Hearing protection behaviour (e.g., use of earplugs) during noisy recreational activities (e.g., concerts, sporting events) to help mitigate against the risk of noise-induced hearing loss and tinnitus is uncommon. Research aimed at understanding and increasing hearing protection behaviour lacks application of health psychology theory, and current literature comparing those who use (ever-performers) and those who do not use hearing protection (never-performers) is limited. The aim of this thesis was to provide an empirical, theory driven, evidence base assessing what needs to change in order to increase uptake, and regular use of hearing protection behaviour within noisy recreational settings, whilst providing content for future interventions. Firstly, a systematic review assessed effectiveness and behavioural content of previous interventions (i.e., behaviour change techniques). Secondly, a cross-sectional survey helped identify potential groups of people and content for interventions by assessing ever- and never-performers' capabilities, opportunities and motivations (COM-B model) to engage with hearing protection. Thirdly, qualitative interview data of ever- and never-performers was mapped to the Theoretical Domains Framework (TDF) to help identify variables necessary for the implementation of interventions to increase hearing protection behaviour (i.e., earplug use). Study 1 found previous interventions had limited effectiveness, and suggested environmental restructuring (adding object to the environment; e.g., provision of earplugs) as a potential starting point for interventions. Study 2 found interventions may benefit from targeting women, older adults, and people in non-manual occupations. Never-performers lacked reflective and automatic motivation compared to ever-performers, suggesting that increased motivation is a requirement of future interventions. Study 3 highlighted 'social influences', 'environmental context and resources', 'beliefs about consequences', 'memory, attention, and decision processes', 'reinforcement' and 'emotion' as priority variables to target in order to increase earplug use during noisy recreational activities. This thesis has compiled the first comprehensive body of empirical evidence derived from theory assessing what needs to change in order to increase uptake, and regular use of hearing protection within noisy recreational settings, whilst providing potential content for intervention development. The evidence generated within this thesis may be valuable to hearing conservationists attempting to increase use and acceptance of hearing protection within adults exposed to recreational noise, and help provide insights into overcoming challenges that hearing conservationists will face.
- theoretical domains framework
- behaviour change wheel
- COM-B model
- hearing protection
- recreational noise
- noise-induced hearing loss
- behaviour change
MODIFYING BEHAVIOUR UNDERLYING RISK OF HEARING DIFFICULTY
Loughran, M. (Author). 1 Aug 2022
Student thesis: Phd