品说明：保护建筑工人免受噪声暴露对听力的影响仍然是一个重大挑战，因为噪声暴露具有间歇性和强烈性，而且人们认为几乎无法控制这一问题。在大多数建筑行业中，听力保护的使用率非常低（30-50%的时间处于高噪音环境中），并且很少有全面的听力保护计划。本研究旨在评估三种干预措施对HPD用途：标准听力保护培训课程、使用新型个人噪声水平指示器（NLI）和后续强化培训的有效性。将评估每种干预措施的独立和综合效果。干预措施的设计符合健康促进模式的修改（Pender，1987），以及该模式的组成部分（例如，生物，障碍，自我效能等）。将用于评估改变干预措施有效性的个人特征。将确定8个建筑工地进行干预，目标是每个工地招募30名受试者参与（共240名）。在一个月的干预前评估和观察后，将向受试者提供培训计划，包括关于噪声、听力和HPD的视频概述以及关于HPD选择和使用的额外实践指导。四个研究中心将不提供额外的培训，而其他四个研究中心将通过两周一次的简短随访培训、咨询和HPD使用问题解决得到加强。每个研究中心将随机选择一半受试者佩戴NLI。初步培训后，干预（强化和NLI使用）将持续两个月。在干预期结束时，将继续对受试者进行为期三个月的现场监测。将在入组时、初始培训后、两个月干预期结束时、三个月随访期结束时提供有关HPD使用和生物行为特征的资料，并在入组后12个月完成随访电话访谈。 在研究的每个阶段（干预前、干预期间、干预后），使用数据记录剂量计和活动卡（用于报告工作日期间的HPD使用情况）监测每例受试者2天，进一步表征轮班水平的HPD使用情况。在这些监测日期间，研究者还将独立观察HPD的使用情况，以与自我报告的数据进行比较。 研究结果将发表在科学刊物上，并将编制成指导和培训材料，供业界使用。

DESCRIPTION: Protection of construction workers from the effects of noise exposure on hearing remains a significant challenge because of the intermittent and intense nature of the exposures and belief that little can be done to control the problem. Hearing protection use is very low in most construction trades (30-50% of time in high noise) and comprehensive hearing conservation programs are rare. This study is designed to assess the effectiveness of three interventions on HPD use: a standard hearing conservation training session, use of a novel personal noise level indicator (NLI), and follow-up reinforcement training. Each of the interventions will be assessed for their independent and combined effects. The interventions are designed to be consistent with a modification of the Health Promotion Model (Pender, 1987), and components of this model (e.g, biological, barriers, self-efficacy, etc.) will be used to assess individual characteristics that modify the interventions' effectiveness. Eight construction worksites will be identified for intervention, with a target of 30 subjects recruited for participation on each site (240, total). After one month of pre-intervention assessment and observation, a training program consisting of a video-based overview about noise, hearing, and HPDs and additional hands-on instruction on selection and use of HPDs will be given to subjects. Four sites will be provided with no additional training, while the other four sites will receive reinforcement via brief bi-weekly follow-up training, counseling and trouble shooting with respect to HPD use. Half of the subjects on each site will be randomly selected to wear the NLI. After initial training, intervention (reinforcement and NLI use) will continue for two months. At the end of the intervention period, subjects will continue to be monitored onsite for three months. Questionnaires concerning HPD use and bio behavioral characteristics will be given at enrollment, after initial training, at the end of the two month intervention period, at the end of the three month follow-up period and a follow-up telephone interview will be completed 12 months after enrollment. HPD use will be further characterized at the workshift level by monitoring each subject for two days during each segment of the study (pre-intervention, during intervention, post intervention) using data-logging dosimeters and activity cards used to report HPD use during the workday. During these monitoring days, investigators will also independently observe the HPD use for comparison with the self-reported data. Results will be presented for scientific publication and developed into guidance and training materials for use by the industry and trades.