Malay Version of Educational Hearing Conservation Programme

Research background

Extreme noise exposure can lead to a hearing problem known as Noise-Induced Hearing Loss (NIHL). Nowadays, similar to occupational noise exposure such as industrial and manufacturing noise exposure, leisure noise exposure is also a cause for concern, especially among youth. Young people exposed themselves to high levels of noise regularly during various leisure activities, such as listening to music through earphones, attending cinema, gaming centre and sports events.

In Malaysia, there is no published evidence in relation to the prevalence of leisure NIHL and the levels of attitudes towards leisure noise in Malaysia. Though there are several studies which highlighted the attitude of youths regarding this factor, most of them were conducted in the western population, but in Malaysia, such studies are yet to be conducted. In addition, a formal educational Hearing Conservation Programme (EdHCP) for youth in Malaysia is undeveloped.

Therefore, the key objective of this study is to develop a Malay version of EdHCP for youth and to measure its effectiveness. This can be achieved through four specific objectives of this study which are to; (1) determine the suitable content for the Malay version of EdHCP based on literature, (2) to validate the content of the Malay version of EdHCP, (3) to conduct pre-testing of the Malay version of EdHCP and (4) to measure the effectiveness of the Malay version of EdHCP.

Five phases involved using The Multilevel Approach to Community Health (MATCH) ecological model as a planning model; phase 1) Goal selection, phase 2) Intervention planning, phase 3) Programme development, phase 4) Programme implementation and phase 5) Programme evaluation. This study adopts a quasi-experimental research design and has been conducted at Desa Murni College, Penang. This study involved fifty students between the age of 18 and 25 who will be equally divided into an intervention group and control group, six experts for content validity and ten laymen for pre-testing. The effectiveness of the Malay version of EdHCP has been assessed using a Malay version of Youth Attitudes toward Noise Scale (YANS) by comparing the pre and post-intervention of YANS’s score between intervention and control group.

The outcomes from this study are expected to produce a validated Malay version of EdHCP for Malaysian youth. The data obtained from this study will provide benefits and guidance in improving hearing health among the target population and a formal education and promotion health care program can be carried out at school, college and university in Malaysia.

LEISURE NOISE EXPOSURE AMONG YOUTH

Noise can be described as unwanted noise at high intensity levels that may interfere with daily oral communication, which may damage the hearing ability and cause ear discomfort (French & Price, 2010). Since the last decade, the exposure of noise to the community is increasing especially among the workers. There are many workers from the manufacturing, construction, and security sectors exposed to noise in the workplace which in turn causes the number of occupational hearing loss cases increasing annually. According to statistics released by the Malaysia Department of Safety and Health (DOSH) in 1999, a total of 153 workers were reported to have hearing loss increased dramatically as compared to the previous year. This increments will result in the payment of high compensation costs which in turn cause losses to the country.

Nonetheless, new concerns need to be addressed as an increase in exposure to loud noise in leisure activities, especially among youths. In 2015, World Hearing Organization (WHO) estimates that 1.1 billion young people worldwide could be at risk of hearing loss due to unsafe listening practices. Nearly 50% of the children and young adults aged of 12 to 35 years old are exposed to high level of sound from the use of personal listening devices (PLD) and some 40% of them are exposed to dangerous sound levels at discotheques, clubs, rock concert and bars.

There are a lot of leisure activities in which youth engage in, which in turn may make them more susceptible to loud noise exposure, commonly is listening to music. Many studies have focused on the music listening behaviours among this population, and the potential consequences of this leisure activity (Portnuff et al., 2011; Vogel et al., 2011; Seluakumaran, 2013). With the increased availability of personal listening devices, such as mp3 players, iPods, and even smartphones via music listening applications, youth may expose themselves to loud music for a prolonged period.

While many studies have focused on the music listening behaviours among youth in PLDs, the use of PLDs is not the only activity in which this population engages in exposure to dangerous levels of noise. Other leisure activities that tend toward loud music exposure include attending or working at nightclubs, attending a concert, listening to music in the car, working out in a gymnasium, and attending a sports event. According to leisure noise survey done by Rawool & Colligon-Wayne (2008), noise levels in nightclubs can range from 94.9 to 112.4 dBA, while the maximum music level in a car can reach levels of 154.7 dBA. Noise levels at rock concerts can range from 100 to 115 dBA. In some gym facilities and health clubs also tend to turn up the music to levels ranging from 78 to 106 dBA. Loud music may be played either in the public area with the exercise machines or in the private classes teaching aerobics.

Most youths have fun from listening to loud music and they think it can reduce stress in everyday life. A study investigating the listening habits among youth found that those who listened to music at high levels did so without thinking about the consequences (Vogel, Brug, Van der Ploeg & Raat, 2011). Also, they reported that this population get satisfaction from listening to loud music contrast with those who listened to music at lower levels were more motivated to engage in healthy listening behaviours. They also found that some of the respondents either were not fully aware of the risks of exposure to loud noise or were not concerned by them.

Therefore, it is essential to provide information and knowledge regarding leisure noise exposure in order to induce behavioural change among them (Widen et al., 2006). Several studies have evaluated the effectiveness of the EdHCP. According to Chermak & Peters-mccarthy, (2017), the levels of knowledge on noise exposure have been statistically increased after attending educational HCP. Folmer & Health, (2016) recommends raising public awareness, persuading teachers and school administrators about EdHCP, and seeking a mandate through a state or federal legislation in order to establish the programme.

PROBLEM STATEMENT

The previous studies have shown that EdHCP may improve attitude or awareness towards Noise-Induced Hearing Loss (NIHL) (Chermak & Peters-mccarthy, 2017, Keppler et al., 2015 & Dell, 2012). Though there are several studies which have reported the attitude of youths towards leisure noise is depending on socio-demographic factors, but most of the studies were conducted in the western population (Lee et al., 2014). In the Malaysian context, such studies are yet to be developed. Moreover, a formal hearing health education and awareness program for Malaysian youth were not developed up till now and most of the available programs from the literature are in English/ other languages and targeted to children. Therefore, the aim of this study is to develop a Malay version of EdHCP for Malaysian youth.

RATIONALE

Young people expose themselves frequently to high levels of noise during leisure-time activities in particular while visiting nightclubs and using personal music players

(Williams et al., 2010). Smith et al. (2000) reported that there are increasingly numerous activities with high potential risk of hearing loss engaged by the young people compared to last decades. Nonetheless, most of them are unaware of any loss of hearing until they begin to have a serious impact on life in the future. According to Rawool et al. (2008), there is still a great deal of unawareness and/or a lot of misconception regarding the effects of noise exposure among young generation. Therefore, it is essential to provide information and knowledge regarding leisure noise exposure in order to induce behavioural change among them (Widen et al., 2006).

Youth with hearing loss will have adverse effects that may disrupt their education, employment and also able to reduce their quality of life that can cause an additional burden to the country (WHO, 2017). Therefore, it is imperative to nurture and convey information about the dangers of noise to these groups so that they are better prepared to make decisions about their hearing health as they grow and face a wide range of noisy environments and activities in becoming a national leader in the future.

The rationale of the current study is to develop a Malay version of EdHCP with the potential to reach a large number of young people, before exposure to hazards, and educate them on how to protect their hearing for life.

RESEARCH QUESTIONS

The research questions of the current study are:

What are the suitable contents based on literature that should be included for a Malay version of EdHCP for Malaysian’s youth?

Is the content of the newly developed Malay version of EdHCP valid to be implemented among Malaysian’s youth?

How satisfactory the newly developed Malay version of EdHCP with respect to the pre- testing?

Is the newly developed Malay version of EdHCP effective in improving attitudes towards noise among Malaysian’s youth?

HYPOTHESIS

The hypotheses of the current study are:

The newly developed Malay version of EdHCP is valid to be implemented among Malaysian’s youth.

The newly developed Malay version of EdHCP is satisfied to have excellent pre-testing outcome.

The newly developed Malay version of EdHCP is effective to improve attitude towards noise among Malaysian’s youth.

Objective

The main objective of this study is to develop a Malay version of EdHCP for Malaysian youth and to measure its effectiveness with four specific objectives.

Specific objectives

To determine the suitable content for Malay version of EdHCP based on literature.

To validate the content of the newly developed Malay version of EdHCP.

To conduct pre-testing of the newly developed Malay version of EdHCP.

To measure the effectiveness of the newly developed Malay version of EdHCP.

Conclusion

In conclusion, this study lays the groundwork for evidence-based interventions to safeguard the hearing health of Malaysian youth. By addressing the gaps in knowledge and providing a framework for educational initiatives, it contributes to the broader efforts aimed at reducing the prevalence of NIHL and enhancing the overall well-being of the population.