Hearing loss prevention for carpenters: part 1 - using health communication and health promotion models to develop training that works.

In phase 1 of a large multiyear effort, health communication and health promotion models were used to develop a comprehensive hearing loss prevention training program for carpenters. Additionally, a survey was designed to be used as an evaluation instrument. The models informed an iterative research process in which the authors used key informant interviews, focus groups, and early versions of the survey tool to identify critical issues expected to be relevant to the success of the hearing loss prevention training. Commonly held attitudes and beliefs associated with occupational noise exposure and hearing losses, as well as issues associated with the use or non-use of hearing protectors, were identified. The training program was then specifically constructed to positively shape attitudes, beliefs, and behavioral intentions associated with healthy hearing behaviors - especially those associated with appropriate hearing protector use. The goal was to directly address the key issues and overcome the barriers identified during the formative research phase. The survey was finalized using factor analysis methods and repeated pilot testing. It was designed to be used with the training as an evaluation tool and thus could indicate changes over time in attitudes, beliefs, and behavioral intentions regarding hearing loss prevention. Finally, the training program was fine tuned with industry participation so that its delivery would integrate seamlessly into the existing health and safety training provided to apprentice carpenters. In phase 2, reported elsewhere in this volume, the training program and the survey were tested through a demonstration project at two sites.

Hearing loss prevention for carpenters: part 2 - demonstration projects using individualized and group training.

Two demonstration projects were conducted to evaluate the effectiveness of a comprehensive training program for carpenters. This training was paired with audiometry and counseling and a survey of attitudes and beliefs in hearing loss prevention. All participants received hearing tests, multimedia instruction on occupational noise exposure/hearing loss, and instruction and practice in using a diverse selection of hearing protection devices (HPDs). A total of 103 apprentice carpenters participated in the Year 1 training, were given a large supply of these HPDs, and instructions on how to get additional free supplies if they ran out during the 1-year interval between initial and follow-up training. Forty-two participants responded to the survey a second time a year later and completed the Year 2 training. Significant test-retest differences were found between the pre-training and the post-training survey scores. Both forms of instruction (individual versus group) produced equivalent outcomes. The results indicated that training was able to bring all apprentice participants up to the same desired level with regard to attitudes, beliefs, and behavioral intentions to use hearing protection properly. It was concluded that the health communication models used to develop the educational and training materials for this effort were extremely effective.

Integrating occupational safety and health information into vocational and technical education and other workforce preparation programs.

The high rates of injury among young workers are a pressing public health issue, especially given the demand of the job market for new workers. Young and new workers experience the highest rates of occupational injuries of any age group. Incorporating occupational safety and health (OSH) information into the more than 20 000 vocational and other workforce preparation programs in the United States might provide a mechanism for reducing work-related injuries and illnesses among young and new workers. We assessed the status of including OSH information or training in workforce preparation programs and found there is an inconsistent emphasis on OSH information.

The contribution of focus groups in the evaluation of hearing conservation program (HCP) effectiveness.

PROBLEM: Exclusive reliance on such practices as policy review, audiometric testing audits, and noise surveillance to evaluate the effectiveness of workplace hearing conservation programs (HCP) fails to capture the impact of these programs as experienced by workers at the "shop floor" and offers little insight into the reasons and potential remedies for noted deficiencies. METHODS: A qualitative approach for evaluating industrial HCPs (and their various components) is discussed using three industrial populations as case studies. For each study population, this paper illustrates how focus groups, comprised of line workers and supervisors, were used to clarify and augment information gathered through more traditional program assessments to provide a more enriched picture of hearing conservation practices. Descriptive data on plant hearing conservation program practices at each plant are presented with a comparison of proactive elements of each program relative to the Occupational Safety and Health Administration (OSHA) Hearing Conservation Amendment (HCA) requirement and to internal plant policy. RESULTS: Yearly program evaluation with input from all end-users is important in the process of hearing loss prevention. The qualitative assessment outlined in this paper serves as a basis for future quantitative assessments of HCP effectiveness using hearing threshold data and noise exposure assessments to examine changes in hearing levels as a function of noise exposure and other risk factors for hearing loss.