Hearing Loss Prevention for Veterans
Condition: Hearing Loss, Noise-Induced
MeSH terms: Hearing Loss; Deafness; Hearing Loss, Noise-Induced
Study type: Interventional

Summary: 
      Hearing loss is the most prevalent service-connected disability in the VA. It causes
      communication difficulties, which contribute to isolation, frustration and depression. A
      major cause of hearing loss is from exposure to high levels of sound, and is referred to as
      Noise Induced Hearing Loss (NIHL). Veterans have inevitably been exposed to high levels of
      sound during military service, and even though they may not yet have NIHL, their ears have
      been damaged. Continued noise exposure in civilian life will result in NIHL. However, it can
      easily be prevented by avoiding noise or using hearing protection. Most people are unaware
      that noise damages hearing, and even when they are, they do not use hearing protection. In
      this study we will use a randomized controlled trial to evaluate the short- and long-term
      effectiveness of two forms of education about NIHL that we have developed for Veterans. One
      is a computerized program; the other is a Hearing Conservation Brochure
    

Detailed description: 
      Hearing loss and tinnitus are the two most prevalent service-connected disabilities in the VA
      system for Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) Veterans, and
      Veterans from World War II, Korea, Vietnam, the Gulf War and during Peacetime. Costs
      associated with health care utilization, provision of hearing aids, rehabilitation services
      and reduced productivity for Veterans with hearing loss are substantial, and continue to
      increase. On a personal level, hearing loss results in communication difficulties, and often
      contributes to social isolation, frustration and depression. A major cause of hearing
      impairment is cochlear damage from exposure to high levels of sound. The longer the period of
      exposure and the more intense the sound pressure level, the greater is the damage that
      occurs. The damage from noise exposure is cumulative over time, and exacerbates the effects
      of aging. Veterans, who have been exposed to high levels of sound in the military are
      therefore highly vulnerable to damage in civilian life, thus they must protect their ears
      from further noise to avoid hearing loss as they age. Unfortunately, most people are unaware
      of the damage noise can do to the auditory system, and even when they are aware, few choose
      to use hearing protection. It is therefore critical to educate Veterans about the dangers of
      noise exposure and the simple actions that can be taken to protect hearing.

      Our long-range goal is to disseminate an effective hearing loss prevention education program
      that will help to reduce the prevalence and associated costs of noise induced hearing loss in
      the Veteran population. Ultimately it is our intention to make the program available to all
      Veterans, military personnel and other members of the public.

      We have developed two forms of intervention to educate Veterans about hearing conservation.
      One is a computerized multimedia interactive program; the other is a printed Hearing
      Conservation Brochure. Both provide information about hearing, the damage noise can do to the
      auditory system, the impact hearing loss has on communication, and the use of hearing
      protection. In this study we will use a randomized controlled trial to evaluate the
      effectiveness of these two forms of intervention at changing knowledge, attitudes and
      behaviors toward hearing conservation. Effectiveness will be examined in three ways through
      assessment of: (1) actual behavioral changes, as evidenced by decreased daily noise exposure
      as measured with noise dosimetry; (2) reported behavioral changes, as evidenced by decreased
      daily noise exposure assessed using a real-time log of daily activities and use of hearing
      protection; and (3) increased knowledge, healthier attitudes and improved intended and actual
      behavior towards hearing protection, as assessed with a self-report questionnaire. Outcomes
      will be measured at baseline, immediately following the intervention and six month
      post-intervention.

      There are many challenges facing military personnel as they reintegrate into society after
      leaving military service. Reducing their risk of acquiring noise induced hearing loss and the
      associated problems with communication, will help to make this transition less difficult and
      traumatic. This study will provide important information about the relative effectiveness of
      two different forms of hearing conservation education. In the long term it has the potential
      to reduce the prevalence and associated costs of hearing loss and tinnitus among Veterans,
      and will demonstrate that prevention of hearing loss can reduce the need for long-term
      rehabilitation.
    

Intervention name(s): Multimedia Hearing Loss Prevention Program; Hearing Conservation Brochure
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Interactive, multimedia, computer-based HLPP that provides hands-on education and training about hearing loss, tinnitus, hearing protection, and general hearing health care for Veterans.; Hearing Conservation brochure provides knowledge-based information similar to that of the multimedia HLPP, but in written form.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Prevention
Keywords: Hearing Loss - Noise-Induced; Prevention; Computer-assisted instruction