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NIOSH Hearing Loss Research Program Review NIOSH Publications on Noise and Hearing The National Academies - Advisors to the Nation on Science, Engineering, and Medicine

What does the HLR Program Do?

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R&D Portfolio - Research Goal 1.6 : Develop a survey instrument to evaluate training effectiveness

Workers routinely fail to wear HPDs when and how they should be worn. Improving the use of HPDs is often the objective of training, which is one of the seven components of an effective HLPP. Successful training programs must focus on developing the knowledge, attitudes, skills, motivation, and abilities that are associated with prevention behaviors, especially the wearing of HPDs. However, the ultimate measure of training success is the reduction of noise-induced threshold shifts among workers.

Because noise-induced hearing loss develops so gradually, it can take 5 to 10 years of audiometric monitoring to know whether the training has actually resulted in fewer occupational hearing losses. By that time, it is too late to correct the deficiency for those who have sustained the hearing loss. However, if a survey instrument could be validated against actual change in protective behavior and subsequent threshold stability, the success of particular training efforts could be evaluated more quickly and shortcomings corrected years before audiometric data would indicate the problem.

The HLR program engaged in a series of activities that culminated in the development of a survey instrument for assessing trainee characteristics and training effectiveness. First, researchers examined relevant literature for trainee characteristic constructs that could be operationalized. They then conducted several focus groups to assess the suitability of these constructs and identify others. Data from these groups were analyzed, and results were used to develop a large pool of candidate survey items. Training effectiveness items such as behavior intention (to wear HPDs) were also developed. Iterative item try-outs and path analysis were used to develop a 28-item survey. A pilot test on 2000 pile drivers, millwrights, and carpenters was undertaken to validate the survey.

The HLR program used the new survey in a two-year field study as part of a trial hearing loss prevention program for carpenters. Survey results showed how training influenced attitudes and behavioral intentions. Interim results show that the survey is an effective instrument for assessing workers’ attitudes, beliefs, and behavioral intentions.

The survey instrument holds the potential to reduce the time required for HLR program effectiveness evaluations. Training effectiveness might be measured in one to two years, whereas audiometric monitoring takes 5 to 10 years for hearing changes to become evident.

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