Training and Reinforcement on HPD Use

保护建筑工人免受噪音暴露对听力的影响仍然是一项重要的工作 挑战，因为暴露的间歇性和强烈的性质，以及认为几乎无能为力 控制住问题。在大多数建筑行业中，听力保护的使用率非常低(30%-50%的时间在高 噪音)和全面的听力保护计划是罕见的。这项研究旨在评估 关于HPD使用的三种干预措施的有效性：标准听力保护培训课程，使用 新颖的个人噪声水平指示器(NLI)，以及后续强化培训。每一次干预都将 对它们的独立和综合影响进行评估。干预措施的设计是一致的 通过对健康促进模型(Pender，1987)的修改，以及该模型的组件(例如， 生物、障碍、自我效能感等)将用于评估修改 干预措施的有效性。将确定8个建筑工地进行干预，目标是30个 每个站点招募参与的受试者(总共240人)。经过一个月的干预前评估 和观察，这是一个培训计划，包括关于噪音、听力和HPD的基于视频的概述 此外，还将向受试者提供有关选择和使用HPD的额外实践指导。四个地点将是 不提供额外培训，而其他四个地点将通过简短的每两周进行一次增援 关于HPD使用的后续培训、咨询和故障排除。各有一半的受试者 现场将随机选择佩戴NLI。在最初的培训之后，进行干预(强化和非LI的使用) 将持续两个月。在干预期结束时，受试者将继续接受监测 在现场呆了三个月。将给出关于HPD使用和生物行为特征的调查问卷 在注册时，在初始培训之后，在两个月干预期结束时，在三个月结束时 一个月的跟踪期和后续的电话面试将在注册后12个月完成。 HPD的使用将在轮班水平上通过监测每个受试者两天来进一步表征 研究的每个阶段(干预前、干预期间、干预后)使用数据记录 用于报告工作日HPD使用情况的剂量计和活动卡。在这些监测日里， 调查人员还将独立观察HPD的使用情况，以便与自我报告的数据进行比较。 成果将提交科学出版物，并开发成指导和培训材料供使用 由行业和行业决定。

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 give_ 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.