Test of a Web-based Intervention to Promote Hearing Protector Use

OBJECTIVE: To further develop and test an intervention to promote farmers' use of hearing
protection devices (HPDs).

SPECIFIC AIMS: The specific aim of this study is to contrast the effects of three
alternative NIHL-prevention intervention strategies, delivered in various combinations on
HPD use and use-related attitudes/beliefs. Specifically, the three approaches include: a) an
interactive, predictors-based intervention delivered via the Internet ("Interactive Web,"
IWI); b) a static informational Web site designed to increase farmers' use of HPDs ("Static
Web," SWI); and c) sampler of HPDs, e.g., ear muffs, plugs ("HPD Intervention," HPD I).

HYPOTHESIS 1: Participants receiving interactive Web interventions (IWI) will have higher
hearing protector device (HPD) use and more favorable use-related attitudes/beliefs than
participants not receiving interactive web interventions (IWI); HYPOTHESIS 2: Participants
receiving the HPD intervention (HPDI)will have higher HPD use and more positive use-related
attitudes/beliefs than participants not receiving the HPD intervention (HPDI). HYPOTHESIS 3:
Participants visiting the Web site more frequently will have higher HPD use than those
visiting less frequently. HYPOTHESIS 4. There will be no interaction between intervention
delivery mode (interactive vs. static) and HPDI.

BACKGROUND: Farmers are among the most noise-exposed group of workers, and experience rates
of noise-induced hearing loss (NIHL) of up to 72% compared to workers in other industries
(x%). NIHL is associated with negative impact on quality of life, including difficulty in
communication, risk of not hearing warning sounds, and tinnitus. Although use of hearing
protection devices (HPDs) would protect them from NIHL, use among farmers is low. An earlier
study identified predictors of use of HPDs as barriers, situational factors and gender, and
accounted for 74% of the variance in use. These results also showed that a small proportion
of farmers have successfully developed a variety of methods to overcome barriers and
situational factors that interfere with HPD use. This project builds on the earlier work by
applying these findings to develop a targeted intervention that also incorporates videotaped
messages from the actual farmers who were frequent users of HPDs.

METHODS: The interventions, based on the Pender Health Promotion Model, will consist of
Internet-based brief interactive motivational packages regarding adopting HPD use behaviors.
Outcome measures will include self-reported frequency of HPD use, measured at 6 and 12
months post-intervention. The study will involve six experimental conditions. In the first
condition, farmers will receive the interactive Web intervention (IWI) and an assortment of
hearing protection devices (HPDs); in the second condition, farmers will receive the
interactive Web intervention (IWI) only; in the third condition, farmers will receive the
static Web intervention (SWI) and HPDs; in the fourth condition, farmers will receive the
static Web intervention (SWI) only; in the fifth condition, farmers will receive the
assortment of HPDs only. A sixth condition will deliver the interactive Web intervention
only to farmers who enroll after the target of 709 enrollees, and will receive this service
as a courtesy to the American Farm Bureau and its affiliates, but cases 710 and beyond will
not receive incentives.

Inclusion Criteria:

- farm operators who are active in production at least half-time,

- speak English

- at least 18 years of age

- have Internet access.