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NIHL Prevention on the Job: Researcher Develops Computer Program to Help Latino Construction Workers

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Construction sites can be noisy places. Just think of all the jack hammering, bulldozing, concrete mixing, soil grading, air compressing, steel welding, and more going on for long hours, sometimes all at once. Exposure to loud noises for a long time can result in noise-induced hearing loss, or NIHL, one of the most common occupational injuries in the country. Although the Occupational Safety and Health Administration has set strict guidelines regarding the protection of workers from exposure to too much noise, the availability of training for many workers has been limited. For Latino workers, who make up about 25 percent of the construction work force in the United States, the availability of training is even less, considering their need for an intervention that is culturally and linguistically relevant.

With this in mind, NIDCD has funded the development of a computer-based bilingual intervention program to help disseminate NIHL-prevention messages among Latino construction workers. Madeleine J. Kerr, Ph.D., R.N., and her team at the University of Minnesota School of Nursing are working on the new program based on a previous intervention she developed in English. The new health education intervention is not a mere translation, however. With this intervention, Dr. Kerr and her team are addressing barriers they had found earlier in their research. They found that to change Latino construction workers' behavior, an effective intervention must address issues such as limited English-language proficiency, cultural attitudes, and perceptions of noise exposure.

The new educational intervention was developed in phases in order to incorporate feedback from volunteer construction workers while changes could easily be made. Early in the process, the research team held six focus group sessions, each involving roughly ten bilingual or monolingual Spanish-speaking Latino construction workers. The researchers asked the volunteers about their experiences with noise and noise protection on the job. The study was published in an April 2007 article in the American Association of Occupational Health Nurses Journal.

The next stage included the development of a questionnaire and computer training program based on the researchers' previous findings and observations. Here, Dr. Kerr and her team set out to learn if Latino workers would find the computer-based intervention both acceptable and useful. The development process consisted of four sessions that were administered to small groups of volunteers. After each session, the researchers made changes to the program, based on the participants' suggestions. The responses led to a reformatting of the questionnaire and new audio, video, animations, and graphics for the training sessions. These adjustments helped improve the original English version as well.

The resulting intervention is a 45-minute training conducted on a laptop computer with audio headsets. Participants can choose their language of preference, English or Spanish, which can be readily switched by pressing a button on the screen. The computer randomly offers one of two versions of the final intervention. One version presents the health information in an individually tailored or personalized manner. The other version covers the same material in a standard way.

The researchers have conducted an intervention trial of the revised computer program with 145 workers in Minnesota. Dr. Kerr and her research team are now measuring if the training has helped in changing the workers' behavior. In the baseline data collection, Dr. Kerr found that Latino workers reported wearing hearing protection significantly more often than non-Latinos (47 percent versus 35 percent, respectively), although the use of hearing protection for both groups was significantly lower than the desirable 100 percent of the time.

Dr. Kerr believes that this health education intervention could be adapted to other languages and cultures as well. She is exploring several distribution opportunities to disseminate the health education intervention free to Latino construction workers throughout the United States.

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