A suggested model for decision-making regarding hearing conservation: Towards a systems theory approach

Objective: The aim of the study was to investigate potential health promotion variables associated with adolescents' hearing protection use at concerts. Study sample: The sample consisted of 242 upper secondary school students aged 15-19 years. Design: Variables defined by the theory of planned behaviour (TBP) and health belief model were tested in this quantitative study. Results: Fifty-three percent of the adolescents reported that they used hearing protection at concerts to some degree, and 33 individuals (14%) reported that they used hearing protection in 50% of cases or more. The average degree of hearing protection use was reported to be 17% of the visits at concerts. Norms, perceived control, barriers, and noise sensitivity were associated with attitudes towards loud music. In addition, norms, barriers, permanent tinnitus, and noise sensitivity were significantly correlated with hearing protection use. However, intention was not significantly correlated with hearing protection use. Conclusions: From a systems theoretical approach it can be suggested that preventive strategies must consider more levels than just the individual, in order to achieve long lasting behavioural changes in adolescents' listening habits. To be able to get useful knowledge about preventive strategies, it is necessary to add context-specific variables into generic models such as TPB.