Application of the transtheoretical model to research on factory workers use of hearing protection.

Abstract

In the United States the National Institute for Occupational Safety and Health (NIOSH, 1996) estimated that more than 30 million workers are exposed to harmful levels of noise on the job, making noise one of the most prevalent occupational health hazards. Use of hearing protection devices (HPDs), as a behavior control method, becomes necessary when worker noise exposure remains at unsafe levels. Past studies of HPD use have demonstrated that worker HPD utilization is below what is required to protect workers (Lusk, Kerr, Ronis, & Eakin, 1999). To prevent noise induced hearing loss it is essential that workers increase their use of HPDs. The specific aims of this project were (a) to evaluate the utility of the Transtheoretical Model (TTM) for staging the behavior of use of hearing protection in factory workers, and (b) to test the TTM suppositions as applied to factory workers' stages of hearing protection use. This project was a secondary analysis of previously collected data from the National Institutes of Health, National Institute of Nursing Research funded research project, Grant number 2R01NR0250, principal investigator Dr. Sally L. Lusk, titled Test of Interventions to Prevent Workers' Hearing Loss. Conceptual links between the original project's framework and the TTM were theorized to support the statistical analyses performed. The findings supported the presence of distinct HPD use stages. Significant differences were found in measures of Social Norms, Social Models, Interpersonal Support, Perceived Barriers, Perceived Benefits, and Self-efficacy by stages of BPD use. These differences were in the theoretically expected directions, consistent with hypotheses based on the TTM. Alternative outcome measurement methods including percent change, dichotomous (goal met versus not met), and changes in stage were examined. The stage change analyses provided a more detailed picture of changes in HPD use following interventions. These findings supported the TTM as a useful heuristic perspective on behavioral change applied to factory workers' use of HPDs. Considering implications for future research, the findings suggest that the TTM offers a meaningful framework for designing future interventions tailored to the TTM stages.