Stages of construction workers' use of hearing protection.

Abstract

The use of hearing protection such as ear plugs and ear muffs can reduce noise exposure and the risk of noise-induced hearing loss, the most common occupational hazard faced by workers (Sarell & Toothman, 1987). Unfortunately, a previous study found that construction workers, a population with the highest rates of work-related injury and illness in the U.S., are at high risk for noise-induced hearing loss with low rates of hearing protection use (16 to 49% during times needed) (Lusk, Kerr, & Kauffman, 1998). A promising approach to better understanding factors influencing hearing protection use involves the application of the stages of change from the Transtheoretical Model of Behavior Change (Prochaska & DiClemente, 1982). The purposes of this study were to examine the application of the stages of change construct of the Transtheoretical Model to the behavior of hearing protection use in association with components of the Health Promotion Model (Pender, 1996) and to assess the effects of the stages of change at pre-test on the post-test use and post-test intention to use hearing protection. Using the existing data from an intervention study, the stages of change and their relationship with perceived benefits, barriers, self-efficacy, situational influences, and interpersonal influences of hearing protection use were assessed in 264 Mid-Western U.S. construction workers. Results indicated that most of the construction workers in this study were in the preparation stage of hearing protection use (68.6%) and fewest in the action stage (4.2%). Individuals in different stages differed significantly on most variables and in the direction predicted by the Transtheoretical Model, e.g., those in the action and maintenance stages had lower scores on perceived barriers to hearing protection use than those in the preparation, contemplation, and precontemplation stages. Discriminant function analyses showed that interpersonal influences (modeling), perceived benefits (value of use), and perceived barriers were the strongest predictors of stages of hearing protection use. Analyses of covariance also suggested that stages of change at pre-test affected post-test use and post-test intention to use hearing protection. These findings have implications for designing interventions using stage of change construct to increase construction workers' use hearing protection.