Testing Effectiveness of Interventions with Construction Workers and Factory Workers Sally L. Lusk, PhD, RN, FAAN University of Michigan School of Nursing

Purpose To test the effectiveness of tailored and predictor-based interventions to increase workers’ use of hearing protection devices.

Studies of HPD Use 1.Cross-sectional correlational studies to identify predictors of HPD use in various samples: Factory workers Male & female blue collar workers Construction workers 2.Intervention effectiveness studies Construction workers Factory workers

Factory (automotive) workers (blue collar, skilled trades, and white collar). n=645 Female blue collar factory (automotive workers in two other plants). n=186 Plumber/pipefitters, carpenters, and operating engineers. n=1,098 Plumber/pipefitter trainers. n=310 Samples of US workers

Factory Workers % of time used in past week, past month, and past three months when in required use areas. Construction Workers % of time used in past week, past month, and past three months, and at last job and job before that when in high noise (need to raise voice to be heard three feet or less away). Measure of Use of Hearing Protection Devices (HPDs)

Use of HPDs by Factory Workers n mean% sd Blue Collar Skilled Trades White Collar Blue Collar Males Blue Collar Females

Use of HPDs by Construction Workers n mean % sd Plumbers/pipefitters Carpenters Operating Engineers Plumber/pipefitter Trainers

Most Important Predictors Perception of: No. of Samples Self-Efficacy of Use 5 Barriers to Use4 Benefits/Value of Use4 Situational Factors1 *Interpersonal Influences2* *Measured in only 2 samples

Causal Model - Construction Workers Value of Use Barriers Self-Efficacy Noise Exposure Use R 2 =.50 Interpersonal Models

Video with content based on strongest predictors, and process guided by Bandura’s Social Learning Theory. Package of samples of different types of HPDs. Practice session with demonstration, trial, and guided practice of use of HPDs. Brochure reinforcing video content and providing additional information regarding noise and HPD use. Handout with information on suppliers of HPDs. Intervention

Comparison of Pre and Posttest Mean Use of HPDs Pretest Only (N=29) Pretest & Intervention (N=45) Pretest Mean Posttest Mean Change* Change as % of base *Change=posttest - pretest

Summary of Results HPM a useful conceptual basis for designing interventions to increase HPD use

Summary of Results HPM a useful conceptual basis for designing interventions to increase HPD use Predictor-based intervention effective in significantly increasing HPD use

Variance in Use of HPDs Explained by Health Promotion Model Variance Factory Workers - one plant 51% Factory Workers - blue collar males 64% Factory Workers - blue collar females 47% Construction Workers 50% Plumber/pipefitter Trainers 30%

Intervention Package