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

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

3. 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

4. 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

5. 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)

6. Use of HPDs by Factory Workers n mean% sd Blue Collar 318 68 40 Skilled Trades 209 44 41 White Collar 116 48 41 Blue Collar Males 250 69 40 Blue Collar Females 237 76 37

7. Use of HPDs by Construction Workers n mean % sd Plumbers/pipefitters143 32 36 Carpenters129 17 30 Operating Engineers132 49 40 Plumber/pipefitter Trainers145 46 39

8. 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

9. Causal Model - Construction Workers Value of Use Barriers Self-Efficacy Noise Exposure Use.17 -.16.16.17.45 R 2 =.50 Interpersonal Models

10. 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

11. Comparison of Pre and Posttest Mean Use of HPDs Pretest Only (N=29) Pretest & Intervention (N=45) Pretest Mean 47 40 Posttest Mean 40 57 Change* -7 +17 Change as % of base -15 +43 *Change=posttest - pretest

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

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

15. 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%

16. Intervention Package