Oidos protegidos: Preventing noise exposure in farmworkers - Agriculture is an exceptionally high-risk industry. Farmworkers are commonly exposed to safety and health hazards including extreme heat, dust, chemical exposure, and machinery operations, all of which contribute to illness and injury. Noise exposure from loud equipment is a prevalent yet overlooked problem. In addition to causing disabling hearing loss, excessive noise contributes to worker fatigue, stress, and an increased risk of injury. Among the handful of noise exposure interventions in farmworkers, all have focused solely on improving individual-level changes in hearing health behaviors and fail to recognize the social/structural context of farmworkers’ health and safety. The NIH Health Disparities Research Framework highlights that individuals’ health behaviors are shaped by larger systems with multiple levels of influence. For farmworkers, barriers to hearing health exist at every level, including individual (perceived seriousness), interpersonal (social norms), organizational (workplace safety culture), and policy (lack of regulations). To address these barriers, we propose testing a multi-level intervention tailored for primarily Latino Spanish speakers, named POP - Proyecto Oídos Protegidos (Protected Ears Project). POP has been adapted from prior single-level interventions and will be further refined in collaboration with a Community Advisory Board. The POP intervention addresses noise exposure at three levels of influence: individual - farmworker knowledge and beliefs on hearing protection, interpersonal – supervisor support of worker safety behaviors, and organizational - hearing protection on farms. The following Specific Aims will be tested: (Aim 1) quantify hazardous noise exposures on farms using objective dosimetry measurements and refine intervention, (Aim 2) evaluate the feasibility and efficacy of POP on changes in noise exposures through an NIH Stage IB randomized controlled trial, and (Aim 3) evaluate barriers and facilitators to implementing POP by interviewing farmworkers, managers, and stakeholders. Study results will serve as the basis for a larger NIH Stage II/III comparative efficacy trial with scaled-up longitudinal data collection to be tested in a follow-up R01. The PI, Laura Coco, PhD, AuD, is a multilingual clinical audiologist and researcher with a background in single-level community-engaged clinical trials with Latinos to address hearing health disparities. This K23 Mentored Career Development Award will fill gaps in her training in occupational health, multilevel interventions, dissemination and implementation science, and independence through professional development. In the supportive environment of San Diego State University, a Hispanic- Serving Institution, Dr. Coco will undergo a five-year training program that includes structured mentorship, coursework, workshops, conferences, and research. Her multidisciplinary team of mentors has unique areas of expertise that will support her transition to research independence. Training from the K23 will provide skills that are needed for clinical trial research addressing the broader topic of hearing health in Latino populations.
