title: Testing decisional balance and self-efficacy applied to workers' use of hearing protection.
abstract: BACKGROUND
  The continued prevalence of low rates of hearing protection device (HPD) use by workers exposed to hazardous noise requires ongoing efforts to investigate ways to increase HPD use.
  
  
  OBJECTIVE
  The aim of this study was to investigate the utility of the Transtheoretical Model (TTM) for research with factory workers' use of HPDs, specifically focusing on the model suppositions related to the constructs of decisional balance and self-efficacy.
  
  
  METHODS
  Using secondary analysis, pretest measures were obtained through a randomized controlled clinical trial of an intervention to increase use of HPDs. The sample included in the analyses were factory workers (N = 1,245) exposed to hazardous noise in a Midwestern automotive manufacturing plant. Using analysis of variance (ANOVA), the TTM constructs pros, cons, and self-efficacy of HPD use were examined across stages.
  
  
  RESULTS
  Using ANOVA, significant variance was found across stages of HPD use. Pros, cons, and self-efficacy significantly differed by stage of HPD use in predicted patterns: pros, F(4, 1240) = 46.29, p < .001; cons, F(4, 1240) = 17.14, p < .001; and self-efficacy F(4, 1240) = 7.32, p < .001. The crossover effect of pros and cons occurred in the preparation stage, as expected.
  
  
  CONCLUSIONS
  Support was found for the presence of conceptually distinct stages of HPD use and the TTM predictions for decisional balance and self-efficacy across stages. Performance of the TTM constructs within current research on HPD use presents opportunities for increased tailoring of training for factory workers on use of HPDs.
authors.affiliation: College of Nursing, Wayne State University, 250 Cohn Building, Detroit, MI 48202, USA. dmr3@wayne.edu
authors.forename: Delbert M
authors.initials: DM
authors.lastname: Raymond
authors.forename: Sally L
authors.initials: SL
authors.lastname: Lusk
mesh_terms: D000704:Analysis of Variance; D003430:Cross-Sectional Studies; D003657:Decision Making; D004430:Ear Protective Devices / Q000706:statistics & numerical data*; D005260:Female; D015438:Health Behavior; D006317:Hearing Loss, Noise-Induced / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015146:Midwestern United States; D008960:Models, Psychological; D009623:Noise, Occupational; D016273:Occupational Exposure / Q000517:prevention & control / Q000706:statistics & numerical data; D016032:Randomized Controlled Trials as Topic; D020377:Self Efficacy