Farm and rural youth experience noise-induced hearing loss (NIHL) from a very young age. They also experience hearing health disparities compounded by lack of access to hearing health education. Intervention studies using technologies such as smartphone applications, mobile text messaging, and audiovisual resources in the internet have been conducted among youth in various community settings. However, evidence regarding the efficacy of these technological approaches is weak due to multiple methodological weaknesses of the studies, including very short follow-up period and lack of control group. It is also not clear whether such interventions are feasible in hard-to-reach rural and agricultural populations in the United States. We propose a pilot longitudinal study with a relatively long follow-up period (i.e., 8 months) with farm and rural youth to test a novel smartphone app-based hearing conservation education program. Additionally, acceptability of the program will be assessed by collecting data on perceived usefulness, perceived ease of use, and perceived barriers to mobile app use. We propose to test an educational intervention module consisting of materials available on the Internet combined with two hearing conservation apps: a noise-measurement app developed by the National Institute for Occupational Safety and Health (NIOSH), and a hearing acuity self-screening app. Pre- and post-intervention hearing conservatio knowledge and behavior will be compared between an experimental group (smartphone app plus printed NIHL prevention education leaflets) and a control group (printed NIHL prevention education leaflets only) to evaluate the efficacy of our technology-based intervention. The proposed study will create the foundation for a long-term collaboration between university researchers and the Sertoma Club, a well-known community organization whose mission is to improve the quality of life for those at risk or impacted by hearing loss through education and support. Additionally, it will generate pilot data for use in future development of a large randomized trial to further evaluate smartphone technology in NIHL prevention among farm and rural youth.
