Hearing Loss, Noise-Induced Clinical Trial
Official title:
Hearing Loss Prevention for Veterans
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
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.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Subject), Primary Purpose: Prevention
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