Which interventions increase hearing protection behaviors during noisy recreational activities? A systematic review
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RESEARCH ARTICLE
Open Access
Which interventions increase hearing protection behaviors during noisy recreational activities? A systematic review Michael T. Loughran1,2* , Stephanie Lyons1, Christopher J. Plack2,3 and Christopher J. Armitage1,4
Abstract Background: Hearing loss and tinnitus are global concerns that can be reduced through hearing protection behaviors (e.g., earplug use). Little is known about the effectiveness of interventions to increase hearing protection use in recreational domains. For the first time we review systematically the effectiveness of such interventions. Methods: Systematic searches of nine databases, as well as grey literature and hand-searching, were conducted. Any study design was included if it assessed quantitatively a purposeful attempt to increase hearing protection in recreational settings. Studies were excluded if they assessed noise exposure from occupational sources and headphones/earphones, as these have been reviewed elsewhere. PROSPERO protocol: CRD42018098573. Results: Eight studies were retrieved following the screening of 1908 articles. Two pretest-posttest studies detected a small to medium effect (d ≥ 0·3 ≤ 0·5), one a small effect (d ~ =0·2) and two no real effect. Three posttest experimental studies detected small to medium effects (d ≥ 0·3 ≤ 0·5). Studies were rated as “poor quality” and 17 out of a possible 93 behavior change techniques were coded, with the majority targeting the intervention function ‘education’. Conclusions: Hearing loss and tinnitus due to recreational noise exposure are major public health concerns yet very few studies have examined preventive interventions. The present systematic review sets the agenda for the future development and testing of evidence-based interventions designed to prevent future hearing loss and tinnitus caused by noise in recreational settings, by recommending systematic approaches to intervention design, and implementation of intervention functions beyond education, such as incentivization, enablement and modeling. Keywords: Hearing protection intervention, Hearing conservation, Hearing protection behavior, Behavior change, Recreational noise-induced hearing loss, Recreational noise activity, Systematic review
* Correspondence: [email protected] 1 Manchester Centre for Health Psychology, School of Health Sciences, University of Manchester, Manchester Academic Health Science Centre, M13 9PL, Manchester, UK 2 Manchester Centre for Audiology and Deafness, School of Health Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were
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