An examination of antecedents to coal miners' hearing protection behaviors:
 

A test of the theory of planned behavior
 

Brian L. Quick a,⁎, Michael T. Stephenson b, Kim Witte c, Charles Vaught d,
 

Steve Booth-Butterfield e

, Dhaval Patel f
 

a Department of Communication, University of Illinois at Urbana-Champaign, Urbana, Il 61801, USA
 b Department of Communication, Texas A&M University, College Station, TX, 77843-4234, USA
 c Department of Communication, Michigan State University, East Lansing, MI 48824
 d Pittsburgh Research Laboratory, National Institute of Occupational Safety and Health, Pittsburgh, PA, 15236, USA
 e Department of Communication Studies, West Virginia University, Morgantown, WV 26501, USA
 f Maria Stopes International in London, W1T6LP United Kingdom
 

Abstract

Problem: The National Institute for Occupational Safety and Health's [NIOSH] National Occupational Research Agenda (DHHS Publication

No. 96 115) reports that approximately 50% of miners will experience hearing loss by age 50, compared to only 9% of the general population. The

present investigation examines three antecedents believed to be associated with miner's use of hearing protection. Method: A posttest delayed

posttest control group field research design was employed to assess antecedents toward wearing hearing protection. Results: Following the initial

posttest, miners' attitudes and subjective norms were antecedents to intentions to wear hearing protection devices. Also, intentions toward wearing

hearing protection predicted hearing protection behaviors. Approximately six weeks later, miners' attitudes and perceived behavioral control were

each significant predictors of intentions to wear hearing protection and again, intentions were positively associated with hearing protection

behaviors. Impact on Industry: Our results indicate that appeals to normative influences may be the most effective antecedent to employ when

persuading coal miners to wear hearing protection. However, messages designed to impact attitudes and perceived behavioral control were also

effective.

1. Problem	 

Noise-induced hearing loss affects approximately 30 million

workers in the United States on a daily basis (National Institute

for Occupational Safety and Health [NIOSH], 1996). While

noise is problematic for several occupations, coal miners along

with individuals working in agriculture, construction, manufacturing and utilities, and the military are at the greatest risk of

experiencing hearing loss due to the noise in each of their

respective working environments. NIOSH (1996) reports that

approximately 50% of miners will experience hearing loss by

age 50, compared to only 9% of the general population.

Moreover, this percentage is believed to jump to 70 by the time

miners reach the age of 60, according to the same report. The

good news is that hearing loss is preventable through the use of

ear plugs, ear muffs, and semiaurals (Murray-Johnson et al.,

2004; NIOSH, 1996). Applying the Theory of Planned

Behavior (TPB; Ajzen, 1991), the present investigation

examined antecedents to both intentions and hearing protection

behaviors among Pennsylvania and West Virginia coal miners.

We begin by providing an overview the TPB.
2. Theory of Planned Behavior

When examining antecedents to behavior change, a commonly

used theory is Ajzen's (1985) TPB. Building off of Fishbein and

Ajzen's (1975) Theory of Reasoned Action (TRA), this theory

provides a more comprehensive depiction of verifiable antecedents

for certain behaviors(i.e., wearing hearing protection)than TRA.In

addition to examining attitudes and subjective norms as antecedents, Ajzen (1991) identified perceived behavioral control as a

predictor of one's behavioral intent. TPB assumes that individuals

rationally weigh the rewards and costs of a behavior before

performing a task. The theory has been applied to health campaigns

promoting a variety of behaviors. For example, Silk, Parrott, and

Dillow (2003) used the TPB in guiding their formative evaluation

of messages promoting genetically modified foods. The theory has

also been applied to evaluating the effectiveness of social norms

campaigns concerning binge drinking on college campuses

(Campo et al., 2003). The present investigation seeks to apply the

TPB to the context of coal miner hearing protection behaviors.

Following TPB, a miner's attitude, subjective norm, and perceived

behavioral control toward wearing hearing protection are predicted

to be positively associated with intentions toward wearing hearing

protection (Ajzen, 1985). In turn, intentions to wear hearing

protection is hypothesized to be positively associated with wearing

hearing protection. Below, we briefly discuss each of the variables

comprising the TPB.

2.1. Attitude

One predictor of an intention is one's attitude toward

performing a specific behavior (Fishbein & Ajzen, 1975). An

attitude is defined as a favorable or unfavorable evaluation of

the belief at hand. Attitudes are often shaped by a belief in the

severity of the threat at hand. Murray-Johnson et al. (2004)

discovered that most miners “reported the concept of hearing

loss as potentially scary and frightening” (p. 746). According to

the same report, others stated that noise exposure in the mine

was “horrible, serious, harmful, permanent and affecting their

quality of life” (p. 746). Despite the perceived severity of noise

exposure in the mine, these miners believed hearing protection

strategies to be only marginally effective (Murray-Johnson

et al., 2004). The beliefs, along with evaluations of these beliefs,

comprise one's attitude (Fishbein & Ajzen, 1975).

Research reveals that attitudes are a stable predictor of

behavioral intentions. Kim and Hunter's (1993) meta-analysis,

which consisted of 92 studies, found an uncorrected mean

correlation between attitude and behavioral intention of .65.

Sheeran and Taylor (1999) and Godin and Kok (1996), metaanalyses of 32 and 56 studies, respectively, found robust

positive associations of .45 and .46 between attitudes and

behavioral intentions. Thus, we assume that one's attitude

toward hearing protection is positively associated with behavioral intentions to wear hearing protection. Thus:

H1. A coal miner's attitudes toward wearing hearing protection

will be positively associated with behavioral intentions toward

wearing hearing protection.

2.2. Subjective Norm

A second antecedent to behavioral intentions is subjective

norms. Subjective norms represent the perceptions that important

others think you should or should not perform a specified

behavior (Fishbein & Ajzen, 1975). Within the context of miners

wearing hearing protection, research suggests that coworkers,

management, spouse, and supervisors represent normative

influences (Murray-Johnson et al., 2004). Many believe that

subjective norms represent a key message design variable as an

influential antecedent as is demonstrated in the number of

campaigns dedicating considerable effort in appealing to

normative influences (Campo et al., 2003). For example, several

colleges and universities have incorporated social norms marketing campaigns to curb underage drinking on college campuses

(see Lederman et al., 2001; Schroeder & Prentice, 1998). The

overriding objective of these campaigns was to correct erroneous

perceptions regarding alcohol consumption among college

students (Campo et al., 2003). From many of these reports, it

appeared that appealing to normative influences was a formidable

strategy in health promotion, particularly when your target

audience is adolescents (Perloff, 2003).

Both the TRA and TPB treat attitudes and subjective norms

as antecedents to behavioral intentions. Although the bulk of

this research indicates that attitude is the prevailing predictor,

subjective norms also provide a reliable predictor of intentions

(Ajzen, 1991). In fact, meta-analytic research indicates a

positive association ranging from .34 to .42 between subjective

norms and behavioral intentions (Godin & Kok, 1996; Sheeran

& Taylor, 1999). Given the established relationship between

these variables and in conjunction with the TPB, we put forth

the second hypothesis:

H2. A coal miner's subjective norms toward wearing hearing

protection will be positively associated with behavioral intentions toward wearing hearing protection.

2.3. Perceived Behavioral Control

After more than 15 years of reliance on attitudes and

subjective norms to predict behavioral intentions, Ajzen (1991)

added a third antecedent to the equation-perceived behavioral

control. Perceived behavioral control is similar to Rotter's

(1966) notion of locus of control. However, perceived behavioral control refers to a belief about the degree of control one

perceives to have in performing a specific behavior (Ajzen,

1991). Whereas perceived behavioral control is a situationalspecific belief, Rotter's locus of control is a personality trait.

Rotter's (1966) conceptualizes a person with an internal locus of

control as someone who believes that outcomes materialize as a

direct result of their behavior whereas someone with an external

locus of control attribute outcomes to fate or chance. On the

other hand, Ajzen's (1991) perceived behavioral control is

concerned with the ease or difficulty one perceives in

performing a behavior. As noted by Ajzen (2002), a “closer

analysis reveals that perceived control over an outcome or event

is independent of the internal or external locus of the factors
responsible for it” (p. 676). Although the conceptualization of

perceived behavioral control appeared concrete, Ajzen (2002)

acknowledged the ambiguity surrounding this theoretical

construct. Through his use of hierarchical modeling, he argued

that perceived behavioral control encompassed aspects of both

self efficacy and controllability. Accordingly, our conceptualization of perceived behavior control is consistent with his recent

writings. Both dimensions of perceived behavioral control were

revealed in a recent study that examined miners' perceptions of

wearing hearing protection (Murray-Johnson et al., 2004). In

doing so, they reported miner concerns ranging “from comfort,

hygiene of HPD [hearing protective devices] products, and cost,

to their inability to want to make a behavior change” (p. 748).

Given these results from approximately 30 miners, we believe

examining the relationship between perceived behavioral

control and behavioral intentions when promoting hearing

protection is important.

Within the context of hearing protection, TPB assumes that

if miners believe they can wear hearing protection, then they

are more likely to wear hearing protection. Although

perceived behavioral control has not received as much support

as the aforementioned antecedents, recent meta-analyses of

TPB revealed a strong association (r) between perceived

behavioral control and intentions ranging from .35 to .53 (see

Ajzen, 1991; Godin & Kok, 1996; Hausenblaus, Carron, &

Mack, 1997). Following TPB, we expect that miners

maintaining perceived behavioral control, both the confidence

and ability, will likely report intentions to wear hearing protection. Thus:

H3. A coal miner's perceived behavioral control toward

wearing hearing protection will be positively associated with

behavioral intentions toward wearing hearing protection.

2.4. Behavioral Intentions

The TPB hypothesizes that behavioral intentions to perform

a specific behavior will be positively associated with performing the behavior. Fishbein and Ajzen (1975) define behavioral

intention as the likelihood a person will perform a specific

behavior. According to TPB, if a coal miner has an intention to

wear ear plugs or ear muffs in the mine, then he or she is likely

to perform this behavior. With that said, we put forth the fourth

hypothesis:

H4. A coal miner's intention to wear hearing protection devices

in the mine will be reflected in his or her self-reported behaviors.

To summarize, this project applies the TPB within the context

of health messages designed to persuade Pennsylvania and West

Virginia coal miners to wear hearing protection in the mines.

Following the TPB, we hypothesize that three antecedents will

be positively associated with intentions to wear hearing

protection-attitudes (H1), subjective norms (H2), and perceived

behavioral control (H3). Also, behavioral intentions to wear

hearing protection are hypothesized to be positively associated

with self-report hearing protection behaviors (H4). Together,

these hypotheses are depicted visually in Fig. 1.

3. Method

3.1. Participants and Procedures

The present investigation employed a posttest, delayedposttest field research experimental design to assess three

antecedents believed to be associated with hearing protection

behaviors. In doing so, coal miners received two postcards (e.g.,

either a positive, neutral, or negative affective appeal) within a

two-week timeframe via the United States postal service (see

Appendix A). Approximately six weeks after the postcards were

mailed, miners who had completed the first survey received a

second identical survey. For coal miners not returning the

second survey, a research firm contacted them via phone to

complete the survey. A second custom-printed mining decal

was provided to those completing the second survey. Miners

randomly assigned to the control condition were not included in

this report.

Participants were miners from 23 randomly-selected coal

mines in Pennsylvania and West Virginia. The list of mines was

provided by the United Mine Worker's Association. During the

posttest, all coal miners (N= 324) were male. The total number

of miners included in this analysis was 254. The average age

was 49.24 (SD= 6.16) and almost all respondents (98.7%)

identified their race as White/European-American with only a

slight representation of Black/African-American or Native

American. Most miners (89.2%) were married. Regarding

educational achievement, the majority of miners had completed

high school (49.6%) or some college (23.3%), while others

completed some high school (10.4%), vocational school

(11.3%), or held a college degree (5.4%). The average amount

of time spent working in a mine was 24.84 years (SD= 6.82). For

the delayed posttest survey, which occurred approximately six

weeks later, 191 miners participated.

3.2. Hearing Protection Campaign

Coal miners in the three experimental postcard conditions

were mailed two different postcards containing recommendations

Fig. 1. Hypothesized Structural Model.
for hearing protection while working (for a detailed description of

these postcards, see Stephenson et al., 2005). Within a week of

receiving the first postcard, miners received a second postcard in

the mail. Miners received a survey one week after the second

postcard arrived. Along with the questionnaire, miners received

both postcards that they had previously received. In all, miners in

the treatment conditions received a total of four postcards

throughout the campaign. Coal miners in the control condition

only received the survey. Lastly, regardless of condition,

participants received a cover letter in the survey packet from the

United Mine Workers' Association, the labor union that

represents the targeted miners, encouraging their assistance with

the survey. Miners were asked to complete and mail back the

survey in exchange for a custom-printed mining decal. The

response rate was 28%.

In order to maximize exposure of the persuasive messages

advocating hearing protection (Hornik, 2002), poster-size

versions of the postcards were located in high traffic locations

inside the mines (e.g., locker rooms, time card sites, drinking

fountains). These poster-sized messages were identical to the

postcards received by coal miners in the mail. Since the mines

were randomly assigned to a condition, they received matching

posters and postcards in order to prevent contamination of the

stimuli among the three conditions.

3.3. Measures

3.3.1. Attitudes toward hearing protection

Attitudes toward hearing protection formed a modestly

reliable scale during the posttest (α=.68) and delayed posttest

(α=.63). On a seven point (1 = strongly disagree to 7 =

strongly agree) scale, miners indicated their attitudes through

the following three items: (a) wearing hearing protection is

good, (b) wearing hearing protection is bad (reverse coded), and

(c) wearing hearing protection is positive.

3.3.2. Subjective norms toward hearing protection

Subjective norms toward wearing hearing protection was

assessed on a 1 (Strongly disagree) to 7 (Strongly agree) scale

using the following items: (a) My spouse wants me to wear

hearing protection; (b) My supervisor wants me to wear hearing

protection; (c) My co-workers want me to wear hearing

protection; and (d) Management wants me to wear hearing

protection. Together, these four items formed a reliable measure

both during the posttest (α=.80) and delayed posttest (α=.81).

3.3.3. Perceived behavioral control toward hearing protection

Following Ajzen's (2002) recent work, the scale employed

in this analysis reflects his operationalization of perceived

behavioral control. Specifically, on a 1 (Strongly disagree) to 7

(Strongly agree) scale, the following four items were used: (a) I

am able to wear hearing protection whenever machinery is on;

(b) I can wear hearing protection whenever I want; (c) It is easy

to wear hearing protection whenever machinery is on; and (d) I

can afford to wear the hearing protection I want. This scale

achieved a reliable index during the posttest (α=.73) and

delayed posttest (α=.72).

3.3.4. Behavioral intentions

Coal miners indicated their intent to wear hearing protection

with the following item on a seven-point (1 = strongly disagree

to 7 = strongly agree) scale: I intend to wear hearing protection

regularly.

3.3.5. Hearing protection behaviors

Miners indicated their current behavior by responding to the

following three items on a seven point scale (1 = not at all to 7 =

all of the time): (a) I wear hearing protection equipment

underground; (b) I wear hearing protection to prevent hearing

loss; and (c) I regularly use hearing protection in the mine.

These items formed a reliable composite for both the posttest

(α=.86) and delayed posttest (α=.87).

3.4. Data Analytic Strategy for Hypotheses

To test the validity of the hypothesized model, structural

equation modeling (SEM) was employed using full-information

maximum likelihood estimators in EQS 6.1 for Windows. SEM

offers unique advantages over path modeling. SEM affords

researchers the ability to visualize and analyze communication

as a process (Stephenson, Holbert, & Zimmerman, 2006).

Additionally, Stephenson and colleagues argue that SEM allows

researchers to test a theoretical model simultaneously as

opposed to running a series of individual regressions that

examine data one association at a time. Lastly, SEM enables

researchers to test direct and indirect effects simultaneously

(Holbert & Stephenson, 2003). In testing the proposed model,

attitudes, subjective norms, perceived behavioral control, and

behavior were treated as latent composite variables (see Holbert

& Stephenson, 2002; Stephenson & Holbert, 2003). Behavioral

intention was represented as a single item observed variable.

Four tests were used to assess the goodness of fit for the

hypothesized models, including the Chi square-distributed

goodness of fit (χ2

) to evaluate the omnibus model, Comparative Fit Index (CFI), Standardized Root Mean Squared

Residual (SRMR), and the Root Mean Squared Error of

Approximation (RMSEA). In determining the adequacy of

model fit, structural models with lower χ2

- distributed goodness of fit values that are not significant represent a better fitting

model. Additionally, CFI values range from 0 to 1, with better

overall fit indicated by higher values. Specifically, Hu and

Bentler (1999) recommend CFI values of .95 or higher indicate

a good fitting model. To the contrary, good fitting models

achieve lower scores on the SRMR and RMSEA. Hu and

Bentler (1999) suggest cutoff values close to .09 for SRMR and

.06 for RMSEA (see Browne & Cudeck, 1993; Holbert &

Stephenson, 2002). The CFI, SRMR, and RMSEA are reported

along with the χ2

-distributed goodness of fit for both structural

models presented in this investigation.

4. Results

Because this investigation combines data across three

treatment conditions, it was important to control for condition

when testing the hypothesized model for both the posttest and
delayed posttest. Because differences between each of the

affective appeals of this campaign have been discussed

elsewhere (Stephenson et al., 2005), the objective of this

investigation was not to reproduce these findings. Rather, the

overarching goal of this investigation was to apply TPB to a

hearing protection campaign aimed at coal miners to assess

sustained association over time. In doing so, identifying

antecedents to wearing hearing protection was the primary

objective. With that said, it was important to statistically control

for the variation due to experimental condition; therefore, two

dummy variables for experimental condition were created given

the categorical nature of the original variable. Second, we

regressed attitude, subjective norm, perceived behavioral

control, behavioral intention, and behavior on both dummy

variables in SPSS. Then, the unstandardized residuals for these

variables, which represent the variance not explained by the

experimental condition, were saved and transferred to EQS for

the structural equation analyses (e.g., Stephenson & Palmgreen,

2001). In this way, the variables are not adversely affected by

any systematic effect attributable to exposure to persuasive

messages. The posttest structural model is presented followed

by results from the delayed-posttest.

Fig. 2. Posttest Structural Model.

4.1. Posttest Structural Model

Before testing model fit for the posttest, the data were

examined for normality. The Mardia's normalized estimate was

acceptable at 14.72. We determined that the hypothesized

structural model was not consistent with the data, CFI= 1.0,

SRMR =.04, RMSEA=.11 (90% confidence interval of .05,

.18), χ2 (3, N=254) = 12.64, pb.001. Following recommendations by the Lagrange Multiplier test, a path was added

connecting subjective norms to behaviors. Following this

recommendation, the structural model fit the data, CFI= 1.0,

SRMR =.01, RMSEA= .00 (90% confidence interval of .00 to

.11), χ2 (N= 254)= 1.36, p=.51. See Table 1 for correlations,

means, and standard deviations for this model's variables and

Fig. 2 for path coefficients.

Table 1

Zero-Order Correlations and Descriptive Statistics for Posttest Structural Model

1 2 3 4 5

1Attitude 1.0

2

Subjective Norm .34⁎⁎⁎ 1.0

3Perceived Behavioral .34⁎⁎⁎ .44⁎⁎⁎ 1.0

Control

4Behavioral Intention .40⁎⁎⁎ .53⁎⁎⁎ .41⁎⁎⁎ 1.0

5Behavior .34⁎⁎⁎ .49⁎⁎⁎ .31⁎⁎ .69⁎⁎⁎ 1.0

Mean -.00 -.01 .00 -.01 -.00

SD .79 1.20 1.13 1.45 1.69

Note. *** pb.01.

4.2. Delayed Posttest Structural Model

When assessing the model fit for the delayed posttest, a

Mardia's normalized estimate was 16.75. Following a review of

the data, one outlier was dropped from the set bringing the new

Mardia's normalized estimate to 12.28. The revised data

revealed that the original hypothesized model did not fit the

posttest data, CFI=.99, SRMR=.07, RMSEA=.20 (90%

confidence interval of .13 to .28), χ2 (3, N= 190) = 25.46,

pb.001. Similar to the posttest data, the Lagrange Multiplier

test suggested adding a direct path connecting subjective norms

and wearing hearing protection, which resulted in a significantly

better fitting model, CFI= 1.0, SRMR=.01, RMSEA=.00 (90%

confidence interval of .00 to .14), χ2 (2, N= 190) = 1.65, p=.44.

See Table 2 for correlations, means, and standard deviations for

this model's variables and Fig. 3 for path coefficients. To

examine differences as well as sustained effects between the

variables of interest for the posttest and delayed posttest models,

see Fig. 4.

Table 2

Zero-Order Correlations and Descriptive Statistics for Delayed Posttest

Structural Model

1 2 3 4 5

1Attitude 1.0

2

Subjective Norm .40⁎⁎⁎ 1.0

3Behavioral Control .47⁎⁎⁎ .39⁎⁎⁎ 1.0

4Behavioral Intention .48⁎⁎⁎ .41⁎⁎⁎ .52⁎⁎⁎ 1.0

5Behavior .40⁎⁎⁎ .50⁎⁎⁎ .47⁎⁎ .67⁎⁎⁎ 1.0

Mean −.00 .01 −.00 .03 −.01

SD .83 1.27 1.03 1.31 1.62

Note. *** pb.01.

4.3. H1: Attitudes and Behavioral Intentions

The first hypothesis predicted a positive association between

attitude toward wearing hearing protection and behavioral

intentions to wear hearing protections (Fishbein & Ajzen,

1975). Results support H1. According to the structural model,

the path coefficient connecting attitudes and behavioral intent

was significant at the posttest (pb.01) and six weeks later

during the delayed posttest (pb.05), thus providing empirical

support for TPB (Ajzen, 1991).
Fig. 3. Delayed Posttest Structural Model.

Fig. 4. Differences between Posttest and Delayed-Posttest Structural Models.

4.4. H2: Subjective Norms and Behavioral Intentions

H2 proposed a positive association between perceived

normative influences from coworkers, family, management,

and supervisors, and intentions toward wearing hearing

protection while in the coal mine. Results reveal partial support

for the second hypothesis. Following exposure to the persuasive

messages, the relationship between subjective norms and

intentions to wear hearing protections was positive (pb.001).

However, this association diminished at the delayed posttest

(pN.05). Although the majority of research on TRA and TPB

indicate that attitudes are a stronger predictor of a specific

behavior than subjective norms (see Hale, Householder, &

Greene, 2002), results from this investigation revealed that

during the initial posttest, subjective norms represented a

stronger predictor of behavioral intent to wear hearing

protection than attitudes. However, this difference was not

replicated during the delayed posttest.

Although mixed results appeared in testing H2, the Lagrange

Multiplier test indicated adding a direct path connecting

subjective norms to behaviors for both models. Following this

recommendation, the revised model fit the data. The path

coefficient linking subjective norms and hearing protection

behaviors was significant (pb.001) for both posttest and

delayed-posttest models. Thus, it appears that a direct effect

exists between subjective norms and behaviors for both models.

In addition, a direct effect emerged between subjective norms

and intentions in the initial posttest. However, for the delayed

posttest, a non-significant direct effect occurred between

subjective norms and intentions, despite the significant

association that emerged between subjective norms and hearing

protection behaviors. In order to understand this linear

association more precisely, a product of coefficient test was

performed to test for indirect effects (see Holbert & Stephenson,

2003; MacKinnon, Lockwood, Hoffman, West, & Sheets,

2002). Following Craig's (1936) product of two normally

distributed variables table, intentions mediated the association

between subjective norms and behaviors (z= 46.04, pb.001) for

the posttest. However, for the delayed posttest, the z-score

product for the mediation path between subjective norm and

behavior (z=.03, pN.05) was non-significant, indicating no

indirect effect.

4.5. H3: Perceived Behavioral Control and Behavioral

Intentions

In addition to attitudes and subjective norms, TPB identifies

perceived behavioral control as an antecedent to intentions

(Ajzen, 1991). In turn, the third hypothesis predicted a positive

association between perceived behavioral control and intentions

to wear hearing protection. H3 received partial support.

Perceived behavioral control was not significantly associated

with intentions to wear hearing protection (pN.05) during the

posttest. However, during the delayed posttest, the path

coefficient for this association was significant (pb.01). Therefore, it appears as if exposure to the messages successfully

increased the association between perceptions of perceived

behavioral control and hearing protection intentions from the

outset, thereby providing partial support for TPB.

4.6. H4: Behavioral Intentions and Behaviors

The last hypothesis articulated a positive association between

intentions to wear hearing protection and self-reported use of

hearing protection such as wearing ear plugs and muffs. Research

on both the TRA and TPB has revealed a strong association

between both variables (see Ajzen, 1991; Hale et al., 2002;

Sheeran & Taylor, 1999). Consistent with this research, both path

coefficients at the posttest and delayed posttest revealed a strong

positive association between both variables (pb.001). Thus,

results provide empirical support for the fourth hypothesis.

5. Discussion

The overarching goal of this investigation was to apply TPB

to assess three antecedents to coal miners' hearing protection
behaviors. This examination was done within the context of a

campaign designed to promote hearing protection behaviors

among coal miners. Two objectives were accomplished. First,

this examination provided an empirical test of the TPB. A

theoretical foundation provides an explanation for why certain

messages are effective or ineffective and therefore are

instructive in understanding variables that may maximize the

effectiveness of a message. A theory, such as the one employed

in this investigation, offers practitioners with a roadmap for

message design strategies. For these reasons, applying and

testing the hypotheses derived from the TPB within the hearingloss context of coal mines was justifiable. Second, this

investigation identified three antecedents to be used in

campaigns aimed at increasing hearing protection behaviors

among coal miners.

Hearing loss is a major problem for coal miners, as indicated

by NIOSH (1996). Given the need for effective promotional

messages designed to advocate hearing protection among coal

miners it is important to identify key antecedents to this

behavior. Once identified, these antecedents can inform

message design strategies in the future. The TPB was employed

as a theoretical framework to examine the theory's testable

hypotheses (Ajzen, 1991). Results suggest that miners' attitudes

toward wearing hearing protection are a significant predictor of

intentions to wear hearing protection in the mine during the

posttest. Six weeks later, attitudes remained a robust predictor of

intentions to wear hearing protection. According to existing

research, attitudes are frequently the strongest predictor of

behavioral intentions (for a review, see Hale et al., 2002). Of the

three antecedents, attitude was the only predictor that was

significantly associated with intentions at both data collection

points. In essence, the association between attitudes and

intentions toward wearing hearing protection was sustained

over time. This finding mirrors meta-analytic research that

demonstrates attitude as the best predictor of behavioral

intentions (Godin & Kok, 1996; Kim & Hunter, 1993; Sheeran

& Taylor, 1999). Although we are unaware of existing research

applying the TPB within the present context, research on TRA

and TPB consistently demonstrates the predictive nature of

attitudes on intentions (Moan & Rise, 2005; Sutton, 1998).

Perhaps one of the most interesting findings that emerged in

this evaluation was the role of subjective norms in predicting

hearing protection intentions. At the initial posttest, results

revealed that subjective norms were the most robust predictor of

behavioral intentions to wear hearing protection. However, at

the delayed posttest six weeks later, the association between

subjective norms and intentions, disappeared. Although this

finding came as a surprise, subjective norms achieved a direct

effect on hearing protection behaviors at both the posttest and

delayed posttest. While a formal test of mediation demonstrated

that intentions did mediate the relationship between subjective

norms and behaviors initially, this indirect effect was not

supported during the delayed posttest. It is worth noting that of

the three antecedents, subjective norms was the only variable

directly associated with behaviors. This finding makes sense

given the camaraderie amongst coal miners (see MurrayJohnson et al., 2004). Coal miners put their lives on the line on a

daily basis and in doing so entrust their fellow miners to assist

them in completing arduous and dangerous tasks. Future

campaigns can incorporate findings from this study into their

message design strategies by emphasizing normative appeals.

More specifically, messages should emphasize that co-workers,

supervisors, and spouses support their hearing protection

behaviors in the mine. Based on an earlier study with this

cohort of miners, messages employing positive-affect messages

appear to be the most persuasive (Stephenson et al., 2005).

Future research should examine the effectiveness of coupling

positive affect messages with the aforementioned normative

influences.

Although the TPB suggests that perceived behavioral

control is a significant predictor of behavioral intentions

(Moan & Rise, 2005; Norman & Conner, 2006), this was not

the case during the initial posttest. During the posttest, a nonsignificant association emerged, albeit positive, between

perceived behavioral control and intentions to wear hearing

protection. However, during the delayed posttest six weeks

later, perceived behavioral control was positively associated

with intentions to wear hearing protection. These findings

suggest that encouraging miners to wear hearing protection

through the dissemination of postcards and posters can

increase the association between perceived behavioral control

and intentions over time. Ease of usage and costs have been

identified by coal miners as major barriers to wearing hearing

protection (Murray-Johnson et al., 2004). Therefore, creating

messages designed to reduce these barriers appears reasonable

and achievable. Findings from the present study indicate that

many of these perceived barriers can be reduced through the

dissemination of postcards and posters. Furthermore and

perhaps most encouraging from a health campaign standpoint,

both of these promotional efforts were achieved with minimal

costs.

The fourth hypothesis predicted a positive association

between intent to wear hearing protection and hearing

protection behaviors. Consistent with Fishbein and Ajzen's

(1975) hypothesis, H4 was supported both at the posttest and

delayed posttest. Coal miners intending to wear hearing

protection also reported wearing hearing protection. This

finding complements meta-analytic work demonstrating a

significant association between intentions and behaviors

(Ajzen, 1991; Kim & Hunter, 1993).

6. Limitations

Despite putting our best foot forward to design an internally

and externally valid experiment to assess three antecedents of

hearing protection intentions among coal miners, a few

limitations hinder the generalizability of these findings. For

starters, the initial response rate was low. Given the low

response rate, a reasonable conclusion to draw is that the sample

was comprised of miners maintaining a vested interest in

hearing protection. While the initial response rate was low at the

posttest, the follow-up mail survey six weeks later resulted in

the loss of 78 miners. Although the response rate was a

disappointment, the response rate garnered within the present
study is not uncommon when mail surveys are employed (Frey,

Botan, & Kreps, 2000). Another limitation within the present

study rests in the single-item measure to assess intentions to

wear hearing protection. In an attempt to secure and retain as

many coal miners as possible, survey length was abbreviated

wherever possible and thus resulted in the single-item measure

above. Future research should seek to incorporate multiple

items to measure intentions. Future research should also

examine if locus of control (Rotter, 1966) moderates the

relationships observed in this investigation. With a better

understanding of how locus of control impacts coal miners'

intentions and subsequent hearing protection behaviors, practitioners will be better equipped to segment audiences on this

trait, and as a result, design more effective messages promoting

hearing-protection behaviors.

7. Impact on Industry

The success or failure of a health campaign is contingent on

multiple factors such as resources, message quality, exposure,

evaluation, and formative research (Backer, Rogers, & Sopory,

1992). The motivation behind this investigation was to apply an

established theory to better understand three potential antecedents to intentions toward wearing hearing protection among

coal miners. In doing so, we are now better situated to identify

antecedents associated with this life-improving behavior for

coal miners. The TPB provided a conceptual understanding for

which variables are associated with hearing protection usage by

coal miners.

In an earlier report documenting the effectiveness of the

postcard and poster intervention, Stephenson et al. (2005) found

that coal miners exposed to either the positive- or neutral-affect

messages reported greater hearing protection behaviors compared to those exposed to the negative-affect message for both

the posttest and delayed posttest. Additionally, the positiveaffect message, compared to the neutral- or negative-affect

messages, was more effective in reducing defensive mechanisms (e.g., defensive avoidance) from occurring. In short, the

campaign was effective for miners exposed to the neutral- and

positive affect messages. The negative-affect messages were not

effective at mobilizing increased hearing protection among

miners. Although these results presented a comprehensive

summative evaluation of the campaign utilizing three different

message appeals, the report did not provide practitioners

interested in promoting hearing protection with theoreticallygrounded antecedents associated with coal miners wearing

hearing protection. This investigation sought to identify key

antecedents to wearing hearing protection. Below, we provide

three recommendations from this investigation.

We have three recommendations for campaigners interested

in promoting hearing protection among coal miners. First and

most importantly, coal miners' self-report behaviors appear to

be most influenced by their co-workers, management, spouse,

and supervisors. Promotional messages encouraging hearing

protection should incorporate these individuals as credible

spokespersons. In a similar vein, normative appeals should be

used in hearing protection promotional materials. However,

both message strategies should undergo pilot testing to ascertain

their perceived effectiveness. Second, miners' attitudes provide

a robust predictor of intent to wear hearing protection both

initially and were sustained over a six-week period. Reinforcing

the benefits of wearing hearing protection will go a long way in

bolstering one's attitude toward wearing hearing protection and

should continue to be included in future hearing protection

campaigns. Stephenson et al. (2005) discovered that positiveaffect messages, as opposed to negative- and neutral-affect

appeals, proved to be the most effective in promoting hearing

protection; therefore, framing messages using a gain-framed

approach appears to be better than a loss-framed approach with

this particular audience (Kahneman & Tversky, 1979). Again,

of the three antecedents of intentions to wear hearing protection,

results indicate that attitudes appear to be the most stable and

thus should be incorporated into future message design

strategies. Third, messages such as “You can talk about hearing

loss concerns with your co-workers and learn what they know

about how to avoid it” and “You can do your part to protect your

hearing by wearing hearing protectors regularly and getting

your hearing tested” were effective in increasing perceptions of

ease. These messages bolstered perceived behavioral control

within the present sample of miners from the initial posttest to

the follow-up posttest six weeks later. Given that issues of

efficacy have been identified as barriers in the past (MurrayJohnson et al., 2004), future campaigns aimed at increasing

hearing protection behaviors among miners should create

messages that emphasize issues of perceived behavioral control

for coal miners.

In sum, we hope the findings presented in this investigation can be used to inform future hearing protection

campaigns to miners and others who function in a noisefilled working environment. Prior to costly and extensive

message development, practitioners need to have a sense of

which variables are associated with the desirable outcome

(Atkin & Freimuth, 2001). Formative research helps enable

health campaigners to effectively create messages that will

resonate with a well defined target market (Andreasen, 1995;

Atkin & Freimuth, 2001; Kotler & Roberto, 1989; Slater,

1995). Although miner perceptions concerning the dangers of

noise are well documented (Murray-Johnson et al., 2004) as

well as their evaluations of different message appeals

(Stephenson et al., 2005), less is known about the antecedents

associated with miners wearing hearing protection. This

investigation represents an attempt at achieving this objective.

Using the three antecedents derived from the TPB, results from

this investigation reveal that attitudes, subjective norms, and

perceived behavioral control are each positively associated

with intentions to wear hearing protection in the mine. It is our

hope that we have taken a step toward filling this gap in this

investigation.

Acknowledgements

This research was funded in part by a grant from the Centers

for Disease Control and Prevention/National Institute of

Occupational Safety and Health, Contract BH61-8533.
Appendix A

Positive Emotion Message

Negative Emotion Message

Neutral Emotion Message

Backside of all postcards

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