Training and Reinforcement on HPD Use

描述：保护建筑工人免受噪音暴露对听力的影响仍然是一个重大挑战，因为噪音暴露的间歇性和强烈的性质以及人们认为几乎无法控制这个问题。在大多数建筑行业中，听力保护的使用非常低（30-50%的时间处于高噪音中），全面的听力保护计划很少。本研究旨在评估三种干预措施对HPD使用的有效性：标准听力保护训练课程，使用新型个人噪音水平指示器（NLI），以及后续强化训练。将评估每一种干预措施的独立效果和综合效果。干预措施的设计与健康促进模型的修改相一致（Pender, 1987），该模型的组成部分（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，每个工地招募30名受试者（总共240名）。经过一个月的干预前评估和观察后，将向受试者提供一个培训计划，包括基于视频的噪音、听力和高压防护装置概述，以及关于选择和使用高压防护装置的额外实践指导。四个站点将不提供额外的培训，而其他四个站点将通过两周一次的简短后续培训、咨询和解决有关HPD使用的问题来得到加强。每个地点将随机选择一半的受试者佩戴NLI。在最初的训练后，干预（强化和NLI的使用）将持续两个月。在干预期结束时，受试者将继续接受为期三个月的现场监测。在入组时、初始培训后、2个月的干预期结束时、3个月的随访期结束时分别对HPD使用情况和生物行为特征进行问卷调查，并在入组后12个月进行电话随访。通过在研究的每个阶段（干预前、干预中、干预后）对每个受试者进行为期两天的监测，使用数据记录剂量计和用于报告工作日HPD使用情况的活动卡，HPD使用情况将在工作班水平上进一步表征。在监测期间，调查人员还将独立观察HPD的使用情况，并将其与自我报告的数据进行比较。研究结果将提交科学出版物，并编制成供工商界使用的指导和培训材料。

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.