Identifying Targets for Interventions to Increase Earplug Use in Noisy Recreational Settings: A Qualitative Interview Study

Abstract

Earplugs can reduce the risk of hearing loss and tinnitus. However, earplug use during noisy recreational activities is uncommon, and methods for increasing uptake and regular use have had limited efficacy. The aim of the present study was to examine barriers and enablers of ever-performers (e.g., people who have used earplugs) and never-performers (e.g., people who have not used earplugs) to identify targets to inform the content of interventions to increase uptake and regular use of earplugs in recreational settings. The Capabilities, Opportunities, and Motivations model of Behaviour (COM-B) informed the outline for 20 semi-structured telephone interviews (ever-performers, N = 8, age range = 20–45 years; never-performers, N = 12; age range = 20–50 years). Thematic analysis was used to identify barriers and enablers to earplug use, which were mapped onto the Theoretical Domains Framework (TDF). Six key domains of the TDF were identified. Ever-performers described being more exposed to ‘social influences’ (e.g., facilitators such as friends/peers) and were more positive than never-performers concerning ‘beliefs about consequences’ (e.g., earplug protection outweighs any negative effects on listening/communication). Involvement of ‘emotion’ (e.g., fear of losing ability to listen to music) and ‘reinforcement’ tactics (e.g., creating habits/routines) were discussed by ever-performers, but were not mentioned by never-performers. Both groups reported lack of ‘environmental context and resources’ (e.g., prompts and cues), and their own ‘memory, attention, and decision processes’ (e.g., deciding when to use earplugs) as barriers to earplug use. The present research identifies the variables that would need to change in order to increase earplug uptake and use in recreational settings among ever-performers and never-performers. Further work is required to translate these findings into testable interventions by selecting appropriate intervention functions (e.g., modelling), policy categories (e.g., communication/marketing), behaviour change techniques (e.g., demonstration of behaviour), and mode of delivery (e.g., face-to-face).

Risk Ratio of Noise-Induced Hearing Loss in Mineral Ore Processing Industry Workers

“…The distance between the noise source and the receiver also affects the level of noise received by workers [16]. Noise barriers such as walls, columns, and structures in the mineral ore processing industry play a role in why the sound pressure received by office workers is lower than that received by industrial workers [17]. Other factors affecting differences in sound pressure reception include the design of the roof structure in ore processing factories.…”

Young Adults’ Knowledge and Perceptions of Permanent Noise-Induced Tinnitus and its Influence on Behavioural Intentions

“…This speculation is supported by recent qualitative research into ear plug use by adults in the United Kingdom. [ 26 ] The researchers reported that people who did wear earplugs had higher exposure to social influences, such as friends and peers, and had more positive beliefs about the consequences of using earplugs compared to those who had never worn them. Emotion and reinforcement tactics, such as fear of losing the ability to listen to music and creating habits, were also mentioned by wearers but not by non-wearers.…”

“…Protective behaviours such as reducing the frequency of noise exposure, reducing the volume of personal listening devices (PLDs), wearing hearing protection devices like earplugs in loud music venues and taking ‘regeneration breaks’ in loud environments can help prevent permanent noise-induced tinnitus in the same way as permanent noise-induced hearing loss. [ 26 ] Although there have been many noise-damage prevention campaigns that focus on permanent hearing loss (PHL) prevention, their effectiveness is often limited,[ 10 27 ] and despite high levels of knowledge of PHL among young adults, few engage in protective behaviours. [ 28 29 30 31 ]…”

New Paradigm of Music Listening: Hearing Protection Perceptions and Treatment Decision‐Making Among Music Venue Attendees

“…Prior studies mostly focused on measuring decibel levels at these large recreational events with limited emphasis on understanding participants' decision-making regarding HP use. 9,[17][18][19] Furthermore, the few studies that examined perceptions and behaviors of HP safety among recreational music event attendees focused on small cohorts, specific genres, or specific events. 7,10,19 While prior literature reporting on similar beliefs and perceptions in other populations was used to create our own literatureinspire survey, [20][21][22][23][24] we aimed to characterize the knowledge, behaviors, and perceptions related to HP use among music venue attendees among a large cohort of recreational music venue attendees via an online survey to better promote HP compliance, especially among at-risk populations.…”

“…Current literature addressing safe recreational music listening focuses on personal music listening devices, 14‐16 while few investigate large recreational events. Prior studies mostly focused on measuring decibel levels at these large recreational events with limited emphasis on understanding participants' decision‐making regarding HP use 9,17‐19 . Furthermore, the few studies that examined perceptions and behaviors of HP safety among recreational music event attendees focused on small cohorts, specific genres, or specific events 7,10,19 .…”