Training and Reinforcement on HPD Use

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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.