Hearing Loss Prevention for Veterans

描述(由申请人提供)： 项目摘要/摘要：听力损失和耳鸣是退伍军人退伍军人系统中最常见的两种与服务相关的残疾，适用于退伍军人、二战退伍军人、韩国退伍军人、越南退伍军人、海湾战争退伍军人和和平时期退伍军人。与听力损失退伍军人的医疗保健利用、提供助听器、康复服务和生产力下降相关的费用是巨大的，而且还在继续增加。在个人层面上，听力损失会导致沟通困难，并经常导致社交孤立、沮丧和抑郁。听力受损的一个主要原因是暴露在高水平的声音中造成的耳蜗损伤。暴露的时间越长，声压级越大，造成的损害就越大。噪声暴露造成的损害是随着时间的推移而累积的，并会加剧老化的影响。因此，在军队中暴露在高水平声音中的退伍军人在平民生活中非常容易受到损害，因此他们必须保护自己的耳朵不受进一步噪音的影响，以避免随着年龄的增长而听力损失。不幸的是，大多数人没有意识到噪音可能对听觉系统造成的损害，即使他们意识到了，也很少有人选择使用听力保护。因此，教育退伍军人了解噪声暴露的危险以及可以采取的简单措施来保护听力是至关重要的。我们的长期目标是传播一项有效的听力损失预防教育计划，这将有助于降低退伍军人中噪音导致的听力损失的流行率和相关成本。最终，我们打算将该计划提供给所有退伍军人、军人和其他公众。我们已经开发了两种形式的干预来教育退伍军人关于听力保护的知识。一种是计算机化的多媒体互动程序；另一种是印刷的听力保护手册。两者都提供了关于听力的信息，噪音对听觉系统的损害，听力损失对交流的影响，以及听力保护的使用。在这项研究中，我们将使用随机对照试验来评估这两种形式的干预在改变听力保护的知识、态度和行为方面的有效性。将通过评估以下三种方式来检验有效性：(1)实际的行为变化，通过噪声剂量法测量的每日噪声暴露的减少来证明；(2)报告的行为变化，通过使用日常活动和使用听力保护的实时日志评估的每日噪声暴露的减少来证明；以及(3)通过自我报告问卷评估的听力保护方面增加的知识、更健康的态度以及改善的预期和实际行为。结果将在基线、干预后立即和干预后6个月进行衡量。军事人员在退伍后重新融入社会面临许多挑战。减少他们患上噪音引起的听力损失的风险以及与沟通相关的问题，将有助于减少这种过渡的困难和创伤。这项研究将为两种不同形式的听力保护教育的相对有效性提供重要信息。从长远来看，它有可能降低退伍军人中听力损失和耳鸣的患病率和相关成本，并将证明预防听力损失可以减少长期康复的需要。 公共卫生相关性： 项目叙述性听力损失是退伍军人管理局最常见的与服务相关的残疾。它会导致沟通困难，从而导致孤立、沮丧和抑郁。听力损失的一个主要原因是暴露在高水平的声音中，被称为噪声性听力损失(NIHL)。退伍军人在服兵役期间不可避免地会接触到高水平的声音，即使他们可能还没有患上NIHL，但他们的耳朵已经受损。平民生活中持续的噪声暴露将导致NIHL。然而，通过避免噪音或使用听力保护很容易预防。大多数人没有意识到噪音会损害听力，即使他们意识到了，他们也没有使用听力保护。在这项研究中，我们将使用随机对照试验来评估我们为退伍军人开发的两种形式的NIHL教育的短期和长期效果。一个是计算机化的程序；另一个是听力保护手册。

DESCRIPTION (provided by applicant): Project Summary/Abstract: Hearing loss and tinnitus are the two most prevalent service-connected disabilities in the VA system for OEF/OIF Veterans, and Veterans from World War II, Korea, Vietnam, the Gulf War and during Peacetime. Costs associated with health care utilization, provision of hearing aids, rehabilitation services and reduced productivity for Veterans with hearing loss are substantial, and continue to increase. On a personal level, hearing loss results in communication difficulties, and often contributes to social isolation, frustration and depression. A major cause of hearing impairment is cochlear damage from exposure to high levels of sound. The longer the period of exposure and the more intense the sound pressure level, the greater is the damage that occurs. The damage from noise exposure is cumulative over time, and exacerbates the effects of aging. Veterans, who have been exposed to high levels of sound in the military are therefore highly vulnerable to damage in civilian life, thus they must protect their ears from further noise to avoid hearing loss as they age. Unfortunately, most people are unaware of the damage noise can do to the auditory system, and even when they are aware, few choose to use hearing protection. It is therefore critical to educate Veterans about the dangers of noise exposure and the simple actions that can be taken to protect hearing. Our long-range goal is to disseminate an effective hearing loss prevention education program that will help to reduce the prevalence and associated costs of noise induced hearing loss in the Veteran population. Ultimately it is our intention to make the program available to all Veterans, military personnel and other members of the public. We have developed two forms of intervention to educate Veterans about hearing conservation. One is a computerized multimedia interactive program; the other is a printed Hearing Conservation Brochure. Both provide information about hearing, the damage noise can do to the auditory system, the impact hearing loss has on communication, and the use of hearing protection. In this study we will use a randomized controlled trial to evaluate the effectiveness of these two forms of intervention at changing knowledge, attitudes and behaviors toward hearing conservation. Effectiveness will be examined in three ways through assessment of: (1) actual behavioral changes, as evidenced by decreased daily noise exposure as measured with noise dosimetry; (2) reported behavioral changes, as evidenced by decreased daily noise exposure assessed using a real-time log of daily activities and use of hearing protection; and (3) increased knowledge, healthier attitudes and improved intended and actual behavior towards hearing protection, as assessed with a self-report questionnaire. Outcomes will be measured at baseline, immediately following the intervention and six month post-intervention. There are many challenges facing military personnel as they reintegrate into society after leaving military service. Reducing their risk of acquiring noise induced hearing loss and the associated problems with communication, will help to make this transition less difficult and traumatic. This study will provide important information about the relative effectiveness of two different forms of hearing conservation education. In the long term it has the potential to reduce the prevalence and associated costs of hearing loss and tinnitus among Veterans, and will demonstrate that prevention of hearing loss can reduce the need for long-term rehabilitation. PUBLIC HEALTH RELEVANCE: Project Narrative Hearing loss is the most prevalent service-connected disability in the VA. It causes communication difficulties, which contribute to isolation, frustration and depression. A major cause of hearing loss is from exposure to high levels of sound, and is referred to as Noise Induced Hearing Loss (NIHL). Veterans have inevitably been exposed to high levels of sound during military service, and even though they may not yet have NIHL, their ears have been damaged. Continued noise exposure in civilian life will result in NIHL. However, it can easily be prevented by avoiding noise or using hearing protection. Most people are unaware that noise damages hearing, and even when they are, they do not use hearing protection. In this study we will use a randomized controlled trial to evaluate the short- and long-term effectiveness of two forms of education about NIHL that we have developed for Veterans. One is a computerized program; the other is a Hearing Conservation Brochure.