Development of a School Based Hearing Conservation Program for Use in Rural Areas

摘要

This project was designed to develop and evaluate hearing loss prevention programs for use with youth in grades 4 and 7 in rural areas. There is a high prevalence of hearing impairment among adolescents living in rural areas, particularly those with farming backgrounds. The prevalence of hearing impairment among rural adolescents is higher than the prevalence observed in the general United States population, and substantial hearing impairment is observed by the majority of rural residents before age 40. Hearing loss prevention programs are needed to reduce the severity of hearing impairment among those who already have hearing impairments and to prevent the occurrence of hearing impairments among those who have normal hearing. Rural schools are a logical place to provide hearing loss prevention information. These schools have large percentages of students who are regularly exposed to occupational or recreational risk factors for hearing impairment and many of these students will continue or increase these exposures upon entry into the workforce. A controlled intervention study with both longitudinal and cross-sectional components was used in each of two grades. Study endpoints included a combination of measurements of hearing status, questionnaire measures of knowledge, attitudes, and health beliefs pertaining to hearing and hearing loss prevention, unobtrusive measures, and participant ratings of program elements. It is possible to develop comprehensive hearing loss prevention programs that address science and health education standards. Both comprehensive and basic hearing loss prevention programs were observed to have long term (9- to 12-month) effects, and the relative merits of these programs can differ with age. Basic and comprehensive hearing loss prevention programs achieved comparable levels of effectiveness among participants in grade 4. A comprehensive hearing loss prevention program was effective for participants in grade 7, but a basic program did not provide substantial benefits.