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dissertation entitled

TRAINING TO PROMOTE WORKERS' USE OF HEARING PROTECTION:

THE INFLUENCE OF WORK CLIMATE FACTORS
ON TRAINING EFFECTIVENESS
presented by

Janice Susan Zarza Brady

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TRAINING TO PROMOTE WORKERS' USE OF HEARING PROTECTION: THE
INFLUENCE OF WORK CLIMATE FACTORS ON TRAINING EFFECTIVENESS

By

Janice Susan Zarza Brady

A DISSERTATION

Submitted to
Michigan State University
in partial fulﬁllment of the requirements
for the degree of

DOCTOR OF PHILOSOPHY

Department of Educational Administration

1999

ABSTRACT

TRAINING TO PROMOTE WORKERS' USE OF HEARING PROTECTION: THE
INFLUENCE OF WORK CLIMATE FACTORS ON TRAINING EFFECTIVENESS

By

Janice Susan Zarza Brady

Work environments pose multiple threats to the health and safety of
construction workers. Among these threats is the potential for occupational
noise-induced hearing loss (NIHL), caused by frequent exposures to hazardous
noise. While permanent in nature, NIHL can be prevented if hearing protection
devices (HPDs) are used appropriately, meaning 100% of the time when
exposed to high-noise environments.

Training workers in the manufacturing industry about the use of adequate
hearing protection is required by federal regulations; however, the construction
industry is not covered by these stringent federal guidelines. Unfortunately, even
when workers have been trained about the importance and techniques for
protecting their hearing, inadequate use of hearing protection often occurs.

Why workers refrain from properly using HPDs (ear plugs, ear muffs, etc.)
is not clearly understood; few empirical studies have focused on identifying the
associated inﬂuencing factors. In an experimental study to evaluate training
effectiveness, previous researchers found that post-intervention use of HPDs by
Midwestern U.S. construction workers remained insufﬁcient to prevent NIHL.

Therefore, more knowledge and insight are needed about what contributes to

training effectiveness and what factors inﬂuence workers’ hearing protection
behaviors.

Using data from a prior experimental study, this quantitative study
examined the relationship between work climate factors and construction
workers’ post-training use of hearing protection. Multivariate analyses suggested
that the inﬂuence of the work climate is a critical component to consider when

planning training programs to promote hearing protection behaviors.

Copyright by
JANICE SUSAN ZARZA BRADY
1999

To my husband, Edward, whose unconditional love, steadfast devotion,
and incredible support have far exceeded any descriptive boundaries. Indeed,
he has been my soul and my inspiration. And to my daughters, Katie and Jenni,
whose enduring love and compassionate encouragement have continued to
fortify and sustain me throughout this journey. Truly, they have been my master

teachers—providing treasured lessons about what really is important in life.

ACKNOWLEDGMENTS

Completing this dissertation has become a reality because of the support
from a number of individuals who have touched my life.

Sincere appreciation is extended to my committee members: my advisor,
Dr. John Dirkx, who so generously agreed to chair my committee and whose
persistent patience guided me in the quest for quality; Dr. Michael Moore, whose
intellect and integrity l have always admired throughout my doctoral program;
Dr. Anna Ortiz, whose expertise with quantitative analysis added invaluable
assistance to my completing this dissertation; Dr. Sally Lusk, whose professional
mentoring has been an energizing force throughout both of my graduate
programs; Dr. Marilyn Amey, who adeptly focused my attention on the unique
relevance for the adult learner; and Dr. Ann Austin, who provided expert advice
and supportive direction in the early stages of this project.

I am deeply indepted to my professional colleagues: Dr. Oi Saeng Hong
and Brenda Eakin, who so often brightened and buoyed my sagging spirits; Drs.
Jane Wilson Coon and Dick Redman, whose well-timed nudges and afﬁrmations
often refocused my sights on the Ph.D. goal; Dr. David Ronis, whose expert
guidance steered me through some of the statistical mazes; and all of my MSU
colleagues, especially Dr. Craig Douglas, whose sincere interest and genuine
concern never ceased to inspire.

Special recognition goes to: my nephew, Matt Johnson, who provided
ﬁrst—hand knowledge of a construction worker’s life; and my sister, Diane Regan,

who vicariously endured the multiple challenges of this dissertation endeavor.

vi

TABLE OF CONTENTS

List of Tables ................................................... x
List of Figures .................................................. xii
List of Abbreviations ............................................. xiii
Chapter 1 ...................................................... 1
Introduction ..................................................... 1
Statement of the Problem .................................... 2
Purpose of the Study ........................................ 3
Research Hypotheses ....................................... 5
Conceptual Model .......................................... 6
Method ................................................... 8
Deﬁnition of Terms .......................................... 9
Independent Variables ................................. 9

Dependent Variable .................................. 10

Signiﬁcance of the Study .................................... 10
Limitations and Delimitations ................................. 11
Chapter 2 ..................................................... 13
Review of the Literature .......................................... 13
Noise-induced Hearing Loss ................................. 14
Health Behavior Theories ................................... 17
Health Belief Model ................................... 18

Health Promotion Model ............................... 19

Conceptual Framework ..................................... 21

Work Climate ....................................... 22

Climate for Safety .................................... 25

Hypothesis 1 ................................... 27

Hypothesis 2 ................................... 27

Self-efﬁcacy ......................................... 27

Outcome Expectancy and Outcome Value ................. 31

Hypothesis 3 ................................... 33

Organizational Studies and Hearing Protection Use .......... 34

Hypothesis 4 ................................... 36

Work Climate and Training Issues ....................... 36

Work Climate and Safety Training ....................... 40

Hypothesis 5 ................................... 41

Hypothesis 6 ................................... 41

Summary of Literature Findings ............................... 41
Chapter 3 ..................................................... 44
Methods ...................................................... 44
Research Hypotheses ...................................... 44

vii

Research Design .......................................... 45

Summary of Original Project ................................. 46
Procedure .......................................... 46
Sample ............................................ 47
Demographics of the Sample ................................. 48
Instruments and Measures .................................. 50
Work Climate Scale .................................. 51
Self-efficacy Scale .................................... 52
Outcome Expectancy Scale ............................ 53
Outcome Value Scale ................................. 53
HPD Use ........................................... 54
HPD Training Intervention .............................. 54
Data Analysis ............................................. 55
Chapter 4 ..................................................... 59
Results ....................................................... 59
Research Hypotheses ...................................... 59
Results Related to Study Variables ............................ 60
Independent Variables ................................ 60
Dependent Variable .................................. 63
Results of Hypothesis Testing ................................ 63
Hypothesis 1 ........................................ 63
Hypothesis 2 ........................................ 64
Hypothesis 3 ........................................ 68
Hypothesis 4 ........................................ 69
Hypothesis 5 ........................................ 70
Hypothesis 6 ........................................ 83
Summary of Results ........................................ 88 , .
//
Chapter 5 ................................................. 7.”. . 89
Discussion .................................................... 89
Relationship between Work Climate and HPD Use ................ 89
HPD Use in Low and High Climate Work Settings ................. 92
Relationship of Work Climate with Self-efﬁcacy, Outcome Expectancy,
and Outcome Value .................................. 93
Model for Predicting HPD Use ................................ 94
Work Climate and Training Effectiveness ....................... 96
Training, Self-efﬁcacy, and Work Settings ....................... 96
Implications for Theory ...................................... 99
Implications for Practice .................................... 102
Limitations .............................................. 105
Recommendations ........................................ 106
Summary ............................................... 1 07
References .................................................. 1 1 0

viii

Appendices .................................................. 120

A—Work Climate .......................................... 121
B—Self-efﬂcacy ........................................... 124
C-Outcome Expectancy ................................... 126
D-Outcome Value ........................................ 128
E—HPD Use ............................................. 130
F—Letter of Approval ...................................... 132
G—Letters of Permission ................................... 134

LIST OF TABLES

 

Table
1 Sample Demographics ....................................... 49
2 Highest Level of Education .................................... 5O
3 Study Variables ............................................. 61
4 Demographics of Construction Workers in Low and High Work

Climates .................................................. 67
5 Pearson Product-Moment Correlations ........................... 69
6 T-tests between Work Climate Levels ........................... 7O
7 Results of Hierarchical Regression with Model Predictors of HPD Use . . 71
8 Work Climate Items and Bivariate Correlations with HPD USe ........ 75
9 Model Summary of Hierarchical Regression with Predictors of

HPD Use .................................................. 76
10 Results of Hierarchical Regression of Self-efﬁcacy on Exogenous

Variables .................................................. 79
11 Results of Hierarchical Regression of Outcome Expectancy on

Exogenous Variables ........................................ 80
12 Results of Hierarchical Regression of Outcome Value on Exogenous

Variables .................................................. 81
13 Descriptive Statistics of Variables Used in Analysis of Variance by

HPD Training .............................................. 84
14 Descriptive Statistics of Variables Used in Analysis of Variance by

Work Climate Level .......................................... 84
15 Analysis of Variance for Self-efﬁcacy by HPD Training and Work

Climate ................................................... 86
16 Analysis of Variance for Outcome Expectancy by HPD Training and

Work Climate .............................................. 86

17

18

Analysis of Variance for Outcome Value by HPD Training and
Work Climate .............................................. 87

Analysis of Variance for HPD Use by HPD Training and Work
Climate ................................................... 87

xi

LIST OF FIGURES

59932
1 Conceptual model with predictors for use of hearing protection

devices (HPDs) .............................................. 7
2 HPD use in low and high climate work settings .................... 65
3 Revised conceptual model .................................... 82

xii

LIST OF ABBREVIATIONS

db Decibel

HBM Health Belief Model

HPD Hearing Protection Device

HPM Health Promotion Model

NIHL Noise-induced Hearing Loss

NIOSH National Institute for Occupational Safety and Health
OSHA Ocupational Safety and Health Administration

SCT Social Cognitive Theory

TWA Time-weighted Average

xiii

Chapter 1

INTRODUCTION

In 1996, the National Institute for Occupational Safety and Health
(NIOSH) indicated that over 30 million workers are exposed to hazardous noise
in work settings (NIOSH, 1996). In approximately one million cases of hearing
loss, the cause can be attributed to occupational factors related to manufacturing
environments (NIOSH, 1988). Once noise-induced hearing loss (NIHL) occurs,
no treatment or assistive technology (e.g., hearing aids) can restore the
damaged auditory function. Unfortunately, hearing loss that results from
prolonged exposure to high-noise levels in a number of industrial settings is a
prevalent occupational health problem; however, it is a disorder that can be
prevented (NIOSH, 1996).

Protecting industrial workers against exposure to hazardous noise levels
in the work setting is an effective method to reduce the incidence of occupational
NIHL. In industrial work settings where workers have daily noise exposures that
exceed an eight-hour time-weighted average (TWA) of 85 decibels (dB), the
Occupational Safety and Health Administration (OSHA) requires that
organizations maintain hearing conservation programs. These programs include
annual audiometric testing and training workers about preventing NIHL (Dessoff,
1995).

Protection against NIHL also can be accomplished through the use of
engineering controls that potentially block or reduce noise emission from
industrial machinery. Even though such controls can be highly effective, they are

1

not always economically or reasonably feasible. This is particularly true for the
construction industry where the workplace environment frequently changes and
ambient conditions can change dramatically (Ringen, Englund, Welch, Weeks, &
Seegal, 1995). Another protective method to reduce NIHL is strict adherence to
policies that require the monitoring of noise levels and the wearing of hearing
protection devices (HPDs) in high-noise areas. Unfortunately, even though such
policies often exist in work settings, occupational hearing loss remains a
pervasive problem.

Given that engineering controls are cost-prohibitive for many
organizations and that hearing protection policies are often ineffective, it is
imperative that workers be adequately trained about the appropriate use of
HPDs. According to Savell and Toothman (1987), one’s hearing can be
protected with the consistent use of HPDs. most commonly recognized as ear
plugs or earrnuffs. Therefore, one of the effective methods for reducing hearing
loss among US. workers is to provide education and training about the
importance of consistent and proper use of HPDs. Despite OSHA regulations
that require hearing conservation programs and training efforts aimed at
preventing NIHL, many US. workers still fail to use HPDs appropriately (Lusk,
1997).

Statement of the Problem
Training workers about preventing NIHL is critical, but even when workers
have been trained in methods to protect their hearing and prevent NIHL, an

inadequate use of HPDs still has been reported ( Lusk, Kerr, & Kauffman, 1998;

Lusk, Ronis, & Baer, 1995; Lusk, Ronis, Kerr, & Atwood, 1994). In a study of
factory workers, the observed and self-reported mean usage of HPDs in
high-noise environments ranged from 54% to 62% (Lusk et al., 1995), thus
reﬂecting a high potential for hearing loss. Why workers refrain from properly
using HPDs in high-noise environments is still not clearly understood.
Unfortunately, few empirical studies have focused on identifying the factors that
inﬂuence workers’ decisions to use appropriate hearing protection (Lusk, Ronis,
& Hogan, 1997). In an experimental study to evaluate the effectiveness of
hearing protection training, Lusk (1997) found signiﬁcant differences in the
post-training use of HPDs among regional and national construction workers who
reported working in high-noise areas; however, HPDs were not used 100% of the
time they were needed to prevent hearing loss in these workers. Therefore,
more knowledge and awareness are needed about the inﬂuencing factors that
contribute to training effectiveness and construction workers’ decisions to protect

their hearing.

Purpose of the Study
The purpose of this study was to examine the inﬂuence of the work
climate on construction workers’ use of HPDs, which is a fairly unexplored area
in health behavior research. Previous studies have focused mainly on the
individual worker and personal attitudes associated with HPD use; therefore, it is
imperative to consider what contextual factors tend to inﬂuence workers to wear
HPDs. Contextual factors in the work setting contribute to the creation of a work

climate that represents workers’ perceptions of the prevailing attitudes in an

organization. According to Reichers and Schneider (1990), the work climate
refers to “shared perceptions of organizational policies, practices, and
procedures, both formal and informal” (p. 22). Schneider (1990) further adds
that work climate can be deﬁned as “perceptions of the events, practices, and
procedures and the kinds of behaviors that get rewarded, supported, and
expected” (p. 384). In the organizational literature, work climate factors have
been demonstrated to signiﬁcantly inﬂuence worker performance and behavior
(Denison, 1993; Tracey, 1992).

Past studies related to health behaviors have primarily focused on
personal perceptions, attitudes, and values that inﬂuence performance. Included
as inﬂuencing factors have been the concepts of self-efﬁcacy, barriers, beneﬁts
or outcome expectations, and outcome value (Janz & Becker, 1984; Lusk et al.,
1997; Pender, Walker, Sechrist, & Frank-Stromborg, 1990; Strecher, Becker,
Kirscht, Eraker, & Graham-Tomasi, 1985). Very few studies have focused
speciﬁcally on hearing protection behaviors and of those that have done so, the
concept of work climate as an inﬂuencing factor is not clearly explicated (Lusk et
al., 1997; Melamed, Rabinowitz, Feiner, Weisberg, & Ribak, 1996). As identiﬁed
by Ribisl and Reischl (1993), contemporary research related to health promotion
activities in work settings has tended to emphasize the importance of individual
behaviors while ignoring the inﬂuence of the contextual dimension.

This research study was designed to explore the relationship between
work climate factors and construction workers’ post-training use of HPDs.
Examination of this relationship is essential in order to develop increased

awareness and understanding about the inﬂuence that the work environment has

4

on construction workers’ transfer of training (i.e., the actual use of HPDs in work
settings). Tracey, Tannenbaum, & Kavanagh (1995) strongly contend that
factors within the formal training setting, and the work environment where
training skills are meant to be applied, play a crucial role in the transfer of
training process. However, very few studies have focused on the speciﬁc factors
that promote transfer of skills and learning to the work setting. Therefore,
research that examines the contextual factors where transfer of training is
intended to occur can expand the existing knowledge about training
effectiveness. Guided by Bandura’s (1986) social cognitive theory (SCT) and
speciﬁcally focusing on work climate factors and hearing protection training, six

research hypotheses were developed for this study.

Research Hypothesg

1. There is a positive relationship between work climate factors and
construction workers’ use of hearing protection devices (HPDs).

2. Construction workers who perceive a supportive work climate will report
a greater use of HPDs than construction workers who perceive a

non-supportive work climate.

3. There is a positive relationship among work climate factors,

self-efﬁcacy, outcome expectancy, and outcome value for using HPDs.

4. Construction workers who perceive a supportive work climate will report
higher self-efﬁcacy, outcome expectancy, and outcome value for using
HPDs than construction workers who perceive a non-supportive work

climate.

5. Hearing protection training, work climate factors, self-efﬁcacy, outcome
expectancy, and outcome value will predict the use of HPDs by
construction workers.

6. For construction workers who received hearing protection training,
those who perceived a supportive work climate will report greater
self-efﬁcacy, outcome expectancy, outcome value, and use of HPDs

than those who perceived a non-supportive climate.

Conceptual Model

Depicted in Figure 1 is the model generated by the research hypotheses
that guided the focus of this study. This model suggests that workers’
post-training use of HPDs is inﬂuenced by: (1) training programs designed to
educate workers about the importance of hearing protection, (2) workers’
perceptions of the climate of the work setting, (3) workers’ perceived level of
self-efﬁcacy in using HPDs, (4) workers’ outcome expectancy for using HPDs.
and (5) workers’ perceived outcome value for using HPDs. This model reﬂects
the importance of the relationships between factors in the contextual work setting
and workers’ post-training use of HPDs. Reﬂecting some of the concepts
described in Bandura’s SCT (1986), workers” behaviors are inﬂuenced by
contextual factors, especially the behaviors of others in the work environment.
Thus, the modeled behaviors and the support of co-workers and supervisors can
inﬂuence the behavior of individuals in organizational settings. As reported by
Noe and Schmitt (1986) and Richey (1992), environments where workers
perceive supportive supervisors and co-workers tend to have a positive inﬂuence

on workers’ transferring knowledge and skills acquired during training.

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This study employed secondary analysis of data from a study of
construction workers and their post-training use of HPDs (Lusk, 1997). An
experimental design was used by Lusk to study the effectiveness of hearing
protection training among Midwestern U.S. construction workers. The sample
(l_\l_ = 798) was speciﬁcally chosen because construction workers represent a
group at high risk for occupational NIHL. Unfortunately, not all US. workers are
covered by stringent OSHA regulations related to hearing protection programs.
Construction workers, including carpenters, operating engineers, and
plumbers/pipeﬁtters, comprise such a group not covered by speciﬁc OSHA
mandates for comprehensive hearing conservation programs. Compared to the
manufacturing sector that includes factory workers, the construction industry has
been less stringently regulated (Franks, 1990).

Construction workers are often independent contractors, typically move
from site to site, and have limited control over their environments (Nwaelele,
1996). At construction sites, workers are frequently exposed to a variety of noise
situations—constant, intermittent, and impulse noise (Franks, 1990). Therefore,
construction workers are highly vulnerable for developing occupational hearing
loss (Reilly, Rosenman & Kalinowski, 1998). Some of the construction trade
associations have educational programs aimed at informing their members about
NIHL; nevertheless, a signiﬁcant number of construction workers still fail to utilize
available equipment and measures to preserve their hearing. Since limited

requirements for hearing protection training exist in the construction industry,

effective methods to educate workers about the necessity to protect their hearing
are indeed imperative.

In the experimental study that was intended to evaluate the effectiveness
of hearing protection training, Lusk (1997) reported a signiﬁcant effect in
post-intervention HPD use in the regional group of plumbers/pipeﬁtters, but not in
the regional group of carpenters or operating engineers. Given that the training
program was designed using a predictor-based model, it is perplexing why
limited post-training effects were found in the overall group of construction
workers. Performing secondary analysis with reconstructed scales on the data
provided by Lusk, multivariate regression analysis was applied to explicate the
relationship of work climate factors with the effectiveness of training, an area not

speciﬁcally addressed in the original study.

Deﬁnition of Terms

Independent Variables

Training. Planned instruction designed to inform workers about the
beneﬁts and methods for protecting their hearing when exposed to hazardous
noise levels as deﬁned by OSHA. For regression analyses, training was coded
as “yes” or “no” and used as a dummy variable.

Work Climate. Workers’ perceptions of factors and characteristics in the
work environment that support and facilitate the use of HPDs. Included are
factors such as supervisor and/or peer encouragement and support, supervisor

and/or co-worker behaviors, availability of hearing protection equipment, and

availability of information about HPD use (Coyle, Sleeman, & Adams, 1995;

Dedobbeleer & Beland, 1991; NIOSH, 1996; Tracey et al., 1995).

Self-efﬁcacy. Workers’ perceptions about their conﬁdence and
capabilities to use HPDs appropriately and effectively in their work settings

(Bandura, 1986).

Outcome Expectancy. Workers’ perceived beliefs about the beneﬁts and

results of using HPDs (Bandura, 1986; Vroom, 1964).

Outcome Value. Workers’ perceived beliefs about the importance of the

possible outcomes associated with using HPDs, (Bandura, 1986; Vroom, 1964).

Personal Factors. Demographic data including workers’ age and trade

category (e.g., carpenter, operating engineer, plumber/pipeﬁtter).

Dependent Variable

HPD Use. Workers’ self-reported use of HPDs (e.g., ear plugs, ear muffs,
etc.) when exposed to hazardous noise in their work settings, measured as
percentage of time that HPDs were worn at most recent and previous job sites,
and at three speciﬁc time periods (i.e., past week, past month, past three

months).

Signiﬁcance of the Study
Knowledge gained from this study is intended to assist program planners
in designing future educational efforts aimed at reducing NIHL among
construction workers. According to the National Safety Council (1992), even

though hearing protection programs might be designed to meet OSHA

10

standards, they still can be quite “ineffective in preventing work-related
noise-induced hearing loss” (p. xi). Occupational NIHL is preventable, yet once it
occurs, it is permanent and costly. Numerous beneﬁts to individuals, families,
and society could be achieved if hearing protection training programs were more
effective. Supporting, educating, and motivating workers to adopt practices that
will protect their hearing are valuable endeavors. In order to accomplish such
endeavors, it is necessary to expand the knowledge about how work
environments inﬂuence workers to effectively use protective hearing devices.
Since past research ﬁndings have indicated that the use of hearing
protection among construction workers remained inadequate even after training
was provided (Lusk, 1997), further investigation of existing data is warranted.
Explicating factors that are speciﬁcally associated with hearing protection
behaviors within the work environment can provide a clearer understanding of
the contextual inﬂuences, along with a more holistic awareness of construction
workers’ use of HPDs. Therefore, by focusing on work climate factors and
performing secondary analysis of the existing post-training data provided by
Lusk, ﬁndings from this study can make a valuable contribution toward efforts to

reduce the incidence of occupational NIHL among construction workers.

Limitations and Delimitations
When relying upon secondary analysis of existing data, the researcher is
constrained by pre-existing questionnaire items, thus limiting the focus of interest
and perhaps reducing the validity of constructs. When self-reported scores are

used, reliability of measures may be reduced. Since construction workers

11

comprised the study sample, generalizability of ﬁndings to other types of workers
is not appropriate. Also, this study focused on training issues related to hearing
protection behaviors; therefore, ﬁndings may not be applicable for all training

endeavors.

12

Chapter 2

REVIEW OF THE LITERATURE

This section begins with an overview of the literature related to signiﬁcant
issues concerning noise-induced hearing loss (NIHL) in occupational settings.
The majority of early research and training efforts to prevent NIHL among
workers focused on individual or personal attitudes and behaviors, not
necessarily organizational or work setting factors. This approach is evident in
some of the current theories that have generally guided health behavior studies.

To provide an evolutionary sense of the conceptual thinking that has
dominated and directed previous research on health behaviors, an introductory
perspective of two relevant theories is ﬁrst discussed. Presented next is the
conceptual framework that guided the speciﬁc focus for this study. A discussion
of the organizational behavior literature related to work climate then follows,
focusing on the sociocultural aspects of the work environment. Bridging the
health-related studies with organizational behavior studies is the concept of
self-efﬁcacy; therefore, an expanded description of this critical element is
provided. Also included is a discussion of the concepts of outcome expectancy
and outcome value that are theorized to be motivators of performance. This is
followed by a presentation of ﬁndings from studies speciﬁcally related to hearing
protection. The chapter concludes with a discussion of the theoretical and
empirical literature related to the work environment and organizational training

issues.

13

Noise-induced Hearing Loss

Noise is a pervasive element in contemporary life. When continuous
noise levels exceed 85 decibels (dB), they become potentially hazardous and
can destroy microscopic tissues in the inner ear that are necessary for adequate
auditory function. Once destroyed, these microscopic elements can never
regenerate, nor can they be repaired. As a result, permanent hearing
impairment ensues. For many workers, industrial work settings pose a
dangerously high risk for such hearing loss to occur. High-noise levels in the
work environment can lead to an insidious loss of hearing, one that is
progressive and irreversible. Known as occupational noise-induced hearing loss
(NIHL), it is non-responsive to treatment. Such hearing loss represents
detrimental and costly effects, both for individual workers and society. For
example, NIHL produces decreased sensitivity to high-frequency sounds, thus
resulting in speech discrimination difﬁculties and social interaction problems
(Bahadori & Bohne, 1993). Exposure to hazardous noise levels has detrimental
effects extending beyond the loss of one’s hearing; evidence exists that reported
stress-related diseases are associated with Iong-tenn exposure to high-noise
levels (Melamed, Luz, & Green; 1992; Smith, 1997; Suter & Franks, 1992).

In terms of monetary costs to society, estimated costs for workers’
compensation claims related to NIHL for the period 1977 to 1987 were reported
to be $800 million (NIOSH, 1988). Relative to actual costs for hearing loss
compensation claims, the US. Veteran’s Administration paid out approximately
$206 million in the 1990 calendar year ( Adera, Donahue, Malit, & Gaydos, 1993;

Dobie, 1995a). Predicted costs for future hearing loss claims are staggering.

14

Using the Canadian claims data presented by Alleyne, Dufresne, Kanji, and
Reesal (1989), it was projected that total payout related to hearing loss claims in
the US. for the time period between 1987 and the year 2000 could potentially
reach $35 billion (Atherley, 1989). Indeed, the price for occupational NIHL will
remain a high cost to bear.

Unfortunately, no comprehensive epidemiologic data on NIHL are
available, but NIOSH estimates that more than 30 million individuals are exposed
to potentially damaging noise levels in their work environments (NIOSH, 1996).
The only effective strategy for reducing the signiﬁcant and tremendous costs
associated with occupational NIHL is to prevent its occurrence. Limiting
hazardous noise levels in work environments through the use of engineering
controls, and practicing hearing conservation techniques in work settings where
engineering controls are not feasible are the primary suggested approaches for
reducing NIHL (Feldman & Grimes, 1985; NIOSH, 1996; Royster & Royster,
1990; Sataloff & Sataloff, 1993; Suter & Franks, 1992).

According to OSHA, at least one million workers in the manufacturing
sector are afﬂicted with an occupational NIHL that interferes with their daily life
activities (Dessoff, 1995) and may even be threatening to their employment
status (NIOSH, 1988). Federal regulations, administered by OSHA, mandate
that industrial employers provide hearing conservation programs in work settings
where noise exposures are at an eight-hour time-weighted average level of 85
dB or greater (OSHA, 1985). One of the required components of such programs
includes employee training about the importance of using hearing protection

devices (HPDs) to prevent NIHL.

15

Construction workers are in a group whose industry is not covered by the
comprehensive OSHA standards that mandate the provision of hearing
conservation programs (Dobie, 1995b; Reilly et al., 1998), even though about
13% of production workers in construction are exposed to hazardous noise
levels (Franks, 1990; Kuhar, 1996). In fact, a 1980s Canadian study of about
5,000 construction workers found that almost half (49%) of the workers were
afﬂicted with NIHL (Schneider, 1995). Such statistics are alarming, considering
that many construction workers are generally in the young- to mid-adult age
groups.

Despite a lack of speciﬁc coverage under OSHA regulations that mandate
the provision of a hearing conservation program, the construction industry does
maintain a noise standard and is covered by the General Duty Clause which
addresses the obligation for employers to provide an employment site that is free
from recognized hazards (OSHA, 1995). The OSHA “noise standard 29 CFR
1926.52 requires that the construction industry provide feasible administrative or
engineering controls, hearing protection, and a hearing conservation program for
employees who are exposed to noise at or above an 8-hour time-weighted
average (TWA) of 90 dBA” (Lusk et al., 1998, p. 466). This noise standard is not
as stringent or comprehensive as the OSHA regulations for industrial work
settings (Franks, 1990; Schneider, 1995). Furthermore, providing worker training
about NIHL is not required in the construction industry (Kuhar, 1996).

Even though construction is one of the most dangerous industries in the
US. (Well, 1992), very little research has explored the safety practices among

construction workers (Dedobbeleer & German, 1987), particularly research

16

 

 

related to the use of HPDs (Lusk et al., 1997). Given the nature of the
dangerous work in the construction industry, it is not unusual that frequent
injuries occur, including the loss of auditory function. Typically, construction
workers are exposed to high-noise levels that vary both in duration and intensity
and may be of a constant, intermittent, or impulse nature (Franks, 1990). The
use of HPDs by construction workers is not well understood nor well
documented. The study reported by Lusk et al. (1998), where construction
workers reported a mean HPD use of 18% to 49%, represents one of very few
studies focused on construction workers’ behaviors related to hearing protection.
Indeed, construction workers face multiple safety challenges in their work
environments and the potential for occupational NIHL remains quite high.
Training workers how to adequately respond to their workplace challenges is a
critical concern. The consistent use of HPDs by construction workers represents
an effective safety behavior that can preserve auditory function. Therefore, it is
beneﬁcial to review the literature about major concepts and studies related to
promoting health behaviors, maintaining safe and supportive work climates, and

providing training to promote changes in behavior.

with Behavior Theories
Given that a major concern of this study is focused on a health-related
behavior (HPD use), two theories are described in the following section in order
to provide some historical perspective for the earlier research related to health
behaviors. These theories are presented as background and some of their

limitations are noted.

17

Health Belief Model

One of the earliest and probably most extensively studied theories related
to health behavior is the Health Belief Model (HBM). This model describes four
major factors that inﬂuence individuals to comply with medical suggestions and
treatment: (1) perceived vulnerability to a disease condition, (2) perceived
severity of the consequences of a disease, (3) degree of motivation or interest in
avoiding disease, and (4) appraisal of the costs and beneﬁts of actions required
to prevent or treat the disease (Becker & Maiman, 1980). Since its inception, the
HBM has provided a theoretical framework for numerous research studies.
Basically, the model postulates that individuals will engage in compliant
behaviors to avoid a serious threat of disease if they perceive themselves as
vulnerable and if they perceive that the beneﬁts of their actions will be greater
than the costs.

In a comprehensive analysis of ﬁndings from 46 studies that used the
HBM as a conceptual framework and were published between 1974 and 1984,
Janz and Becker (1984) found that the dimension of perceived barriers
(i.e., costs and obstacles of action) was the most powerful concept of the HBM.
Regardless of study design, barriers consistently demonstrated statistically
signiﬁcant relationships with health actions and behaviors.

Notably absent, however, from the early studies guided by the HBM were
direct measures of variables related to the concepts of self-efﬁcacy and social
approval. Janz and Becker (1984) acknowledged this omission and indicated
that subsequent research endeavors conﬁrmed the importance of considering

these concepts as inﬂuencing factors related to health behaviors. Furthermore,

18

Janz and Becker concluded that self-efﬁcacy and normative approval were
implied in the dimensions of perceived beneﬁts and barriers. Later discussions
of the HBM supported the concept of self-efﬁcacy and explicitly described it as a
separate independent variable that warranted inclusion with perceived risk,

severity, beneﬁts, and motivation (Rosenstock, Strecher, & Becker, 1988).

Heatlth Promotion Model

Developed by Pender (1987), the Health Promotion Model (HPM) focuses
on health promotion behaviors and excludes the threat of disease as an
inﬂuencing factor (Pender et al.,1990). The HPM, a multivariate model, is an
expansion of the HBM and is based upon the social cognitive theory (801) of
Bandura (1986); therefore, it fully recognizes the inﬂuence of perceived
self-efﬁcacy as a health behavior determinant. Used as the conceptual model by
Pender et al. to explain and predict health-promoting lifestyles among employees
in their work settings, 31% of the variance in health-promoting behaviors was
explained by workers’ perceived control of health, personal competence
(self-efﬁcacy variable), deﬁnition of health, and health status. The sample was
comprised of employees who were currently actively engaged in health ﬁtness
programs in their work environments; therefore, results may have reﬂected their
already established health-promotion tendencies.

Interestingly, Pender et al. (1990) noted a positive relationship between
employees’ health-promoting practices and their perception that health was
externally controlled by powerful others. Given this ﬁnding, the authors

speculated that employees in the sample may have enrolled in ﬁtness programs

19

because such programs afforded an opportunity for co-worker support and
encouragement. As a result of this ﬁnding, Pender et al. suggested that future
studies should explore the contribution of interpersonal and situational factors in
explaining health-promoting behaviors. Such a suggestion implies a need to
consider the inﬂuence of organizational factors on employee behaviors in
worksite settings.

In using the HPM as a conceptual framework in a study of hearing
protection use among 645 factory workers, researchers reported that
self-efﬁcacy, beneﬁts, and low barriers were strong determinants in workers’ use
of HPDs (Lusk et al., 1994). In causal modeling, the HPM was found to account
for up to 53% of the variance in hearing protection use. Absent from this study,
however, was a focus on organizational support or work setting inﬂuences that
might have provided a more expansive understanding of workers’ decisions to
use HPDs.

In summary, what is clearly evident from the reported research studies
using the HBM and the HPM as conceptual models is that the concept of
self-efﬁcacy is an important variable to include when studying health-related
behaviors. Also clearly evident is the focus on individual behaviors with the
exclusion of contextual factors that might potentially inﬂuence behaviors.
Unfortunately, what remains unknown is how the organizational setting or work
climate factors tend to inﬂuence individuals in their decisions to carry out speciﬁc
health-promoting behaviors. By exploring contextual factors and their

relationship with health-related behaviors, interventions can be planned that will

20

strengthen individuals’ perceptions of their abilities to enact desirable levels of

performance.

Conceptual Framework

Research ﬁndings and the literature support the concept that social
interactions occurring in the work setting are major contextual factors that play a
critical role in determining workers’ perceptions and behaviors (Ribisl & Reischl,
1993; Reichers & Schneider, 1990; Sloan & Gruman, 1988). Workers are
continually inﬂuenced by work setting factors and their interactions among peers
and supervisors, thus strongly suggesting the value of drawing upon a social
interaction theory as the conceptual framework for this study. Representing
such a framework is Bandura’s (1986) theory of social learning, more recently
called social cognitive theory (SCT). Elements from Bandura’s SCT have
provided a theoretical foundation for a number of research endeavors. This is
evident both in the area of health behavior (Melamed et al.,1996; Pender, 1987;
Rosenstock et al., 1988; Schwarzer, 1992; VIﬁIson, Sisk, & Baldwin, 1997) and in
the area of organizational behavior (Frayne & Latham, 1987; Latham, 1989;
Tannenbaum & Yukl, 1992).

Guided by the conceptual framework provided by Bandura’s SCT (1986),
this research study was designed to explore how work setting characteristics
(workers’ perceptions of work climate factors) relate to construction workers’
perceptions and behaviors about protecting their hearing. The following sections

present a discussion of the critical elements comprising the focus for this study

21

using Bandura’s concepts related to the Ieaming that is derived from social

interactions.

Work climate

Notably absent from many of the studies related to promoting health
behavior among workers in organizations is a focus on the climate of the work
environment. The literature typically indicates that the primary focus has been
on individual behaviors; subsequently, most educational efforts have been
directed toward changing personal or individual behaviors. Relative to health
promotion programs in work settings, this absence of a focus on the work climate
has been highlighted and recently addressed (Crump, Earp, Kozma, and
Hertz-Picciotto, 1996; Ribisl & Reischl, 1993; Sloan & Gruman, 1988). These
researchers emphasize the importance of organizational factors when
considering what elements typically inﬂuence workers to participate in
wellness-oriented programs.

Interestingly, the concept of the work climate with its inﬂuence on worker
performance and behavior has been extensively discussed in organizational
literature (Denison, 1993; Reichers & Schneider, 1990; Rousseau, 1988; Field &
Abelson, 1982; Tagiuri & Litwin, 1968). According to Tagiuri (1968), the concept
of work climate refers to “a relatively enduring quality of the internal environment
of an organization that (a) is experienced by its members, (b) inﬂuences their
behavior, and (c) can be described in terms of the values of a particular set of
characteristics (or attributes) of the organization” (p. 27). When speaking of

organizational climate, Tagiuri (1968) further noted that “organizational climate

22

connotes that the environment is interpreted by the members of the organization
to have a certain quality to which they are sensitive and which , in turn, affects
their attitudes and motivation” (p. 27). Climate is created through the dynamic
interaction that occurs between environmental and personal variables
(Forehand, 1968).

As Moos (1976) observed, societal institutions establish social
environmental conditions to maximize beneﬁcial behaviors; such environmental
conditions, or social climates, greatly inﬂuence the behavior of individuals
operating within the institution. Moos, who developed tools to measure the
social climate in institutions, spoke of social climate as the “personality” of an
organization or social institution. In work environments, individuals perceive the
existing climate and then pattern their behaviors to coincide with the perceived
climate (Field & Abelson, 1982; Reichers & Schneider, 1990).

Human interactions and group behaviors occurring within a work setting
are among the characteristics included when exploring the concept of
organizational climate. As Owens (1995) described, “organizational climate is
the study of perceptions that individuals have of various aspects of the
environment in the organization” (p. 86). Factors in the study of organizational
climate generally include: (1) workers’ perceptions of management commitment,
(2) supervisorlco-worker support, (3) obstacles impeding performance, and (4)
availability of appropriate equipmentﬁnformation (Crump et al., 1996; Glasgow,
McCaul, & Fisher, 1993; Kozlowski & Hults, 1987; Litwin & Stringer, 1968;
Owens, 1995; Ribisl & Reischl, 1993; Reichers & Schneider, 1990; Tracey et al.,
1995)

23

Within work organizations, it is common for multiple subclimates to exist,
generally representing diverse groupings of work procedures and practices. In
these situations, individual workers develop their own psychological climate,
which, in turn, inﬂuences the workers’ motivation and performance. The term
“psychological climate” was introduced by James and Jones (1974) to denote the
individual’s perception of the work environment as opposed to “organizational
climate” which refers to the consensual perceptions among groupings of
organizational workers (Howe, 1977).

Debate continues over which level of analysis (individual or group) is more
appropriate for assessing work climate factors (Rousseau, 1988; Tracey, 1992).
In the exploratory work of Ribisl and Reischl (1993), climate was measured at
the Individual level. Other researchers (Rouiller & Goldstein, 1993; Zohar, 1980)
aggregated individual responses to achieve a general climate score. For this
research study, it is reasonable to measure work climate at the individual level,
since the sample of construction workers was drawn from unidentiﬁable and
multiple organizations. According to Rousseau (1988), “aggregated climates are
constructed based on membership of individuals in some identiﬁable unit”

(p. 145).

Conceivably, it also is possible to perform group-level analysis using
aggregated climate scores representing construction workers from three trade
groups: carpenters, operating engineers, and plumber/pipeﬂtters. Doing so can
reveal unique group-related perceptions of work climate issues. Collective
climate scores are also appropriate to distinguish differences in HPD use among

groups of workers who demonstrate similar perceptions of behavioral contexts

24

(Rousseau, 1988). For example, workers who perceive highly supportive work
climates might be more likely to report greater use of hearing protection than

workers who perceive less supportive work climates.

__limate for Safety

Schneider and Rentsch (1988) expanded on the notion of multiple
subclimates and Reichers & Schneider (1990) suggested that organizational
climate can be referred to in speciﬁc terms, such as “the climate for service or
the climate for safety” (p. 23). In other words, the focus of interest should guide
the measurement of speciﬁc dimensions of climate. Recently, NIOSH (1996)
deﬁned safety climate as “the general level of safety awareness and commitment
among management and workers in the organization” (p. 56). Safety climate is
manifested by a variety of factors, including company safety policies,
organizational attitudes about safety concerns, workgroup norms related to
safety practices, availability of protective equipment, and provision of information
and feedback relative to safety behavior (Lindell, 1994; NIOSH, 1996).

Focusing on a speciﬁc dimension of organizational climate, such as the
climate for safety, provides a clearer direction for exploring the relationship
between factors in the work context and workers’ enactment of safety behaviors.
In fact, Zohar (1980) used such an approach by incorporating the concept of
safety climate in studying workers’ perceptions about the importance of industrial
safety behavior in Israeli factories. One of the major ﬁndings from this study was
that workers’ perceptions of management’s attitude toward safety, demonstrated

by the safety ofﬁcer’s level of authority and involvement in decision making,

25

strongly inﬂuenced accident prevention and the success of safety programs. By
focusing on more speciﬁc components of the climate dimension (i.e., safety
climate), signiﬁcant relationships can be identiﬁed (Tracey, 1992; Zohar, 1980).
In the safety literature, Zohat’s study is often referenced; however, the sample
consisted of factory workers in Israel and ﬁndings should not be generalized
beyond this population.

More recent research by Hofrnann and Stetzer (1996) supported Zohar’s
(1980) ﬁndings. Using a survey instrument based on Zohar’s original measure
for safety climate and revised by Dedobbeleer and Beland (1991), the
researchers found signiﬁcant relationships between safety climate, unsafe work
behaviors, and actual accident occurrence in a Midwestern chemical processing
plant. These ﬁndings must be interpreted cautiously, however, because the
sample was drawn from only one organization. A more representative sample
drawn from multiple work settings would allow greater generalization of ﬁndings.

Relative to the safety climate in work settings, prevailing attitudes about
safety issues can strongly inﬂuence self-protective behaviors. In a study to
identify determinants of the use of respirator equipment among construction
painters, White, Baker, Larson, and Wolford (1988) identiﬁed that discomfort was
the primary reason reported for failing to use a respirator. However, the
researchers discovered the inclusion of a social behavior determinant—workers’
perceptions of their co-workers’ attitudes also inﬂuenced decision making about
respirator use. Unfortunately, the authors provided no information about the
reliability or validity of their measures; therefore, caution should be applied when

interpreting the reported results.

26

In summary, the reported ﬁndings from studies involving health and safety
behaviors in organizations strongly indicate that the climate of the work setting
exerts a deﬁnite inﬂuence on workers’ behaviors. Prevailing attitudes about
safety issues and behaviors that were demonstrated by supervisors and co-
workers clearly contributed to workers’ use of safety equipment. Given these

ﬁndings, the following hypotheses were proposed for testing in this study.

Hypothesis 1 . There is a positive relationship between work climate
factors and construction workers’ use of hearing protection devices (HPDs).

Hypothesis 2. Construction workers who perceive a supportive work
climate will report a greater use of HPDs than construction workers who perceive

a non-supportive climate.

Self-efﬁcacy

The element most visible and common to research efforts both in the
areas of health promotion and organizational behavior is the concept of
self-efﬁcacy. According to Bandura (1986), perceived self-efﬁcacy is a
determinant of an individual’s behavior and is deﬁned as a person’s belief in his
or her capability to engage in and perform speciﬁc behaviors. Bandura contends
that beliefs about one’s capabilities are inﬂuenced by self-mastery of
performances and vicarious experiences—observations of the performance of
others. Therefore, in work settings, individuals’ perceptions of their self-efﬁcacy
can be affected by contextual factors. Thus, the modeled behaviors and the
support of co-workers and supervisors can inﬂuence the behavior of individuals

in organizational settings.

27

As Hergenhahn and Olson (1997) explain, Bandura’s SCT (1986) focuses
on humans as dynamic social beings whose Ieaming involves information
processing and problem solving that frequently occurs in social settings.
Learning occurs through interactions with others and observations of the
performances of others. According to Bandura (1986), self—efﬁcacy involves the
ability to integrate cognitive, social, and behavioral skills to perform designated
actions; however, more than just these skills are required for successful levels of
performance. Individuals also must have an inherent belief in their ability to
appropriately use their skills when faced with speciﬁc tasks to accomplish.
Self-efﬁcacy is “concerned not with the skills one has but with judgments of what
one can do with whatever skills one possesses” (Bandura, 1986, p. 391).

Bandura (1986) contends that even when individuals believe that certain
actions will produce desired outcomes, they still may not carry out the actions or
behaviors necessary to achieve valued outcomes, because they may lack
conviction in their ability to perform. Intentions to carry out speciﬁc behaviors are
strongly inﬂuenced by one’s perceived self-efﬁcacy. In organizational settings,
the construct of self-efﬁcacy has been studied in its relationship to training
effectiveness; individuals who perceive high levels of self-efﬁcacy have been
found to demonstrate higher levels of performance than those who perceive low
levels of self-efﬁcacy (Tannenbaum & Yukl, 1992). Gist and Mitchell (1992)
emphasize that self-efﬁcacy is a critical motivational construct, inﬂuencing
individuals in their choices, goals, efforts, and achievement. In the area of health
behaviors, self-efﬁcacy has been demonstrated to have a powerful inﬂuence

both on behavioral intentions and course of action (Schwarzer, 1992).

28

In a study of cigarette-smoking behavior, Strecher et al. (1985) found that
smokers involved in a smoking-cessation program were most likely to reduce
their smoking habits if they reported high-efﬁcacy expectations along with a
perceived high susceptibility to future smoking-related illness. In this study,
efﬁcacy expectations were measured as the subject’s perceived ability to refrain
from smoking in speciﬁc situations. Individuals least likely to reduce their
smoking habits were those who reported perceived high susceptibility to illness
and low-efﬁcacy expectations. In light of their study ﬁndings, the researchers
emphasized the importance of strengthening efﬁcacy expectations when
attempting to inﬂuence health-related behavioral changes.

Using a correlational study design and guided by Bandura’s SCT (1986),
Wulfert and Wan (1993) studied the relationship between psychological factors
(self-efﬁcacy, attitudes, expectancies, peer inﬂuence, knowledge, vulnerability)
and the practice of risky sexual behaviors among undergraduate students. The
researchers hypothesized that students’ perceived ability to practice safe sex
behaviors would be positively associated with their outcome expectancies
(consequences of behavior) and peer group inﬂuences. Results of their study
indicated that self-efﬁcacy was a central mediator in the relationship between
safe behaviors and factors such as outcome expectancies and peer inﬂuences.
Not surprisingly, the study results also suggested that safe sex behaviors were
directly inﬂuenced by peer group actions.

While the research ﬁndings of Wulfert and Wan (1993) supported the use
of Bandura’s (1986) theory in explaining safe sex behaviors among college

students, results cannot be generalized beyond this particular population. Also,

29

a convenience sample was used, further limiting the ability to generalize the
ﬁndings. In addition, it is important to note that self-efﬁcacy was measured with
one item that rated students’ perceived conﬁdence about practicing safe sex
behavior in the subsequent six months. As Graziano and Raulin (1989) contend,
reliability is reduced when only one observation or measurement for a construct
is used. Indeed, increasing the number of observations to obtain a score,
generally tends to improve the reliability of that score (Graziano & Raulin).

In a study of the use of hearing protection devices (HPDs) among factory
workers (N = 281) in Israel, researchers found that workers’ perceived
self-efﬁcacy for using HPDs, their perceived susceptibility to hearing loss, and
their degree of noise annoyance were strong predictors (Melamed et al., 1996).
Together, these strong predictors explained 48% of the variance in workers’ use
of HPDs. Of these predictors, Melamed et al. found that self-efﬁcacy was the
most powerful, supported by the fact that self-efﬁcacy alone accounted for 42%
of the variance in HPD use. Given their ﬁndings, the researchers suggested that
attempts to increase workers’ use of HPDs should focus on improving workers’
perceived self-efﬁcacy.

In their study of construction workers, Lusk et al. (1997) reported that
construction workers tended to report higher HPD use when they perceived high
value (beneﬁts) and low barriers (obstacles); furthermore, construction workers
who reported higher levels of self-efﬁcacy in using HPDs tended to report greater
HPD use. Again, self-efﬁcacy was identiﬁed as an important concept in
understanding some of the determinants associated with speciﬁc worker

behaviors related to hearing protection.

30

To summarize, self-efﬁcacy is a central construct in Bandura's SCT
(1986). Self-efﬁcacy refers to “a person’s estimate of his or her capacity to
orchestrate performance on a speciﬁc task” (Gist & Mitchell, 1992, p. 183).
Health behavior studies indicate that self-efﬁcacy is a strong determinant for
adopting health-related behaviors (Lusk et al., 1997; Pender et al., 1990;
Schwarzer, 1992). In organizational studies, it is reported that self-efﬁcacy and
work performance are positively correlated and that some types of training can
lead to enhanced levels of self-efﬁcacy (F rayne & Latham, 1987; Gist, 1987; Gist

& Mitchell, 1992).

Outcome Expectancy and Outcome Value

An individual’s judgment of the ultimate results of a speciﬁc course of
action is considered to be an outcome expectancy. Schwarzer (1992)
emphasizes the importance of considering both self-efﬁcacy and outcome
expectancy concepts in health behavior studies. In SCT, Bandura (1986) clearly
distinguishes between perceived self-efﬁcacy and outcome expectation.
Self-efﬁcacy can be thought of as the “can do” belief in one’s ability to perform,
while outcome expectancy can be considered the “desired and valued result” of
the “can do” behavior. Therefore, an outcome expectancy can be deﬁned as a
perceived beneﬁt of carrying out speciﬁc behaviors (Schwarzer, 1992).

Complementing Bandura’s SCT (1986) is Vroom’s Expectancy Theory
(1964) that relates to one’s beliefs about performance capabilities (expectancies)
and one’s beliefs about outcome contingencies. Vroom’s concept of

expectancies parallels Bandura’s self-efﬁcacy concept, while outcome

31

contingencies are similar to Bandura’s outcome expectations. Thus, an
individual’s behavior is motivated by self-perceptions about expectancies and
outcome contingencies. According to Vroom, an individual’s degree of
motivation is determined by how strongly one perceives he or she can capably
perform behavior that will achieve a valued outcome. If individuals perceive that
they are capable of performing skills and that their performance will lead to a
valued outcome, they will be more inclined to enact the performance behavior.

Vroom (1964) explained that outcome expectancies motivate behavior.
“Expectancy is an action-outcome association” (Vroom, p. 18). Health behavior
theories that incorporate variables related to the beneﬁts of speciﬁc actions
generally are referring to the concept of outcome expectancy. The value of the
outcomes, or “valence” as described by Vroom, refers to the “affective
orientations toward particular outcomes” (Vroom, p. 15). How strongly the
anticipated outcomes are desired determines the degree of outcome value.
Therefore, both the perception that speciﬁc results of action are probable and
the degree of value associated with the probable outcomes tend to inﬂuence
behavior.

Maddux, Norton, and Stoltenberg (1986) investigated the role of
self-efﬁcacy, outcome expectancy, and outcome value in predicting behavioral
intentions relative to improving interpersonal skills. The authors reported that
correlation analyses indicated all three concepts were signiﬁcant and relatively
comparable predictors of behavioral intentions. A major limitation of their study,
however, is that the sample consisted of undergraduate students enrolled in an

introductory psychology course, thereby reducing generalization of ﬁndings.

32

The literature and research ﬁndings suggest that self-efﬁcacy, outcome
expectancy, and outcome value are important concepts to explore in an attempt
to understand workers’ behaviors to protect their hearing. Also supported in the
literature and of critical importance to consider is the work setting where hearing
protection behaviors are, or are not, consistently enacted. Unfortunately, in
health behavior studies, the focus on contextual settings has been fairly limited.

Therefore, the following hypothesis was posed for testing in this study:

Hypothesis 3. There is a positive relationship among work climate

factors, self-efficacy, outcome expectancy, and outcome value for using HPDs.

In summary, self-efﬁcacy has been reported to be a strong predictor for
the use of hearing protection; however, little is known about how work settings
may contribute to increased levels of self-efﬁcacy and the use of hearing
protection. Using workers’ perceptions of characteristics in their work settings,
this study was designed to explore the relationships among work climate,
self-efﬁcacy, outcome expectancy, and outcome value, while ultimately exploring
the relationship of these variables to post-training use of HPDs. According to
Bandura (1986), observing the performance of others is a major source of
strengthening one’s perception of self-efﬁcacy; therefore, work settings provide
tremendous opportunities for vicarious learning.

In reference to this learning from the experiences of others, Hergenhahn
and Olson (1997) note that “Bandura’s theory is called social cognitive theory
because it emphasizes the fact that most of the information we gain comes from

our interactions with other people” (p. 351). In fact, a reciprocal determinism

33

occurs, thus resulting in constant interaction among the environment, behavior,
and individual (Bandura, 1991; Hergenhahn & Olson, 1997). Cognizant of
Bandura’s concept of vicarious Ieaming and its inﬂuence on perceived
self-efﬁcacy and behavior, it is imperative to investigate the inﬂuence of work
climate factors when studying workers’ perceptions and behaviors related to the

use of hearing protection.

Mational Studies and Hearing Protection Use

Using a convenience sample for a survey study of workers from 48 British
organizations, and including in-depth case studies from 10 of these
organizations, Leinster, Baum, Tong, and Whitehead (1994) investigated the
management, organizational, and psychological factors associated with
occupational NIHL. Among the individual workers surveyed, 41% reported using
HPDs some of the time when in noisy areas, 43% indicated always wearing
HPDs, and 16% reported never using HPDs. Thirty-six percent of the
respondents indicated that discomfort was the most common reason for failure to
use hearing protection. The researchers contend that important factors
associated with strengthening workplace HPD norms include the establishment
of clear rules and commitment by senior management, along with ongoing
support and modeling of appropriate HPD use by supervisors. Unfortunately, no
statistical data about correlational ﬁndings were provided in the article. Given
this omission, the strength and signiﬁcance of the reported relationships are

unclear.

34

In their study of HPD use among Israeli factory workers, Melamed et al.
(1996) identiﬁed a relationship between HPD use and management or co-worker
support. Workers who reported non-use of HPDs also reported less
management and co-worker pressure to use hearing protection. However, in
performing stepwise discriminant analysis to determine the most powerful
predictors of HPD use, results were somewhat in contrast to ﬁndings from other
studies. Melamed et al. found that management pressure and social pressure
were not directly related to HPD use. However, management and social
pressures were related to workers’ perceptions of self-efﬁcacy in using HPDs.
Interestingly, this ﬁnding provides support for Bandura’s (1986) argument that
self-efﬁcacy perceptions can be strengthened through social interactions and
vicarious experiences. Caution must be used, however, when interpreting these
results. Melamed et al. reported that the two variables of management pressure
and co-worker pressure were each measured with one item; therefore, the
reliability of these measures was possibly reduced.

Hofmann and Stetzer (1996) urged replication and strongly recommended
the need for additional studies to address the inﬂuence of work and social factors
on safety behavior. In addition, very little health-related research has focused on
the relationship between work climate factors and self-efﬁcacy, speciﬁcally those
studies related to hearing protection behaviors. Therefore, a more
encompassing framework is needed to understand the overall relationship of
factors associated with construction workers’ use of hearing protection.
Recognizing the central theme of SCT (Bandura, 1986), and based upon the

literature describing the importance and relevance of work climate factors,

35

self-efﬁcacy issues, and hearing protection behaviors, the following hypothesis

was proposed for testing in this study:

Hypothesis 4. Construction workers who perceive a supportive work
climate will report higher self-efﬁcacy, outcome expectancy, and outcome value
for using HPDs than construction workers who perceive a non-supportive work

climate.

In summary, the majority of research studies strongly suggest the
existence of a relationship between work climate factors and worker behaviors.
Most notable is the relationship between safety climate factors and the
performance of safe behaviors, particularly those related to the use of hearing
protection. While results of the research ﬁndings have been impressive, some
limitations exist due to sample selection methods and issues related to

instrument reliability and validity. Therefore, additional research is warranted.

Work Climate and Training Issues

Obviously lacking in the literature are studies that have explored the
interrelationship of work climate factors, self-efﬁcacy, and training efforts to
reduce the incidence of occupational NIHL among construction workers. As
reported in the literature, even when workers are trained to use HPDs. many of
them fall to transfer learning from training programs to their workplace settings
(Merry & Franks, 1995; NIOSH, 1996).

Often neglected, but critical to consider when training adult learners in

work settings, is the climate of the environment where workers will be expected

36

to use the skills acquired in training sessions. The degree to which newly
learned skills are applied to the work setting can be considered a measure of
training effectiveness, or essentially a transfer of training (T annenbaum & Yukl,
1992). Applying knowledge, behaviors, skills, and attitudes learned In training
programs to real world environments is symbolic of transfer of training—an
indicator of training effectiveness (Kirkpatrick, 1994; Tracey et al., 1995).

As Garavaglia (1996) contends, training efforts are successful when
workers not only acquire desired knowledge and skills, but also when they apply
the newly-gained knowledge by utilizing the newly-learned skills in the work
setting. A critical component for such transfer of Ieaming to occur is a work
climate that encourages and facilitates workers to use their new knowledge and
skills (Tracey et al., 1995). In reference to working with adult learners and
identifying factors that inﬂuence the application of Ieaming from training
programs, Caffarella (1994) emphasized that an organizational context “either
supports or inhibits the transfer of learning” (p. 110). As reported by Noe and
Schmitt (1986) and Richey (1992), environments where workers perceive
supportive supervisors and co-workers tend to have a positive inﬂuence on
workers’ transferring knowledge and skills acquired during training.

Support and encouragement from managers, supervisors, and peers are
essential components for transfer of learning to occur (Baldwin & Ford, 1988;
Caffarella, 1994). In an extensive review of the organizational training literature,
Baldwin and Ford cited seven studies that focused on the relationship between
work environment factors and transfer of training. All seven studies used a

correlational, survey design and most of the studies involved human relations

37

training. Based upon results from these studies, the authors concluded that
supportive work climates greatly contribute to positive transfer of training.
Acknowledging limitations in the existing empirical evidence related to the
inﬂuence of work environments on training effectiveness, Baldwin and Ford
strongly recommended that “more research is needed to identify and
operationalize variables that signiﬁcantly facilitate or inhibit transfer" (p. 92).

Using an experimental design, Brinkerhoff and Montesino (1995)
examined the relationship between management support interventions (mutual
goal setting and follow-up discussions) and transfer of training in a group of 91
participants enrolled in development courses in a Fortune 200 company.
Unfortunately, contamination of the study groups occurred. A few members in
the treatment group reported having received no management interventions, or
less than planned. In the control group, some members reported having
received management interventions, similar to that intended for the experimental
group. Despite the fact that the study design was weakened, results indicated a
signiﬁcant relationship between management support and transfer of training to
the work setting. Study participants who perceived more favorable supervisory
support tended to report more application of their training-acquired skills. Even
though this study lacked experimental rigor and a small sample size was used,
results still conﬁrmed the importance of work climate factors (management
support) in fostering the transfer of training.

In a study of manager trainees in the fast-food industry, ﬁndings reported
by Rouiller and Goldstein (1993) support the concept that work climate factors

inﬂuence transfer of training to work settings. Rouiller and Goldstein

38

operationalized their climate measures to be situations and consequences that
inhibit or facilitate the use of skills learned in training. Among some of the work
climate factors measured by the authors were supervisor/peer inﬂuences,
provision of feedback, and availability of equipment/opportunities to apply
newly-Ieamed skills. The researchers found that supportive work climate factors
were signiﬁcantly associated with positive post-training behaviors in the work
environment.

Expanding on the work conducted by Rouiller and Goldstein (1993),
Tracey, et al. (1995) performed LISREL analyses to examine the inﬂuence of
transfer of training climate and continuous-learning climate on the post-training
performance of supermarket manager trainees. Using some measurement tools
similar to those reported by Rouiller and Goldstein, Tracey et al. concluded that
post-training behaviors were directly inﬂuenced by the climate or culture factors
of the work environment. When trainees perceived factors to be supportive, they
demonstrated increased performance of newly-learned skills. Most inﬂuential of
the climate or culture factors were those related to the social system, namely
supervisory encouragement and facilitation for using newly-acquired Ieaming.
While Rouiller and Goldstein and Tracey et al. reported signiﬁcant ﬁndings
related to transfer of training, it is important to note that both studies lacked a
control group. If control groups had been included in the study designs, the

reported results would bear more strength.

39

Work Climate and Safetv Training

Recognizing that the inﬂuence of organizational climate can often be
overlooked when considering training effectiveness, Richey (1992) examined
results from an extensive evaluation of three safety-training programs conducted
over approximately four years in the automotive industry as a joint
labor/management endeavor. The theory of Systemic Training Design (STD)
was used for analyzing program outcomes. As a conceptual framework, the
STD model incorporates organizational climate and learner attitudes as major
inﬂuencing factors associated with the accomplishment of training goals. In
describing concepts supported by the STD framework, Richey emphasized that
“organizational climate plays its most important role as either a facilitator or an
inhibitor of transfer of training” (p. 154). Contending that deﬁciencies in
post-training performance are often attributed to problems with instructional
design or delivery, Richey argued that the problems may actually result from
characteristics or factors in the work environment itself.

Study ﬁndings reported by Richey (1992) indicated that critical factors in
the work climate associated with transfer of Ieaming included management and
supervisory support, along with modeling of behaviors central to the goals of the
training program. While the extensive ﬁndings presented by Richey merit
considerable attention, results should be viewed cautiously. The safety-training
project involved a convenience sample and had no control group for comparison.
In addition, the study was conducted over a four-year time period. Other events
in the overall work environment may have contributed to the observed outcomes

and maturation of subjects could have occurred, possibly posing as threats to the

40

validity of ﬁndings. Nevertheless, the reported ﬁndings are impressive and
provide considerable insight about the inﬂuence that the work climate exerts on
post-training behaviors.

Clearly, research ﬁndings reported in the literature suggest that factors in
the work setting can signiﬁcantly inﬂuence training efforts and should not be
overlooked if training is to be effective. Supportive work environments tend to
promote transfer of training to the work setting. Focusing on the combination of
issues related to transfer of training, safety behaviors, and organizational climate
that have been reported in the literature, the following hypotheses were

presented for testing in this study.

Hypothesis 5. Hearing protection training, work climate factors,
self-efﬁcacy, outcome expectancy, and outcome value will predict the use of

HPDs by construction workers.

Hypothesis 6. For construction workers who received hearing protection
training, those who perceived a supportive work climate will report greater
self-efﬁcacy, outcome expectancy, outcome value, and use of HPDs than those

who perceived a non-supportive climate.

Summary of Literature Findings
Occupational NIHL is preventable. In order to reduce its occurrence, it is
imperative to combine knowledge gained from organizational behavior studies
with those related to health promotion and health behaviors. Research that

focuses on the contextual factors where transfer of training is intended to occur

41

can expand the existing knowledge about the effectiveness of training to protect
construction workers” hearing in the work setting. Such knowledge can lead to
the development of more effective training programs.

Organizational behavior studies designed to examine the relationship
between work climate factors and training effectiveness have provided evidence
that climate plays a major inﬂuential role in contributing to training outcomes.
What has not been extensively studied with scientiﬁc rigor is how work climate
factors inﬂuence the practice of health-related behaviors in work settings.
Relative to safety and health promotion behaviors in organizational settings, a
number of researchers have strongly urged that future studies address the
inﬂuence of work climate factors (Hofmann & Stetzer, 1996; Pender et al. 1990;
Ribisl & Reischl, 1993; Sloan & Gruman, 1988). Guided by the concepts
espoused by Bandura (1986), it is valuable to explore how work climate factors
and hearing protection training inﬂuence workers’ perceptions and behaviors
associated with the use of HPDs in work settings.

In the study conducted by Lusk (1997), results indicated that training to
promote the use of HPDs by regional construction workers had signiﬁcant, but
limited, effects. What remains unknown and warrants further investigation is the
importance of the speciﬁc relationship between work climate factors and
construction workers’ post-training use of HPDs. Additional insight is needed
about how work climate factors inﬂuence workers’ self-efﬁcacy, outcome
expectancy, outcome value, and post-training behaviors.

In this research study, secondary analysis of the data reported by Lusk

(1997) was planned to provide explication of the association between work

42

climate factors and construction workers’ post—training behaviors to protect their
hearing. Such analysis can contribute to the existing knowledge about
construction workers’ use of HPDs. By explicating how the work climate tends to
inﬂuence transfer of training to actual work settings, more effective training
programs for construction workers can be designed and implemented. In doing
so, the incidence of occupational NIHL among construction workers might be

greatly reduced.

43

Chapter 3

METHODS

In the area of health education, minimal attention has focused on the
environmental aspects associated with the settings where individuals are
expected to enact healthy behaviors. Most studies on health promotion and
health behavior issues have focused on a combination of personal and
situational factors related to enacting healthy behaviors. The purpose of this
study, however, was to examine the context of the work setting as a distinct
factor that inﬂuences construction workers’ post-training use of hearing
protection devices (HPDs). The literature on training effectiveness strongly
suggests that work climates have a critical inﬂuence on post-training behaviors
(Baldwin & Ford, 1988; Richey, 1992; Tracey et al., 1995). Drawing upon
concepts related to Bandura’s (1986) SCT and ﬁndings related to work climate
factors reported in the literature, the hypotheses stated below were posed for

testing in this study.

Research Hypothese_s

1. There is a positive relationship between work climate factors and

construction workers’ use of hearing protection devices (HPDs).

2. Construction workers who perceive a supportive work climate will report
a greater use of HPDs than construction workers who perceive a

non-supportive work climate.

44

There is a positive relationship among work climate factors,

self-efﬁcacy, outcome expectancy, and outcome value for using HPDs.

Construction workers who perceive a supportive work climate will report
higher self-efﬁcacy, outcome expectancy, and outcome value for using
HPDs than construction workers who perceive a non-supportive work
climate.

Hearing protection training, work climate factors, self-efﬁcacy, outcome
expectancy, and outcome value will predict the use of HPDs by

construction workers.

For construction workers who received hearing protection training,
those who perceived a supportive work climate will report greater
self-efﬁcacy, outcome expectancy, outcome value, and use of HPDs

than those who perceived a non-supportive climate.

mm

This ex post facto study used secondary analysis as the research design

to explore additional concepts from the study of construction workers by Lusk

(1997). Secondary data analysis is an effective mechanism for applying new

analytical perspectives to data previously collected by others (Bryman, 1989;

Hakim, 1982; Hyman, 1972; Kiecolt & Nathan, 1985). In addition, secondary

data analysis can be viewed as an economic and practical tool to derive

additional beneﬁt from pre-existing data, thereby expanding the value of the

original study (Polit & Hungler, 1991). Lusk measured workers’ perceptions of

factors that related to the use of HPDs in work settings; some of these factors

included both a personal and organizational focus. This research study was

intended to extricate some of these factors and speciﬁcally examine the

45

inﬂuence of organizational factors (work climate) on workers’ use of HPDs, thus

expanding knowledge gained from the original study.

Summarv of Original Project
Procedure

In the research project conducted by Lusk (1997) and funded by NIOSH
(Grant No. R01 0H03136), an experimental design was used to test the
effectiveness of a theory-based training program for improving construction
workers’ use of HPDs. Participation was voluntary and informed consent of the
construction workers was obtained prior to data collection. Based upon a
Solomon four—group design, construction workers were randomly assigned to
one of four groups: (1) pretest and posttest; (2) pretest, training, and posttest; (3)
training and posttest; and (4) posttest only. A self-administered written
questionnaire in booklet format was used for both pretest and posttest data
collection and approximately 35 to 45 minutes were required for completion of
the questionnaire. For purposes of this research study, secondary data analysis
focused on the posttest data collected during 1996, approximately 10 to 12
months after the hearing protection training occurred.

A total of four instructors-trainers (working as a team of two in each
training session) provided all the hearing protection training by using a
standardized script and instructional format. Overall, the training session lasted
about 45 minutes and included a 20—minute videotape segment that was
speciﬁcally developed for construction workers and based upon previous

research by Lusk et al. (1997). In the video segment, a discussion about the

46

importance of hearing protection was portrayed between an occupational health
nurse and a construction worker. Also portrayed in the video were interactions
among construction workers as they discussed the use of HPDs in their work
settings. The training program included an opportunity for questions and
answers, along with a guided-practice session for construction workers to try
various types of hearing protection. Brochures that provided general information
about hearing loss and HPD availability also were distributed to the construction

workers as part of the training program (Lusk et al., in press).

_S_a_mp_|s

The original convenience sample of regional construction workers
(N = 798) used by Lusk (1997) for posttest data analysis consisted of unionized
construction workers in the Midwestern US. who represented three trade
groups: carpenters, operating engineers (heavy equipment operators), and
plumbers/pipeﬁtters. Workers had been recruited through principal contact
individuals from trade unions and trade group associations. These contacts
arranged for the researcher to collect data and provide training during the time
when workers were assembled in classroom settings for regular training update
sessions.

Of the original 798 construction workers (carpenters, operating engineers,
and plumbers/pipeﬁtters) who participated in the posttest phase of the study
conducted by Lusk (1997), workers who reported no worksite exposure to
hazardous noise (p = 146) were excluded from the secondary analyses

performed for this study. Since this study focused on the effectiveness of

47

training related to workers’ use of HPDs when exposed to potentially harmful
noise, it was reasonable to include only those workers who reported actual
exposures to high-noise levels in their work environments. Therefore, the
sample for secondary analysis in this study consisted of 652 unionized
construction workers who reported having been exposed to hazardous noise in
their work settings during the past week, past month, past three months, most
recent job site, and/or previous job site. Since no pretest effect on HPD use was
reported by Lusk (1997), the original Solomon four groups were collapsed into
two groups for this study, thus representing the groups of construction workers
who had received hearing protection training (p = 336) and those who had not

(Q = 316).

Demographics of the Samﬁ

 

In this research study, the sample consisted of construction workers who
had been exposed to hazardous noise in their work settings. Workers ranged in
age from 20 to 60 years with a mean age of 36 years (ﬂ = 10.5). The study
sample represented a fairly homogeneous group; workers were predominately
male (96.3%) and Caucasian (90.2%). Length of time that workers had practiced
their trade ranged from 1 to 45 years (M = 11.44, _S_[_) = 9.9). Table 1 describes

the demographic characteristics of the study sample.

48

Table 1

Sample Demographics

 

 

Characteristics [1 percent
Trade
Operating Engineers 288 44.2
Plumbers/Pipeﬁtters 200 30.7
Carpenters 164 25.2
TOTAL 652 100.1
Gender
Male 628 96.3
Female 19 2.9
No response 5 .8
TOTAL 652 100
Ethnicity
White 588 90.2
Black 26 4.0
Native American 13 2.0
Hispanic 12 1 .8
Asian 1 .2
Other 1 .2
No response 11 1.7
TOTAL 652 100.1

 

Note. Percents may not add to 100 due to rounding.

49

Almost all of the workers (91.1%) had at least a high school education,
with 31.1% reporting some type of additional education (trade school or college)

beyond high school. Educational categories are described in Table 2.

Table 2

Highest Level of Education

 

 

Level 11 percent
Eighth Grade 9 1.4
High School 391 60.0
Trade School 44 6.7
High School and Trade School 122 18.7
Associate Degree 40 6.1
Associate Degree and Trade School 21 3.2
Baccalaureate Degree 15 2.3
Associate and Baccalaureate Degree 3 .5
Graduate Degree 2 .3
No Response 5 .8
TOTAL 652 1 00.0

 

Instruments and Measures
Portions and reconstructions of the original instruments reported by Lusk
et al. (1997) that were used in this research study are described in the following

section. VIﬁth regard to the work climate and self-efﬁcacy scales used in this

50

study, theoretical concepts and research ﬁndings reported in the health
promotion and organizational behavior literature guided their creation. In
addition, an expert panel consisting of individuals with knowledge and
experience in organizational behavior reviewed both of these scales for face

validity.

Work Climate Scale (seeAppendix A)

The work climate scale created for secondary analysis in this study
consisted of 21 items that measured construction workers’ perceptions of
organizational or work setting factors facilitating or impeding the use of hearing
protection. These items were drawn from multiple scales used by Lusk et al.
(1997) and were originally measured on 3-point, 4-point, 5-point, and 6-point
Likert—type scales. Prior to secondary analysis, appropriate items were
reverse-scored and the values for each of the 21 items were transformed into
standardized scores; thus the mean was equal to zero and the standard
deviation was equal to one. Following this conversion to standardized scores,
the work climate scale was computed as the mean of the standardized scores on
the 21 items.

Four of the 21 items were drawn from the HPD beneﬁts and barriers scale
developed by Lusk et al. (1997) and adapted from an instrument related to
exercise behavior that was originally created by Murdaugh and Hinshaw (1986).
Eight situational items in the climate scale related to HPD use by construction
workers in the work setting. Also included in the climate scale was one item

previously used as a self-efﬁcacy item by Lusk et al. (“I am sure that I can ask for

51

help if I have difﬁculty using hearing protection”). This item was selected for the
work climate scale in this study because it represented availability of assistance
for workers relative to using hearing protection equipment in their work setting.
The literature on occupational NIHL suggested the need for having consistent
and reliable support available for workers in order to encourage the use of
appropriate hearing protection equipment (Leinster et al., 1994).

The work climate scale constructed for this study also incorporated eight
items developed by Lusk et al. (1997) to measure norms, modeling, and
interpersonal support related to the use of hearing protection. These items were
developed by Lusk et al. and based upon instruments originally designed by the
Child Adolescent Health Behavior Research Center at the University of Michigan
to measure social support for exercise behavior (cited in Lusk et al., 1997).

In this study, psychometric reliability assessment (Cronbach’s alpha) of

the work climate scale was .89.

Self-efﬁcacy Scale (see Appendix B)

The self-efﬁcacy scale consisted of 12 items drawn from several scales
originally developed by Lusk et al. (1997). Items on this scale represented
construction workers’ perceptions about their ability to use HPDs correctly and
adequately. All self-efﬁcacy items were measured on a 6-point Likert-type scale,
ranging from strongly disagree (1) to strongly agree (6). Items that were
negatively worded were reverse-scored for data analysis and a self-efﬁcacy

score was computed using the mean of the 12 items.

52

In this study, psychometric reliability assessment (Cronbach’s alpha) of

the self-efﬁcacy scale was .76.

Outcome Expectancy Scale (see Appendix C)

Seven items represented construction workers’ perceptions about the
potential results or beneﬁts related to using hearing protection. These items
were drawn from the beneﬁts and barriers scale of Lusk et al. (1997) and were
measured on a 6-point Likert-type scale, ranging from strongly disagree (1) to
strongly agree (6). Appropriate items were reverse-scored prior to statistical
analysis and the outcome expectancy score was computed from the mean of the
seven items.

In this study, psychometric reliability assessment (Cronbach’s alpha) of

the outcome expectancy scale was .70.

Outcome Va_lue Scale (see Appendix D)

Five items were used to measure workers’ perceptions of the importance
of the expected outcomes resulting from the use of HPDs. These items were the
original items developed by Lusk et al. (1997), based on Pender’s value of
outcome exercise scale (cited in Lusk et al., 1997). Items were measured on a
visual analog scale (10 centimeters in length), ranging from slightly important
(0%) to highly important (100%). Workers were asked to mark an “X” on the line
of the visual analog scale to indicate the point that described their personal rating
of the importance of the outcome associated with using hearing protection.

In scoring the ﬁve items on this scale, a ten-centimeter ruler was used to

measure the point where the “X” was made; each millimeter on the line

53

corresponded with one percent of value. For example, an “X” measured at 60
millimeters on the line was coded as 60%. The score for the outcome
expectancy scale was then computed using the mean percent from these ﬁve
items.

In this study, psychometric reliability assessment (Cronbach’s alpha) of

the outcome expectancy scale was .87.

HPD Use (see Appendix E)

Five items originally developed by Lusk et al. (1997) measured the
frequency of HPD use by construction workers. Representing the ratio-level
measure used as the dependent variable in the multivariate regression analysis,
a mean use frequency score was computed from the mean of these ﬁve items.
Items measured percentage of time workers reported using HPDs (e.g., ear
plugs, ear muffs) when exposed to high-noise levels at their most recent and
previous job sites, and at three speciﬁc time periods (i.e., past week, past month,
past three months). Computing a mean use frequency score was recommended
by Lusk et al. since high correlations (.79 to .96) were achieved among the ﬁve
items. With regard to the use of self-reported measures as the primary
dependent variable, researchers have investigated the results of such measures
in other studies and found the self-reported measures to be valid and reliable

(Hofmann & Stetzer, 1996; Lusk et al., 1995).

HPD Training Intervention
Hearing protection training consisted of approximately 45 minutes of

planned instruction about the beneﬁts and methods for protecting one’s hearing

54

when exposed to hazardous noise levels. Content included information related
to the fact that when levels of environmental noise reach or exceed 85 to 90
decibels, they are considered hazardous and sustained exposure can be
detrimental to one’s hearing. The existence of hazardous noise levels was
roughly identiﬁed by having to shout in order to be heard by another at a
distance of three feet or less. Included during the training session was planned
time for construction workers to practice with different types of hearing
protection.

The Solomon four-group design originally used by Lusk (1997) included
two groups of construction workers who had been assigned to the training
intervention (experimental grouping) and two groups who had received no
training (control grouping). In each of the experimental and control groupings to
which construction workers had been randomly assigned, one of the two groups
also received a pretest in order to assess for any evidence of pretest
sensitization at the time of posttest data collection. As previously mentioned, no
pretest effect was observed in study results reported by Lusk, thus indicating that
no pretest sensitization had occurred. Therefore, the Solomon four groups were
collapsed into two groups (training, no training) for purposes of secondary
analysis in this study (Braver & Braver, 1988). In the multivariate analyses, a

dummy variable was used and coded: training = 1, no training = 0.

Data Analysis

Data were analyzed using SPSS 7.5 for Windows Graduate Pack.

Statistical analyses were conducted to describe the sample of construction

55

workers who participated in the study. Descriptive statistical analyses (e.g.,
means, standard deviations, percentages, etc.) were performed on the
independent variables measured on interval-level scales to provide an overall
summary of the general perceptions of construction workers relative to climate
factors, self-efﬁcacy, outcome expectancy, and outcome value associated with
using hearing protection in work settings. Since the independent variable of
training was measured on a nominal scale (training, no training) only the number
and percentage of workers who received training or did not receive training were
reported. For the dependent variable of workers’ self-reported use of HPDs,
measured as ratio-level data, descriptive statistics were performed. Relative to
each of the research hypotheses, speciﬁc statistical tests were applied and are
described in the following sections. The alpha level was set at .05 for

determining statistical signiﬁcance.

Hypothesis 1. There is a positive relationship between work climate
factors and construction workers’ use of hearing protection devices (HPDs).

Bivariate linear regression was performed to determine if workers’
perceptions of climate factors predicted workers’ use of HPDs. The strength and
statistical signiﬁcance of the relationship between these two variables were

analyzed.

Hypothesis 2. Construction workers who perceive a supportive work
climate will report a greater use of HPDs than construction workers who perceive

a non-supportive work climate.

56

Two categories were formed using high and low scores from the work
climate scale. High scores represented the group of workers who perceived a
supportive work climate and low scores represented the group of workers who
perceived a non-supportive work climate. An independent-samples t—test was
performed to determine if the mean HPD use was signiﬁcantly different between

these two groups.

Hypothesis 3. There is a positive relationship among work climate
factors, self-efﬁcacy, outcome expectancy, and outcome value for using HPDs.

Pearson product-moment correlations were performed to determine the
existence, degree, and signiﬁcance of linear relationships among these

variables.

Hypothesis 4. Construction workers who perceive a supportive work
climate will report higher self-efﬁcacy, outcome expectancy, and outcome value
for using HPDs than construction workers who perceive a non-supportive work
climate.

Three independent-samples t-tests were performed to determine if the
mean scores on self-efﬁcacy, outcome expectancy, and outcome value differed
signiﬁcantly between workers who perceived supportive work climates and those

who perceived non-supportive work climates.

Hypothesis 5. Hearing protection training, work climate factors,
self-efficacy, outcome expectancy, and outcome value will predict the use of

HPDs by construction workers.

57

Multiple regression analysis was performed to determine how much of the
variance in workers’ post-training use of HPDs (dependent variable) was
explained by the independent variables as illustrated in the conceptual model for
this study (see Figure 1). This analysis was conducted to indicate how well the
group of independent variables (e.g., training, work climate, self-efﬁcacy,
outcome expectancy, and outcome value) predicted the amount of HPD use.
Hierarchical multiple regression analysis was performed to determine the degree
of change that occurred in the predictive power of the model as independent
variables were added in a series of steps, while controlling for the effects of the
previously-entered independent variables. Subsequent multiple regression
analyses were conducted to identify direct and indirect effects among the

predicator variables.

Hypothesis 6. For construction workers who received hearing protection
training, those who perceived a supportive work climate will report greater
self-efﬁcacy, outcome expectancy, outcome value, and use of HPDs than those
who perceived a non-supportive climate.

Multifactor analysis of variance (tvvo-way ANOVA) was performed to
assess the main effects of training and work climate on the mean scores of
self-efﬁcacy, outcome expectancy, outcome value, and HPD use. This method
of analysis was performed to reveal the existence of an interaction between
training and climate level, indicating that the effect of training might vary between

supportive and non-supportive work climates.

58

Chapter 4

RESULTS

The purpose of this research study was to examine the inﬂuence of work
climate factors on the effectiveness of training that was designed to improve the
use of hearing protection among regional Midwestern U.S. construction workers.
Secondary data analysis, employing the database provided by Lusk (1997), was
used to test six hypotheses. The data were derived from 652 construction
workers. These workers consisted of individuals from the Midwestern US. and
represented three trade groups: carpenters (p = 164), operating engineers
(p = 288), and plumbers/pipeﬁtters (p = 200).

Data analyses included Pearson product-moment correlations, bivariate
linear regression, independent-samples t—tests, multiple regression, and
multifactor analysis of variance (two-way ANOVA). In this chapter, results of the
data analyses are presented, beginning with descriptive ﬁndings related to the
study variables and followed by ﬁndings related to the research hypotheses. The

six hypotheses stated below were tested in this study.

Research Hypotheses
1. There is a positive relationship between work climate factors and

construction workers’ use of hearing protection devices (HPDs).

2. Construction workers who perceive a supportive work climate will report
a greater use of HPDs than construction workers who perceive a

non-supportive work climate.

59

There is a positive relationship among work climate factors,

self-efﬁcacy, outcome expectancy, and outcome value for using HPDs.

Construction workers who perceive a supportive work climate will report
higher self-efﬁcacy, outcome expectancy, and outcome value for using
HPDs than constnrction workers who perceive a non-supportive work

climate.

Hean'ng protection training, work climate factors, self-efﬁcacy, outcome
expectancy, and outcome value will predict the use of HPDs by
construction workers.

For construction workers who received hearing protection training,
those who perceived a supportive work climate will report greater
self-efﬁcacy, outcome expectancy, outcome value, and use of HPDs
than those who perceived a non-supportive climate.

Results Related to Studv Variables

Results from descriptive analyses of each of the independent variables

and the dependent variable that were measured in this research study are

presented below. A concise description of the measured values of the research

variables can be found in Table 3 (excluding HPD Training that was measured

as a dichotomous variable).

Independent Variables

HPD Trainiilg; Construction workers who received the hearing protection

training intervention (p = 336) represented 51.5% of the overall sample

(I! = 652).

60

 

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61

Work Climate. Construction workers reported an overall perception that
their work climates were fairly moderate in terms of supportiveness for hearing
protection behaviors. Scores ranged from -1.246 to 1.515 (M = 0.001,

_S_D = .550). (Items comprising the work climate scale in this research study were
originally measured on varying scales; therefore, the original scores were
transformed into standardized scores {M = 0} prior to scale construction.)

For additional analyses, the work climate scale was receded into a
dichotomous variable using a median split. Low scores on the work climate
scale (-1.246 through -0.020) were considered to represent perceptions of
individuals (9 = 326) from work settings with non-supportive climates for the use
of HPDs. High scores on the work climate scale (-0.019 through 1.515) were
considered representative of individuals (p = 326) who perceived that their work
environments supported the use of HPDs.

Self-efﬁcacy. Construction workers reported a moderate perception that
they could use HPDs appropriately to protect their hearing. Scores on the
self-efﬁcacy scale ranged from 2.2 to 6.0 (M = 4.2, S_D = .70).

Outcome Expectancy Construction workers reported a high level of belief
in the potential beneﬁts for using hearing protection. HPD outcome expectancy
scores ranged from 2.3 to 6.0 (M = 5.3, S_D_ = .72).

The reported values on this scale reﬂected a negatively skewed
distribution; however, the skewness index (-1.05) revealed that the distribution
was not a severe violation of the assumptions required for multivariate

regression. According to Lewis-Beck (1980), regression analysis is a robust

62

technique where parameters are not severely inﬂuenced by mild departures from
normality, particularly when the sample size is large.

Outcome Value. Construction workers reported a high degree of value for
the outcomes associated with using HPDs. Scores ranged from 6.6% to 100%
(M = 86.3%, E = 12.0%).

Scores on the outcome value scale represented a highly skewed
distribution with the majority of scores at the high end of the scale. Given that
the skewness index was found to be -2.35, a transformation of the variable was
attempted to improve the distribution in order to avoid a violation of the
assumptions for multivariate analyses. By raising the outcome value scores to a
power of six, the skewness index of the outcome value scale was reduced to
-0.325; however, using such a transformation makes interpretation of results
extremely difﬁcult. Therefore, given the large sample size and the robust nature
of multivariate regression, the original form of the variable was used and was not

transformed.

Dependent Variable

HPD Use. Construction workers reported a moderate use of HPDs when
exposed to high noise in their work environments. Self-reported scores ranged

from 0% to 100% (M = 49.1%, _S_D = 35.1%).

Results of Hypothesis Testing

Hypothesis 1
There is a positive relationship between work climate factors and

construction workers” use of hearing protection devices (HPDs).

63

Using bivariate linear regression, the analysis revealed a low to moderate
positive relationship between work climate factors and HPD use, I (648) = .34,
p < .001. Work climate factors were a signiﬁcant predictor for workers’ use of
hearing protection, accounting for 11.4% of the variance in HPD use,
E (1, 648) = 83.69, p < .001. As hypothesized, construction workers in

supportive work climates reported a greater use of hearing protection.

Hypothesis 2
Construction workers who perceive a supportive work climate will

report a greater use of HPDs than construction workers who perceive a

non-supportive work climate.

Using a median split of the work climate scale, a dichotomous work
climate variable was created to distinguish between work settings that were
supportive of HPD use (high climate) and work settings that were non-supportive
(low climate). The low climate category represented work climate scores ranging
from -1.246 through -.020, thus indicating work settings where HPD use was not
strongly supported or encouraged. The high climate category included work
climate scores ranging from -.0186 through 1.515, and indicated work settings
where the use of hearing protection was encouraged and supported.

To test the hypothesis, an independent-samples t—test was performed to
determine if the use of hearing protection differed between the climate groups.
Results indicated a statistically signiﬁcant difference in mean HPD use between
construction workers in high climate settings and workers in low climate settings,
1(648) = -8.17, p < .001. In the high climate group, workers reported using their

HPDs 59.8% (S_D = 33.6) of the time when exposed to high-noise environments,

64

while workers in the low climate group reported using hearing protection 38.4%
(S_D = 33.3) of the time when they were exposed to high-noise levels. Therefore,
the hypothesis was supported. Illustrated in the bar graph in Figure 2 is the

difference in average HPD use between the high and low work climate groups.

 

HPD Mean Percent Use

Low and High Climate Work Settings

Mean Percent HPD Use
8

 

   

Low "I!“

 

Work Climate Levei

 

 

Figure 2. HPD use in low and high climate work settings.

65

Table 4 provides information on the demographic characteristics of
workers in the high and low work climate groups. In the low climate group
(p = 326), construction workers ranged in age from 20 to 63 years (M = 33) while
workers in the high climate group (p = 326) ranged in age from 21 to 63 years
(M = 38). Construction workers in the high climate group were signiﬁcantly older
than workers in the low climate group, 1 (642) = -5.38, p < .001. Of the three
trade groups, operating engineers tended to report more supportive work
climates for HPD use. Over half of the operating engineers (64.6%) were in the

high work climate group.

66

Table 4

Demggraphics of Construction Workers in Low and High Work Climates

 

 

 

 

 

 

 

 

 

 

cram... ”(titaﬁl'g‘i’a‘fieiff If:.fl;1’i°3fy:2:f
p % p %
Trade category
Carpenters 121 37.1 43 13.2
Operating Engineers 102 31.3 186 57.1
PIumbers/Pipefitters 103 31 .6 97 29.8
Gender
Male 315 96.6 313 96.0
Female 8 2.5 11 3.4
No response 3 .9 2 .6
Ethnicity
White 293 89.9 295 90.5
Black 12 3.7 14 4.3
Native American 7 2.1 6 1.8
Hispanic 6 1.8 6 1.8
Asian 1 .3 — —
Other — — 1 .3
No response 7 2.1 4 1.2
Educaﬁon
High school or less 213 65.3 231 70.9
Beyond high school 110 33.7 93 28.5
No response 3 .9 2 .6

 

67

Hypothesis 3
There is a positive relationship among work climate factors,

self-efficacy, outcome expectancy, and outcome value for using HPDs.

Pearson product-moment bivariate correlations were performed among
work climate, self-efﬁcacy, outcome expectancy, and outcome value scales.
Results indicated that all correlations were positive and statistically signiﬁcant at
a level of p < .01. As workers perceived their work settings to be more
supportive for using HPDs. their self-efﬁcacy, outcome expectancy, and outcome
value for using HPDs also increased. Table 5 indicates the intercorrelations
among the variables. As depicted, there is a moderate relationship between
work climate and self-efﬁcacy, while weak relationships are evident between
work climate and outcome expectancy and between work climate and outcome
value. Also interesting to note is the moderately strong relationship between

outcome expectancy and outcome value.

68

Table 5

Pearson Product-Moment Correlations

 

 

 

 

 

Work Outcome Outcome
Climate Self-efﬁcacy Expectancy Value
Scale

Scale Scale Scale
Work Climate
Scaie 2 11° __-_ ,_____2
se'f'eff'cacy .388" 1.000
Scale 7 __L- f_ _ _ ("__ﬁ“ _ ﬁ____¥ fu#_ _‘
Outcome
Expectancy .180" .383" 1 .000
_Scale ______ _ ‘_._i_ s2____ __-_______
Outcome .3 i... t.
Value Scale .188 281 .422 1 000

 

** p <.01, two-tailed.

Hypothesis 4
Construction workers who perceive a supportive work climate will

report higher self-efficacy, outcome expectancy, and outcome value for
using HPDs than construction workers who perceive a non-supportive

work climate.

Three independent—samples t-tests (see Table 6) were performed to
determine if the study variables of self-efﬁcacy, outcome expectancy, and
outcome value for using HPDs differed between construction workers in
supportive work settings and those in non-supportive settings. As hypothesized,
workers in supportive work climates reported signiﬁcantly higher levels of

self-efﬁcacy, outcome expectancy, and outcome value at an alpha level of

69

p < .001. Mean scores of these variables for the low and high climate groups

and _t_-test results are depicted in Table 6.

Table 6

T-tests between Work Climate Levels

 

 

 

 

 

 

Variable Work Climate Level Mean t-value df prob. (2-tailed)
Self—efﬁcacy f — % ﬂ __ 332 -9.48 646 <.001 _
_
Outcome value Iii‘gvh 33g: -4.88 630 <.001

 

Hypothesis 5
Hearing protection training, work climate factors, self-efficacy,

outcome expectancy, and outcome value will predict the use of HPDs by

construction workers.

Hierarchical multiple regression (see Table 7) was used in order to enter
the predictor (independent) variables in systematic steps as suggested by the
conceptual model illustrated in Figure 1. Predictor variables (training, work
climate, self-efﬁcacy, outcome expectancy, and outcome value) were entered in
ordered steps or “blocks”, thus allowing an examination of the 32 changes at
each step. As suggested by Astin (1993), demographic variables (age, trade
group) were entered ﬁrst, at step 1, in the multiple regression analysis to control
for their effects (eliminate their inﬂuence) on the dependent variable (HPD use).
By entering variables related to demographic characteristics in step 1 of the

70

Table 7

Results of Hierarchical Regression with Model Predictors of HPD Use

 

 

 

 

 

 

 

 

 

 

 

 

 

 

71

 

Variable B _E _B_ B t Sig. 1
Step 1
Age .154 .174 .046 .885 .377
Operating Engineers 24.797 4.347 .353 5.704 .000
Plumbers/Pipeﬁtters 6.453 3.561 .086 1.812 .070
Step 2
Age .129 .174 .039 .742 .458
Operating Engineers 25.314 4.347 .360 5.824 .000
PIumbers/Pipeﬁtters 6.498 3.554 .086 1 .828 .068
HPD Training 4.985 2.605 .071 1.914 .056
Step 3
Age .059 .168 .018 .352 .725
Operating Engineers 17.988 4.328 .256 4.156 .000
PIumbers/Pipeﬁtters 1 .138 3.517 .015 .323 .746
HPD Training 5.422 2.515 .078 2.156 .031
Work Climate 16.936 2.456 .266 6.894 .000
Step 4
Age .101 .167 .030 .606 .545
Operating Engineers 17.400 4.293 .247 4.053 .000
Plumbers/Pipefitters .659 3.489 .009 .189 .850
HPD Training 4.230 2.516 .061 1.681 .093
Work Climate 13.462 2.626 .212 5.127 .000
Self-efﬁcacy 7.005 1 .984 .138 3.531 .000
T T T T T T T (table continues)

Table 7 (continued)

 

 

Variable B _Sﬁ B B t Sig. 1
Step 5
Age .097 .167 .029 .584 .560
Operating Engineers 17.507 4.298 .249 4.073 .000
PIumbers/Pipeﬁtters .702 3.491 .009 .201 .841
HPD Training 4.261 2.517 .061 1.693 .091
Work Climate 13.379 2.630 .210 5.087 .000
Self-efﬁcacy 6.529 2.119 .128 3.081 .002
Outcome Expectancy 1.209 1.889 .025 .640 .522
Step 6
Age .055 .166 .016 .328 .743
Operating Engineers 17.332 4.269 .247 4.060 .000
Plumbers/Pipefitters .033 3.474 .000 .009 .993
HPD Training 4.332 2.500 .062 1.733 .084
Work Climate 12.814 2.619 .201 4.894 .000
Self-efﬁcacy 5.936 2.1 13 .1 17 2.809 .005
Outcome Expectancy -.972 2.002 -.020 -.485 .628
Outcome Value .369 .118 .124 3.116 .002

 

 

Note. Overall Model (Step 6): I32 = .21, _F_(8, 631) = 21.24, p< .001.

72

analysis, statistical control is exerted. Variables entered at subsequent steps
can then reveal their contributions to prediction beyond that provided by
demographic characteristics. Since trade group was a categorical variable that
represented the three groups of construction workers, three dichotomous dummy
variables were created. The carpenters’ category served as the reference group;
therefore, it was not entered into the multiple regression (Astin, 1993).

Results of the hierarchical multiple regression (see Table 7) suggest that
workers who reported being in high climate (supportive) settings tended to use
hearing protection more than workers in low climate (non-supportive) settings. In
the overall model at step 6, HPD training did not signiﬁcantly predict the
construction workers’ use of HPDs; therefore, the hypothesis as stated was only
partially supported. However, in addition to work climate, three other signiﬁcant
contributors to the model were trade category, self-efﬁcacy, and outcome value.
Of the four signiﬁcant predictors, type of construction worker (operating
engineers) and work climate factors were the strongest predictors for HPD use,
indicated by standardized betas of .25 and .20 respectively.

An unexpected and perplexing result, depicted in the regression results
displayed in Table 7, was the non-signiﬁcant and negative standardized beta
(-.02) for outcome expectancy in step 6. The negative sign would suggest that
construction workers used HPDs more when they perceived a low expectancy for
the results associated with using hearing protection. Since the bivariate
correlation between outcome expectancy and HPD use was positive,

I (648) = .13, p < .01, the negative beta for outcome expectancy revealed in step

6 of the hierarchical regression might be indicative of multicollinearity between

73

outcome expectancy and outcome value. The bivariate correlation between
these two variables was .42 (p < .001), indicating a moderate correlation.
Furthermore, the beta for outcome expectancy changed signs when outcome
value entered the regression equation at step 6, a sign often signaling the
possibility of multicollinearity (Hamilton, 1992). When multicollinearity exists, the
coefﬁcient estimates tend to be unstable and less precise.

Using the non-standardized regression coefﬁcients from the overall
model, the multiple regression equation to predict HPD use in construction
workers is:

Predicted HPD Use = -14. 147 + .055(age) + 17.332(operating
engineers) + .033(plumbers/pipeﬁtters) + 4. 332(HPD training) +
12.814(work climate) + 5. 936(seIf-efﬁcacy) -.972(outcome

expectancy) + .369(outcome value).

With reference to individual items that comprised the work climate scale
(see Table 8), the strongest signiﬁcant bivariate correlations with HPD use
occurred between peer modeling of HPD use, 1 (641) = .41, p <.001, and having
enough time to use hearing protection, 5 (647) = .33, p <.001. Slightly lower in
strength was the bivariate correlation between supervisor modeling of HPD use

and HPD use, 5 (640) = .29, p < .001.

74

Table 8

Work Climate Items and Bivariate Correlations with HPD Msﬂ Us_e

 

 

Variable Correlation
Co-worker pressure gets in way” .13“
No time for HPDs‘” .33"
HPD information unavailablea .07"‘°‘
Nobody cares if I wear HPDs‘I .22“
Can ask for HPD help .10*
HPDs available at worksite .26**
Own HPDs assigned to me .19**
Need request for HPDs” .13**
Not enough HPDs available” .18**
HPD supply is far awaya .18**
Free to use many HPDs .21**
HPD work signs present .16**
HPD choices available .11**
Co—worker thinks I should wear .20**
Supervisor thinks I should wear .20**
Co-worker wears (models) HPDs .41 **
Supervisor wears (models) HPDs .29**
Supervisor encourages me .20**
Supervisor praises me .13**
Co-worker encourages me .13“
Co-worker praises me .15**

 

" Indicates reverse-scored item.
* p<.05, two-tailed. ** p<.01, two-tailed. NS = not signiﬁcant.

75

As illustrated in Table 9, the overall model with all the independent

variables entered at step 6 signiﬁcantly predicted the use of hearing protection

by construction workers. As a group, the predictor variables accounted for

21.2% (adj. l32 = 20.1%) of the variance in HPD use by construction workers.

After controlling for demographic characteristics and training effects, work

climate factors made a signiﬁcant contribution to the explanatory power of the

model. When work climate entered the regression equation at step 3, a

signiﬁcant change in the 32 occurred, increasing the explanatory power of the

model by 6.1%.

Table 9

Model Summarv of Hierarchical Regression with Predictors of HPD Uss

 

Variable

Step 1

Age

Operating Engineers
PIumbers/Pipelitters

III

.343

.118 .113

Adj. §_E_of B} E Sig._E
R2 3’ Estimate Change Change d_f Change

32.89 .118 28.23 3,636 .000

 

 

Step 2

Age

Operating Engineers
Plumbers/Pipeﬁtters
Training

 

Step 3

Age

Operating Engineers
Plumbers/Pipeﬂtteis
Training

Work Climate

.350

.123 .117

32.83 .005 3.66 1 ,635 .056

 

 

 

.429

.184 .177

31.68 .061 47.53 1,634 .000

(table continues)

76

Table 9 (continued)

Adj. s; of
Variable g 3’ 3}

Estimate Chgnge Cha-nge d_f

R2 F Sig. E
Change

 

Step 4 .447 .200 .192 31.40
Age

Operating Engineers

PIumbers/Pipeﬁtters

Training

Work Climate

Self-efficacy

Step 5 .447 .200 .191 31.42
Age

Operating Engineers

PIumbers/Pipefitters

Training

Work Climate

Self-efﬁcacy

Outcome Expectancy

 

 

Step 6 .461 .212 .202 31.20
Age

Operating Engineers

Plumbers/Pipeﬁtters

Training

Work Climate

Self-efﬁcacy

Outcome Expectancy

Outcome Value

.016 12.47 1,633 .000

.012 9.71 1,631 .002

 

Note. Overall Model (Step 6): E (a, 631) = 21.24, Q < .001.

77

For purposes of clarifying the direct and indirect effects among the
predictor variables and HPD use, and to revise the conceptual model that
directed the focus of this study, three additional hierarchical multiple regression
analyses were performed. Self-efﬁcacy, outcome expectancy, and outcome
value (endogenous variables) were individually regressed on age, trade
category, training, and work climate (exogenous variables). Results of these
analyses are reported in Tables 10 through 12.

The conceptual model was revised using the signiﬁcant standardized
betas resulting from step 3 in the additional regression analyses, and the
signiﬁcant standardized betas resulting from step 6 (overall model) in the multiple
regression analysis previously reported in Table 7. These signiﬁcant betas are
included on the variable paths of the revised conceptual model depicted in
Figure 3. As illustrated in the revised model, training exhibits an indirect effect
on HPD use through the mediating inﬂuence of self-efﬁcacy. Work climate has
both direct and indirect effects on HPD use, while trade category (operating
engineers) has a direct effect. Work climate and trade category represent the
strongest predictors in the revised conceptual model. Combined (direct and

indirect) effects of work climate = .26 and the direct effect of trade = .25.

78

Table 10

Results of Hierarchical Regression of Self-efﬁcacy 0n Exogenous Variables

 

 

Variable 5 g B B t Sig. t
Step 1

Age -.004 .004 -.060 -1 .099 .272

Operating Engineers .263 .091 .189 2.905 .004

Plumbers/Pipeﬁtters .209 .074 .139 2.812 .005

 

Step 2
Age -.005 .004 -.071 -1.297 .195
Operating Engineers .276 .090 .198 3.061 .002
PIumbers/Pipeﬁtters .209 .074 .140 2.829 .005
HPD Training .140 .054 .101 2.590 .010
Step 3
Age -.007 .003 -.104 -2.051 .041
Operating Engineers .066 .086 .047 .759 .448
Plumbers/Pipeﬁtters .054 .070 .036 .766 .444
HPD Training .155 .050 .112 3.083 .002
Work Climate .502 .049 .398 10.248 .000

 

Note. Model at Step 3: 32: 16.4, E(5,640)=25.1, p< .001.

79

Table 11

Results of Hierarchical Regression of Outcome Expectancy on Exogenous

 

 

 

 

Variables
Variable B _E B 8 t Sig. t
Step 1
Age -.0007 .004 .010 .178 .859
Operating Engineers .068 .095 .047 .718 .473
Plumbers/Pipeﬁtters .085 .078 .055 1 .099 .272
Step 2
Age .0005 .004 .007 .129 .897
Operating Engineers .071 .095 .049 .752 .452
Plumbers/Pipeﬁtters .085 .078 .055 1 .099 .272
HPD Training .036 .057 .025 .635 .525
Step 3
Age —.0006 .004 -.009 -.169 .866
Operating Engineers -.036 .096 -.025 -.376 .707
Plumbers/Pipefitters .006 .078 .004 .080 .936
HPD Training .044 .056 .030 .779 .437
Work Climate .256 .055 .195 4.685 .000

 

Note. Model at Step 3: 32 = .04. E(5, 640) = 4.81, p< .001.

80

Table 12

Results of Hierarchical Regression of Outcome Value on Exogenous Variables

 

 

 

 

 

 

Variable B S_E s B t Sig. t
Step 1
Age .09 .063 .078 1.433 .152
Operating Engineers 2.248 1.573 .093 1.429 .154
Plumbers/Pipeﬁtters 3.241 1.289 .125 2.514 .012
Step 2
Age .089 .063 .078 1.417 .157
Operating Engineers 2.261 1.577 .094 1.433 .152
Plumbers/Pipeﬁtters 3.242 1.290 .125 2.513 .012
HPD Training .128 .945 .005 .135 .892
Step 3
Age .073 .062 .064 1 .175 .240
Operating Engineers .675 1.607 .028 .420 .674
Plumbers/Pipeﬁtters 2.079 1 .307 .080 1 .590 .1 12
HPD Training .214 .934 .009 .229 .819
Work Climate 3.685 .912 .168 4.040 .000

 

Note. Model at Step 3: 52: .05, _E(5,636)=6.0, p< .001.

81

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Hypothesis 6
For construction workers who received hearing protection training,

those who perceived a supportive work climate will report greater
self-efficacy, outcome expectancy, outcome value, and use of HPDs than

those who perceived a non-supportive climate.

Essentially, this hypothesis consisted of four subsections. To test this
hypothesis, four separate multifactor analysis of variance tests (two-way
ANOVAs) were conducted to examine the main and combined (interaction)
effects of HPD training and work climate level on: (1) self-efﬁcacy, (2) outcome
expectancy, (3) outcome value, and (4) HPD use. Descriptive statistics for
self-efﬁcacy, outcome expectancy, outcome value, and HPD use by training and
work climate level are presented in Tables 13 and 14 respectively. Table 13
indicates that construction workers who received HPD training had higher mean
levels of self-efﬁcacy, outcome expectancy, outcome value, and HPD use than
workers who had received no training. Similarly, in Table 14, the mean levels of
self-efﬁcacy, outcome expectancy, outcome value, and HPD use are higher for

workers in supportive work climates versus non-supportive work climates.

83

Table 13
DescLiptive Statistics of Variables Used in Analysis of Variance bv HPD Training

 

HPD Outcome Outcome

 

 

 

 

 

Training Self-efﬁcacy Expectancy Value HPD Use
No a 316 316 314 315
Mean 4.124 5.238 86.172 46.865
Std. Deviation .705 .744 12.081 34.716
Variance .497 .554 145.956 1205.214
Yes Q 336 336 334 335
Mean 4.269 5.275 86.410 51.250
Std. Deviation .683 .693 12.014 35.352
Variance .467 .480 144.324 1249.782
Total n 652 652 648 650
Mean 4.199 5.257 86.294 49.125
Std. Deviation .697 .718 12.038 35.087
Variance .486 .515 144.904 1231.104
Table 14

Descriptive Statistics of Variables Used in Analysis of Variance by Work Climsts
Lﬂé‘l

 

Work Outcome Outcome

 

 

 

 

 

Climate Self-efﬁcacy Expectancy Value HPD Use
Low [1 326 326 324 325
Mean 3.956 5.124 84.028 38.416
Std. Deviation .626 .746 12.754 33.306
Variance .392 .556 162.672 1109.271
High Q 326 326 324 325
Mean 4.442 5.390 88.561 59.834
Std. Deviation .680 .664 10.830 33.566
Variance .462 .440 1 17.284 1 126.653
Total n 652 652 648 650
Mean 4.199 5.257 86.294 49.125
Std. Deviation .697 .718 12.038 35.087
Variance .486 .515 144.904 1231.104

 

ANOVA (1). Results indicated in Table 15 identify signiﬁcant main effects
for HPD training and work climate level. Self-efﬁcacy was signiﬁcantly greater for
workers who received HPD training. In addition, self-efﬁcacy was greater for
workers who perceived supportive work climates; however, no signiﬁcant
interaction (joint effect) of HPD training and work climate level was observed.

There was no moderating effect by climate level on HPD training effects.

ANOVA (2). (3). and (4). With regard to (2) outcome expectancy, (3)
outcome value, and (4) HPD use, results indicated signiﬁcant main effects for
work climate level, but no main effects for HPD training. Workers who perceived
supportive work climates had signiﬁcantly greater outcome expectancy (see
Table 16), outcome value (see Table 17), and HPD use (see Table 18) than
workers who perceived non-supportive climates. As indicated in the respective
tables, no signiﬁcant main effects were observed for HPD training and no
signiﬁcant combined (interaction) effects of training and climate level occurred.

Overall results from the four separate multifactor analysis of variance tests
did not support the study hypothesis. Even though HPD training and work
climate level had signiﬁcant main effects on self efﬁcacy, no interaction was
revealed in any of the four ANOVA results. Work climate had no moderating
effect on training effects. For those construction workers who had received HPD
training, the workers who perceived supportive work climates were no different
than the workers who perceived non-supportive work climates, in terms of

reported self-efﬁcacy, outcome expectancy, outcome value, and HPD use.

85

Table 15

Analysis of Variance for Self-efﬁgcv bv HPD Training and Work Climate

 

 

 

 

 

 

 

 

 

Source 88:32; _ 3:32:39 _ Sig.
HPD Training 3.16 1 3.16 7.47 .01
Work Climate Level 37.83 1 37.83 89.46 .00
HPD Training X .61 1 .61 1.45 .23
Work Climate Level
Model 42.20 3 14.07 33.27 .00
Residual 273.98 648 .42
Total 316.18 651 .49
Table 16
Analysis of Variance for Outcome Expectancy tMHPD Tr_a_ining and Work
_Cimeie
5...... 3.2.22 — 3:322. — Sis-
HPD Training .18 1 .18 .36 .55
Work Climate Level 11.46 1 11.46 22.93 .00
HPD Training x .01 1 .01 .02 .88
Work Climate Level
Model 11.67 3 3.89 7.79 .00
Residual 323.67 648 .50
Total 335.34 651 .52

 

86

Table 17

Analvsis of Variance for Outcome Value by HPD Training_and Work Climate;

 

 

 

We 3:12.22 9!- sIJZZ'J. E Sis-
HPD Training 5.41 1 5.41 .04 .84
Work Climate Level 3245.52 1 3245.52 23.23 .00
HPD Training X 449.11 1 449.11 3.22 .07
Work Climate Level

Model 3781.92 3 1260.64 9.02 .00
Residual 89971 .26 644 139.71

Total 93753.18 647 144.90

 

Table 18

Analysisof Variance for HPD Use by HPD Training and Work Climate

 

 

Source 88 (:1: r2; d_f 5,232; E Sig.
HPD Training 2848.20 1 2848.20 2.55 .11
Work Climate Level 73796.41 1 73796.41 66.12 .00
HPD Training X 585.22 1 585.22 .52 .47
Work Climate Level

Model 77978.91 3 25992.97 23.29 .00
Residual 7210076 646 1116.1 1

Total 7989865 649 1231.10

 

87

Summam of Results

Statistical analysis revealed a signiﬁcant positive relationship between
work climate factors and construction workers’ HPD use. Workers who
perceived supportive work climates, where peers and supervisors encouraged
and modeled hearing protection behaviors, tended to report a higher mean use
of HPDs. Results from the hierarchical multiple regression indicated that the
overall conceptual model, displayed in Figure 3, successfully explained 21.2 % of
the variance in HPD use by Midwestern U.S. construction workers. Variables in
the overall model that were demonstrated to be signiﬁcant predictors of HPD use
included: trade category (operating engineers), work climate, self-efﬁcacy, and
outcome value. HPD training did not signiﬁcantly predict HPD use; however, it
had an indirect effect on HPD use, through a mediating inﬂuence of self-efﬁcacy.
Results from the ANOVA analyses indicated there was no interaction effect
between work climate and HPD training, thus suggesting that work climate had
no moderating inﬂuence on HPD training effectiveness. Nevertheless, work
climate consistently inﬂuenced self-efﬁcacy, outcome expectancy, outcome

value, and HPD use.

88

behaviors, it was not surprising to find that workers tended to report a greater
use of HPDs. In fact, supportive work climates were signiﬁcant predictors for
hearing protection behaviors, accounting for 11.4% of the variance in HPD use.

A critical component of supportive work climates is having adequate time
and appropriate equipment available for using hearing protection. But even
more important in work settings, as revealed in this study and previously reported
by Lusk et al. (1997), is the visibility of role models to encourage workers to wear
their HPDs. In this research study, when co-workers actually demonstrated
desired hearing protection behaviors, construction workers were more likely to
enact similar behaviors, as evidenced by the moderately strong correlation
between peer modeling and workers” reported use of HPDs (see Table 8).
Interestingly, supervisor modeling had a slightly lower correlation with workers’
HPD use (see Table 8). In the sample of construction workers in this study, the
inﬂuence of cooworkers was stronger than that of supervisors, thus emphasizing
the critical importance of peers in modeling desired behaviors.

Findings from this study both support and somewhat contradict earlier
studies reported in the literature. In a study of painters and their use of
respirators, White et al. (1988) found that social factors, such as perceived
attitudes of others in the work setting, played a major role in promoting
health-protective behaviors. Similarly, the work of Zohar (1980) and Leinster et
al. (1994) substantiated the importance of management commitment for
producing adequate hearing protection behaviors in the workplace. Slightly
different from the perceptions reported by construction workers in this study,

Richey (1992) determined that modeling of desired safety behaviors by

90

supervisors and management was more inﬂuential than behavior modeling by
co-workers. In contrast to these ﬁndings that emphasized the importance of a
supportive work setting, Melamed et al. (1996) reported that social and
management pressure explained little additional variance in HPD use among
factory workers in Israel. However, Melamed et al. admitted that their ﬁnding
might have been the result of a ceiling effect related to the already conscientious
use of HPDs in factory sites where management had agreed to participate in the
study.

Clearly, ﬁndings from this study align with previous studies that highlighted
the importance of supportive work climates to encourage the enactment of safety
behaviors. What differs among the studies is the source of the more inﬂuential
modeling support: co-workers or supervisors. For the construction workers in
this research study, the inﬂuence of co-workers was found to be somewhat
stronger than that of supervisors, thus indicating the more inﬂuential role of work
peers in modeling hearing protection behaviors. Perhaps this greater inﬂuence
from work peers is related to the nature of the construction industry itself where
OSHA requirements relative to hearing protection are not as stringent, and
where workers tend to be more transient—often changing sites as a team and
encountering variable supervisors. Whatever the source of support for hearing
protection behaviors might be, the importance of role modeling in the work
setting cannot be ignored. Indeed, it is a critical factor to consider when
attempting to improve the practice of safety behaviors, particularly the use of

HPDs among construction workers.

91

HPD Use in Low and High Climate Work Settings

As hypothesized in this study, data analysis revealed a signiﬁcant
difference in the use of hearing protection between construction workers in
supportive and non-supportive climates. ln supportive climates, however, the
average reported use of HPDs by construction workers was approximately 60%
and still inadequately low (see Figure 2). Interestingly, this average use in
supportive climates reﬂects the higher end of the range of HPD use (18%-62%)
that has been previously reported in the literature (Hong, Chen, & Conrad, 1998;
Lusk et al., 1998; Lusk et al., 1995; Lusk et al., 1997; Melamed et al., 1996).
Even though high climate settings in this study promoted HPD use more than
50% of the time, it is crucial to emphasize that HPDs must be worn 100% of the
time in order to achieve maximum hearing protection when exposed to
high-noise levels (Savell & Toothman, 1987).

Therefore, even more inadequate and certainly disconcerting was the
mean HPD use of 38% reported by construction workers in low climate settings.
Work climates that were perceived by construction workers to be non-supportive
relative to the use of HPDs had a negative inﬂuence on hearing protection
behaviors. Given that the average age of workers in the low climate group was
33 years, it is extremely unfortunate to realize how vulnerable this group is for
acquiring an occupational noise-induced hearing loss (NIHL) so early in life.
With the permanent nature of such a hearing loss, the future quality of life for
these construction workers is greatly jeopardized. Even more tragic to consider
is that occupational NIHL is entirely preventable when appropriate use of HPDs

is fostered in work settings.

92

Relationship of Work Climate with Self-efﬁcacy. Outcome Expectangr.
and Outcome Value

As hypothesized in this study, work climate factors were positively
associated with construction workers’ perceptions of their self-efﬁcacy for using
HPDs, their expectancy of the outcomes (beneﬁts) for using HPDs, and their
valuing of the outcomes related to the use of HPDs. All three relationships were
statistically signiﬁcant with the correlation between work climate factors and
self—efﬁcacy being the strongest among the three (see Table 5). The relationship
between self-efﬁcacy and work climate factors is especially important to
consider, in light of the research findings reported by Schwarzer (1992) indicating
that self-efficacy exerts a powerful inﬂuence on behavior.

In this research study, construction workers in supportive climates differed
signiﬁcantly from workers in non-supportive climates. Since the self-efﬁcacy
scale measured workers’ perceptions about their ability to use HPDs correctly
and effectively, it is understandable that supportive work climates contributed to
higher levels of self-efﬁcacy perceptions. As construction workers in this study
were encouraged to use HPDs in their work settings and as they observed
modeled behaviors, it is not surprising that their confidence to use HPDs
correctly was enhanced. Furthermore, by observing consistent hearing
protection behaviors of peers and supervisors, construction workers were more
likely to anticipate the beneﬁcial outcomes and values associated with using
HPDs

Observational learning is a central concept in social cognitive theory

(SCT) espoused by Bandura (1986). Certainly consistent with SCT is the notion

93

that a supportive work climate provides ongoing opportunity for workers to
engage in vicarious Ieaming. Even if workers are encouraged in training
sessions to adopt hearing protection behaviors, they are still much more likely to
do so when they witness their peers enacting hearing protection behaviors.
According to Bandura’s concepts, observing the successful experiences of
others provides a dynamic catalyst and mediates the adoption of new behaviors.
Reﬂecting some of the earlier ﬁndings reported by Lusk (1997) are the
results clearly highlighted in this study. The inﬂuence of social modeling in the
work setting plays a dramatic role in promoting hearing protection behaviors
among construction workers. In a sense, the work setting provides an
opportunity for ongoing “real-time” testimonials where the beliefs and behaviors
of co-workers dynamically afﬁrm the value of HPD use. Clearly supporting this
contention is the previously discussed correlational ﬁnding from this research
study: construction workers’ use of HPDs increased when they observed their

peers modeling HPD behavior (see Table 8).

Model for Predm HPD Us;

In the hierarchical multiple regression analysis, using the conceptual
model that directed the focus of this study, results indicated that 21% of the
variance in HPD use by construction workers was explained by the group of
predictor variables (age, trade, training, work climate, self-efﬁcacy, outcome
expectancy, and outcome value). The research hypothesis relative to the
predictive ability of the overall model was partially supported. While the variance

in HPD use explained by the model is rather modest, the regression results

94

clearly emphasize the inﬂuence of trade category, work climate factors,
self-efﬁcacy, and outcome value as signiﬁcant predictors for HPD use among
construction workers.

Even though training was not evident as a signiﬁcant predictor in the
overall model, it is important to recognize that self-efﬁcacy was a signiﬁcant
predictor for HPD use, having a standardized beta of .12 (p = .005). This is
worthwhile to note because subsequent analysis (ANOVA) revealed that
construction workers who had received hearing protection training also perceived
and reported a signiﬁcantly higher level of self-efficacy for using HPDs. There
was an indirect inﬂuence of training in relationship to HPD use; training appeared
to be mediated by self-efﬁcacy as illustrated in the revised conceptual model
(see Figure 3). Therefore, training contributed to construction workers’ feeling
more conﬁdent about their ability to use HPDs adequately and effectively, which
then resulted in a higher use of HPDs.

In considering that a guided-practice session was included in the HPD
training intervention for construction workers (Lusk, 1997), this indirect inﬂuence
of training on HPD use (mediated by self-efﬁcacy) seems quite plausible.
Opportunity to practice skills, along with observing others doing the same, can
lead to increased levels of self-efﬁcacy (Bandura, 1986). This ﬁnding certainly
strengthens the justiﬁcation for incorporating “hands-on” opportunities during
training, especially since adult learners tend to be pragmatic and respond
favorably when Ieaming can be applied to their current situations (Caffarella,

1 994).

95

Work Climate and TrainirLoLEffectiveness
Recognizing that work climate was found to be a fairly important predictor
in the regression model, it was somewhat surprising to note that work climate did
not moderate the training effects on self-efﬁcacy, outcome expectancy, outcome
value, and HPD use. An interaction between training and work climate had been
hypothesized; increased levels of self-efﬁcacy, expectancy, value, and HPD use
were anticipated in construction workers who had received hearing protection

training and who had reported working in supportive climates. However, data

Fmﬂ— _'=..._.

analyses did not support the hypothesis. Perhaps if the training effect had been
stronger, an interaction effect may have been observed.

As suggested by Tracey (1992), underlying values related to training in
general may inﬂuence training effects. Certainly, it is well recognized that adult
learners bring a myriad of experiences to any training event. With the absence
of an interaction effect in this study, further investigation is needed to reveal the
dynamics involved. Given the modest predictive power of the conceptual model,
additional predictor variables for HPD use remain to be identiﬁed. If we maintain
that HPD training is essential and support the concept that factors in the work
context inﬂuence behaviors, then future research is imperative in order to reduce

the occurrence of occupational hearing loss.

Irgining. Self-efﬁcacy, and Work Settings
An important ﬁnding emerged from this study. As previously discussed,
training was not a signiﬁcant predictor for HPD use in the overall regression

analysis using the conceptual model. However, additional data analysis revealed

96

that training had an indirect effect on HPD use, working through the mediation
effect of self-efﬁcacy. Perhaps the inﬂuence of training might have been more
evident if self-efﬁcacy were given more time to develop. Meaningful behavior
changes are generally not quickly enacted. Despite its limitations as an overall
signiﬁcant predictor, the relationship between training and self-efﬁcacy is
encouraging and certainly provides a point of departure for future research
endeavors.

Results from this study build upon the research of Mathieu, Martineau,
and Tannenbaum (1993) who explored the antecedents of self-efﬁcacy levels in
relationship to training effectiveness. Aggregate situational constraints, such as
non-supportive group dynamics in the training session, were hypothesized to
inﬂuence self-efﬁcacy levels and training effectiveness. Mathieu et al. reported
that individual constraints (i.e., competing demands, time limitations) were found
to adversely affect the development of self-efﬁcacy, but situational constraints
did not signiﬁcantly impede self-efﬁcacy development. Individual and situational
constraints were associated, however, with less favorable responses to training.
Failing to ﬁnd support for their hypothesis regarding the relationship between
situational factors and self-efﬁcacy, Mathieu et al. strongly emphasized the need
for further research to examine the inﬂuence of work setting constraints on
training effectiveness, suggesting that work policies and supervisor behaviors
could impede the training process. Interestingly, in a study addressing transfer
of training, Rouiller and Goldstein (1993) found that supportive climates tended

to promote transfer of skills Ieamed in training.

97

Consistent with the hypothesis of Mathieu et al. (1993) and ﬁndings
reported by Rouiller and Goldstein (1993), this research study demonstrated a
signiﬁcant correlation between work climate and self-efﬁcacy, which then
inﬂuenced construction workers’ use of HPDs. Most assuredly, if organizations
fail to address situational constraints in the work environment, they are likely to
experience minimal gains from training efforts. Given the ﬁndings from the work
of Rouiller and Goldstein, it was somewhat puzzling to observe no interaction
effect between training and work climate in this research study. Perhaps more
reﬁned and discrete instruments for variable measurement would reduce the
potential for measurement error and enhance understanding of the complex
interplay involved in workers’ behaviors to protect their hearing.

The theory-based training intervention that was provided for construction
workers in the study reported by Lusk (1997) consisted of one classroom session
that lasted approximately 45 minutes and included a video presentation, along
with a guided-practice session and distribution of relevant printed materials. In
order to change the hearing protection behaviors of construction workers, it also
is important to recognize and plan for adjustments that might be needed in work
settings where transfer of what is Ieamed in training is intended to occur. Failure
to perform an adequate assessment of the actual and potential needs in the
work environment may result in wasted training efforts (Schneider & Rentsch,
1988). Training will be much more effective if it is rooted in the workplace
environment and nurtured on a continuing basis (Minter, 1996). In addition,
contractors, managers, and site supervisors should be assisted and encouraged

to provide post-training feedback that is likely to reinforce desired behaviors.

98

 

Also important to consider are periodic refresher training sessions that tend to

engender more enduring changes in hearing protection behaviors (Minter).

Implications for Theory

Theories, such as the Health Belief Model (HBM) and the Health
Promotion Model (HPM) that guided earlier research about health-related
behaviors focused predominantly on individual or personal factors that
inﬂuenced health-promoting behaviors. Juxtaposing this individual-personal
focus is the evidence from this study which indicates that construction workers’
behaviors to protect their hearing are inﬂuenced by more than just individual or
personal factors. Contextual factors, such as supervisor and peer support within
the work environment, exert a moderately strong inﬂuence on construction
workers’ hearing protection behaviors. Given the ﬁndings from this study, it is
imperative to expand upon the earlier health behavior theories by including an
explicit focus on the sociocultural factors that inﬂuence workers’ behaviors.
Focusing primarily on personal factors is not enough; the organizational context
must also be addressed.

Speciﬁcally with regard to health and safety behaviors occurring in work
settings, the earlier theories could be enhanced by moving beyond a primary
focus on individual-personal factors and incorporating a focus on work climate
factors that function as signiﬁcant predictors of behaviors. Inclusion of elements
that create a climate for inﬂuencing workers’ behaviors within the work

environment would strengthen the existing health-related theoretical models.

99

Consequently, a greater awareness and clearer understanding of workers’
behaviors might be achieved if more inclusive theories are applied.

Overall ﬁndings from this study strongly support the concepts that
Bandura (1986) espoused about self-efﬁcacy and vicarious learning in SCT. Of
primary importance in SCT is the critical role that the social environment plays in
determining individual behaviors and performance. As emphasized by Bandura
and reinforced by ﬁndings in this study, contextual factors have a deﬁnite
inﬂuence on behavior. In reference to adult learners, Merriam and Caffarella
(1999) contend that Bandura’s theory has major relevance. It is the dynamic
combination of the individual within a social context that profoundly inﬂuences
adult Ieaming. Certainly, ﬁndings from this study provide support for the use of a
social interactive theory to predict and explain post-training hearing protection
behaviors. \Mth increased knowledge and awareness of the predictors for
workers’ post-training behaviors, more comprehensive training programs can be
designed and implemented.

What has been well recognized by educators of adult learners is that the
process of Ieaming occurs not in a vacuum, but within a social context that
exerts tremendous inﬂuence on Ieaming outcomes (Merriam & Brockett, 1997).
Indeed, ﬁndings from this study demonstrate how important it is to evaluate the
associated social context where learned behaviors are expected to occur.
Construction workers’ post-training HPD use was signiﬁcantly inﬂuenced by
contextual factors such as peer-supervisor support and modeling of hearing
protection behaviors. These ﬁndings align with some of the tenets associated

with situated cognition, a concept gaining more recognition in the ﬁeld of adult

100

education. “Situated cognition is based on the idea that what we know and the
meanings we attach to what we know are socially constructed” (Merriam &

Brockett, 1997, p. 156). Clearly, interactive experiences within a social context
play a prominent role in adult Ieaming and subsequent behavior (Wilson, 1993).

Findings from this study also support the concept of outcome value as a
motivating force of behavior described by Vroom (1964) in Expectancy Theory.
Not surprisingly, when construction workers highly valued the outcomes
associated with wearing hearing protection, (e.g., prevention of hearing loss,
protection from harmful noise) their use of HPDs increased. However, ﬁndings
from the multiple regression analysis in this study tend not to support Vroom’s
concept of outcome expectancy as a motivating force. Somewhat surprising and
certainly perplexing was the non-signiﬁcant negative beta (-.02) of outcome
expectancy in the ﬁnal step of the hierarchical regression analysis. This ﬁnding
would suggest that high expectations of the outcomes (beneﬁts) from wearing
HPDs (e.g., reduction of hearing loss from noise exposure, protection of hearing)
contributed to a low use of HPDs—a ﬁnding somewhat contrary to logical
expectation and Vroom’s theoretical model.

A more likely reason for this unexpected ﬁnding is the possibility of
multicollinearity between outcome expectancy and outcome value, since they
appear to measure similar concepts. Even though the bivariate correlation of .42
(p < .001) between these two variables is not necessarily high to produce
multicollinearity, a linear combination of the two variables with an undetectable

third predictor variable could produce a multicollinearity problem (Hamilton,

101

1992). Perhaps more reﬁned instruments are needed to improve the

measurement precision of these variables in future research studies.

Mations for Practice

With regard to the practical application of ﬁndings obtained from this
research study, it should be recognized that the work climate is a critical factor to
consider when planning hearing protection training. Not only should efforts focus
on changing individual behaviors, but work climates as well must be addressed
and adjusted. As suggested in the literature related to safety behaviors
(Dedobbeleer & Beland, 1991; White et al., 1988) and worksite health promotion
programs (Ribisl & Reischl, 1993), the inﬂuence of work settings must be a
primary concern. When workers Ieam behaviors in training sessions, it cannot
be generally assumed that the targeted behaviors will automatically transfer to
the work environment (Baldwin & Ford, 1988). Situational factors such as lack of
equipment and supervisor-peer support can often constrain enactment of desired
safety behaviors.

Unfortunately, adult learning principles and their relevance are often
neglected when training programs are designed and implemented in work
settings. In planning educational programs for adult learners, the potential for
authentic application of Ieaming is a critical element to assess (Knowles, 1984).
For adults, Ieaming is strengthened when they perceive a reality for the
opportunity to apply newly-learned skills. Therefore, if a work environment is
perceived by workers as non-conducive for the application of skills Ieamed in

training, minimal transfer of learning will occur. Consequently, the effectiveness

102

of training programs is often jeopardized when work environments lack support
for the application of newly-Ieamed skills.

It would be beneﬁcial to plan HPD training interventions that incorporate
principles that are relevant for adult learners. Particularly useful to consider are
context-based instructional sessions where real-life work situations and
experiences of construction workers could be drawn upon to guide the
presentation and discussion of training content (Dirkx & Prenger, 1997).
Context-based instruction involves actively engaging adult learners in the
process of identifying and determining what is meaningful for them to Ieam. This
type of strategy could provide a reality orientation for the HPD training content
and increase the potential for transfer of Ieaming to actual work settings.

Given that the reported HPD use by construction workers in this study was
inadequate to fully protect their hearing, it also is crucial to recognize the
inﬂuence of the peer group in work environments when planning and
implementing hearing protection training programs. As demonstrated by the
ﬁndings from this research study, even when well-designed, theory-based
training programs are conducted, work climate factors still exert a moderate
inﬂuence in predicting hearing protection behaviors. Therefore, serious
consideration must again be focused on the work setting where hearing
protection behaviors, taught during training sessions, are expected to transfer.
Enactment of behaviors Ieamed in training programs will be inﬂuenced by
contextual factors such as peer and supervisor support.

It is important to consider how speciﬁc ﬁndings from this study might be

applied to the population of construction workers. Recalling that HPD modeling

103

by peers and supervisors signiﬁcantly predicted construction workers’ HPD use,
training sessions could be designed to include on-site peer groups along with
supervisors and managers. It would be advantageous to consider training
programs that incorporate teams or groups of workers whose daily work activities
involve close interaction. Supervisors also should be included in such training
sessions, thus providing visible commitment and credible support for hearing
protection efforts. In essence, not only must supervisors and organizational
management “speak” a commitment for training efforts, but they must visibly
“practice” it too. When messages about the importance of using HPDs are
consistently conveyed throughout the organizational setting and among various
levels, there is greater potential for increased transfer of knowledge, skills, and
attitudes from training programs to work environments (Ford & Fisher, 1994).

Brief “tool box” or “tailgate” sessions (Schneider, Johanning, Belard, &
Engholm, 1995) that are familiar to the construction industry might effectively
reinforce annual HPD training. Having HPD equipment available during these
on-site sessions would encourage construction workers to practice with the
devices and try them on for size, thus potentiating their sense of self-efﬁcacy.
Comprehensive HPD training is valuable, but desired behaviors must be
encouraged and reinforced in the work environment if adequate use of HPDs
and reduction of occupational NIHL are to be achieved.

The sample in this study consisted of unionized construction workers;
therefore, involving union leaders in efforts to reduce NIHL is another strategy to
consider when planning training programs for unionized groups. Dedobbeleer,

Champagne, and German (1990) found that exposure to safety training tends to

104

be more prevalent among unionized construction workers. Building upon this
reported ﬁnding, the participation of union leaders can be encouraged, thus
providing additional opportunities for construction workers to observe social
modeling of acceptable HPD behaviors.

Cognizant of the inﬂuence that work climate exerts, training efforts should
include preparation of the worksite for reinforcing HPD training. Visible
management support is essential for transfer of training to occur. Encouraging
site managers and supervisors to provide adequate HPD equipment and
consistent reminders for HPD use in their work environments can help to
improve the retention of training skills. The environment should reﬂect and
reinforce what has been emphasized in training. When workers perceive that
management is serious about the dangers associated with exposure to
hazardous noise, they are much more likely to enact positive hearing protection

behaviors.

Limitations

It is helpful to note that some limitations of this study exist. Midwestern
U.S. construction workers comprised the sample for this study; therefore,
ﬁndings cannot be generalized beyond this population. In addition, self-reporting
of HPD behaviors was used to measure the dependent variable, thus possibly
reducing the reliability of reported results. A lack of a signiﬁcant relationship
between training and HPD use may have resulted from the fact that the training
intervention occurred outside of the normal work setting and consisted of one

45-minute classroom session. Perhaps this may have been a limiting factor.

105

Construction workers might beneﬁt from training that is conducted on a more
frequent basis within their work environments.

Secondary analysis of existing data was the technique applied in this
research study. Performing secondary data analysis has distinct advantages
accompanied by deﬁnite disadvantages. At best, using a pre-existing data set
provides an economical approach for conducting additional studies in the current
environment of limited resources (both time and money). However, one of the
primary drawbacks of secondary data analysis is the limitation imposed by
pre-existing variables and scales that have been designed and developed from
another theoretical perspective. Scales and measurements may lack validity and
not match the desired precision for the secondary analysis. Nevertheless,
working with pre-existing data sets affords access to large sample sizes, often
not readily available and very difﬁcult to obtain. Lastly, performing secondary
data analysis encourages a researcher to be creative by looking at existing data

with a different point of view.

Recommendations
Future research should continue to focus on self-efﬁcacy and examine its
antecedents in order to develop a more comprehensive understanding of what
contributes to training effectiveness. Construction workers in this study who
received hearing protection training had signiﬁcantly higher levels of self-efﬁcacy.
Continued examination of this apparent linkage is warranted if a broader
awareness of learning dynamics is desired. Also, since operating engineers in

this study demonstrated a higher use of hearing protection, research should be

106

directed on exploring the factors contributing to their unique behaviors and
characteristics.

Still to be answered is the perplexing question about the role of outcome
expectancy in relation to hearing protection behaviors. Contrary to the
conceptual model that directed the focus of this study, outcome expectancy was
not a signiﬁcant predictor. Again, this emphasizes the need for improved
measurement precision to reduce the potential for multicollinearity and confusing
regression results.

While the overall conceptual model used in this study was successful in
predicting HPD use among Midwestern U.S. construction workers, the 32
achieved (21%) was somewhat modest, but not too uncommon in studies
involving the social sciences. Nevertheless, the modest predictive power
strongly suggests that further investigation is needed to explain the remaining
79% of the variance in hearing protection behaviors among construction workers.
In addition, a clearer operational understanding and comprehensive description
of elements comprising the work climate construct are needed in order to ensure
greater measurement precision. To identify and clarify other factors associated
with HPD behaviors, qualitative studies that are grounded in construction
workers’ actual experiences are worthwhile to consider for future research

efforts.

Summam

Currently, there is a renewed focus on the effectiveness of training,

particularly by those involved with training endeavors in work settings.

107

Increasingly, organizations are critically analyzing costs and beneﬁts associated
with training programs since they represent a major organizational investment of
both time and money. Needless to say, sound evidence is needed to justify
training expenditures (Cascio, 1989). Consequently, it is imperative that
researchers and practitioners increase their awareness and understanding of the
contextual factors that contribute to effective training efforts.

In light of this urgency, what has this research study provided? How
enlightened have we become about providing hearing protection training for
construction workers? Most emphatically, ﬁndings from this study have
emphasized the importance of work setting factors in predicting post-training
hearing protection behaviors. For the group of construction workers in this study,
co-worker support and modeling of HPD behaviors played a dominant role.
When asked about what would encourage him to wear HPDs, one young
construction worker spontaneously responded, “If my buddies wore them, I
would too!” Therefore, the context where learned skills are expected to transfer
should be of crucial concern and must not be ignored.

Generally, those who work closely with adult learners develop an acute
appreciation for the dynamics involved in Ieaming environments, but an
awareness of the critical factors that promote transfer of learning to work settings
is often limited. Knowledge gained from this study can encourage us to expand
our focus beyond the speciﬁc training environment, thus broadening our view to
include work settings where other important lessons are learned. Therefore, it is
absolutely essential to assess and recognize the inﬂuence of work environments

if training is to be effective. By understanding the dynamic contextual factors

108

associated with hearing protection behaviors in work settings, more suitable
training strategies can be developed. Most assuredly, with more effective HPD

training, the potential to reduce occupational NIHL will be greatly enhanced.

 

109

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110

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119

APPENDICES

120

APPENDIX A

121

APPENDIX A
WORK CLIMATE

The following are beliefs about hearing protection (for example, ear plugs or ear
muffs). Circle the number that best represents how much you disagree or agree
with the statement.

Strongly Moderately Slightly Slightly Moderately Strongly
, 01 r _

1.a Pressure from co-workers can often get 1 2 3 4 5 6
in the way of wearing hearing protection.

2.“ Even though it may be a good idea, I
don’t have time to use hearing 1 2 3 4 5 6
protection.

3.‘ The information on the beneﬁts of using
hearing protection is too 1 2 3 4 5 6
inconclusive/unavailable to encourage
me to use hearing protection.

4.‘I Nobody at work cares if I wear hearing 1 2 3 4 5 5
protection.

5. I am sure that I can ask for help if I have 1 2 3 4 5 6
difﬁculty using hearing protection.

6. Ear plugs are available to pick up at my 1 2 3 4 5 6

job sites.
I have my own ear muffs assigned to me. 1 2 3 4 5 6
8.‘I l have to make a request in order to 1 2 3 4 5 6

obtain ear plugs.
9.“ There are not enough ear plugs available

so that I can use several pairs in one 1 2 3 4 5 6
day.
10.‘I The supply of ear plugs is not close to
my work. 1 2 3 4 5 6
11. I am free to use as many pairs of ear
plugs in a day as I want to. 1 2 3 4 5 6
12. There are signs at my job sites 1 2 3 4 5 6
reminding me to use hearing protection.
13. At my job sites, I have a choice of
different types of ear plugs. 1 2 3 4 5 6

Note. 8 Indicates reverse-scored item.

122

Work Climate
Appendix A
(continued)

How much do you believe the following people think you should wear hearing
protection when you are in a high-noise work environment? Circle your answer.
(Circle “Does Not Apply” ONLY if you have NO person in that particular
category.)

1. The workerlspend the most time Not at All Sort of Alot Does Not

 

with Apply
2. Supervisor at work Not at All Sort of A lot Does Not
Apply

In general, how much do you think the following people wear hearing protection
when expos_ed to high noig? Please circle a response.

3. The coworker I Never Usually About Half Usually Always
spend the most Not the Time
time with
4. My supervisor Never Usually About Half Usually Always
Not the Time

In general, how much do you think the following people do these things?
Please circle the best response for you.

5. My supervisor encourages me to Never Sometimes Often
wear hearing protection

6. My supervisor praises me for Never Sometimes Often
wearing hearing protection

7. My co-workers encourage me to Never Sometimes Often
wear hearing protection

8. My co-workers praise me for Never Sometimes Often
wearing hearing protection

Note. From Preventing Noise-Induced Hearing Loss in Construction Workers by S.L. Lusk, 1997, The
University of Michigan School of Nursing. Adapted with permission.

123

APPENDIX B

124

APPENDIX B

SELF-EFFICACY

The following are beliefs about hearing protection (for example, ear plugs
or ear muffs). Circle the number that best represents how much you
disagree or agree with the statement.

2.‘

3."

4.al

9.1’

10.”

11.

12.

Note.

Strongly Moderately Slightly Slightly Moderately Strongly
Disagree Disagree Disagree Agree Agree Agree

 

It’s difﬁcult to talk with other people 1 2 3 4 5 6
when I’m wearing my hearing protection.

Hearing protection keeps me from 1 2 3 4 5 6
hearing what I want to hear.

When I use hearing protection, it does 1 2 3 4 5 6
not effectively block out noise for me.

I need to Ieam more so that I can use 1 2 3 4 5 6
hearing protection effectively.

I can use hearing protection correctly. 1 2 3 4 5 6

I do not always use my hearing 1 2 3 4 5 6
protection the way it should be used.

I know how to use my hearing protection 1 2 3 4 5 6
so that it works effectively.

I do everything possible to make my 1 2 3 4 5 6
hearing protection work effectively.

I am not sure that I can use hearing 1 2 3 4 5 6
protection correctly.

I am not sure I can tell if my hearing 1 2 3 4 5 6
protection is working effectively.

I am sure I can talk with someone while 1 2 3 4 5 6
using my hearing protection.

I am sure I can use my hearing 1 2 3 4 5 6
protection so it works effectively.

From PreventingNoise-lnduced Hsan'nq Loss in Construction Workers by S.L. Lusk, 1996, The
University of Michigan School of Nursing. Adapted with permission.

3 Indicates reverse-scored items.

125

 

APPENDIX C

126

APPENDIX C

OUTCOME EXPECTANCY

The following are beliefs about hearing protection (for example, ear plugs
or ear muffs). Circle the number that best represents how much you
disagree or agree with the statement.

2.‘

3.‘I

4.al

7.El

Wearing hearing protection protects me
against hearing loss from noise
exposure.

Even if I wear my hearing protection at
all times on the job, I will not reduce my
chances of developing hearing loss.

It’s debatable if wearing hearing
protection will lessen my chances of
becoming hard of hearing.

If I do not have a hearing problem now,
I don’t see any need to wear hearing
protection.

Regular use of hearing protection is
beneﬁcial to me because it helps
protect my hearing.

Protecting my hearing is not important
to me.

In the long run, my hearing will
decrease anyway so I need not bother
to wear hearing protection.

         

Stron
Di . e

1

QIY

Moderately Slightly
011- era“, DI .— rfas

2 3

2 3

2 3

2 3

2 3

2 3

2 3

Slightly

A1

Moderately Strongly
5 6‘
5 6
5 6
5 6
5 6
5 6
5 6

Note. From Preventing Noise-Induced Heamiq Loss in Construction Workers by S.L. Lusk, 1997, The
University of Michigan School of Nursing. Adapted with permission.

3 Indicates reverse-scored item.

127

 

APPENDIX D

128

 

 

APPENDIX D

OUTCOME VALUE

Possible outcomes from using hearing protection are listed below. Please
indicate your personal rating of their importance by placing an X on the line
that best shows the value or importance of that outcome for you.

1.

.03

5‘

.0'

Protection of inner ear
Slightly Highly
Important Important

 

Keep out noise

 

 

 

Slightly l Highly
Important 4 Important
Prevention of hearing loss

Slightly I Highly
Important Important
Keep out harmful noise

Slightly I Highly
Important 4 , Important
Reduce amount of hearing loss

Slightly I l Highly
Important , 4 Important

 

Note. From Preventing Noise-Induced Hearing Loss in Construction Workers by S.L. Lusk, 1997, The

University of Michigan School of Nursing. Adapted with permission.

129

APPENDIX E

130

 

APPENDIX E

HPD USE

This part of the survey deals with noise exposure on your job sites. Noise
levels are high when you have to shout to be heard by a co-worker who is

three feet or less away.

The following questions ask you about your exposure to high noise and use of
hearing protection during speciﬁc time periods. First answer whether or not you
were exposed to high noise at your job sites during the given time period. If you
were not exposed to noise during that time, go on to the next question; if you
were, what percent of the time that you were exposed to high noise did you wear
hearing protection?

% of time
Were you exposed in high noise
to high noise (Circle NOIYES: you used
at yourjob sites: If YES, then =1» =>) hearing protection?
a. at your most recent job site? NO YES => => %
II
b. at the site b_ef_qa that? NO YES => => %
l
c. during the past week? NO YES => => %
l
d. during the past month? NO YES => => °/o
11
e. during the past 3 months? NO YES => => %

Note. From Prevent1nq Noise-Induced Hearing Loss in Construction Workers by S.L. Lusk, 1997, The
University of Michigan School of Nursing. Adapted with permission.

131

APPENDIX F

132

 

OFFICE OF
RESEARCH
AND
GRADUATE
STUDﬂﬁi

University Committee on
mmnNBMmhmg
Human Suited:
(nouns

Michigan State University
246 Administration Budding
autummiuuwﬁi
tapemﬁ

51 71355-2180
FAX; 5l7/432-1171

newsman”
IDE‘BMWW
Emmnm

W is an m.
amt-omit lnsrllwm

APPENDIX F

MICHIGAN STATE

U IV I V’ E Ii 5 l I' Y

 

July 8. 1998

TO: John M. Dirkx
408 Erickson Hall

RE: IRB#: 98-424‘
TITLE: TRAINING TO PROMOTE WORKERS' USE OF HEARING
PROTECTION: THE INFLUENCE OF WORK CLIMATE
FACTORS ON TRAINING EFFECTIVENESS
REVISION REQUESTED: N/A
CATEGORY: l-E
APPROVAL DATE: 06/25/98

The University Committee on Research Involving Human Subjects'lUCRIHsl

review of this project is complete.. I am pleased to adVise that the

rights and welfare of the human subjects appear to be adequately

protected and methods to obtain informed consent are appropriate.

aEgrefore, the UCRIHS approved this prOJect and any reViSions listed
ve.

RENEWAL: UCRIHS approval is valid for one calendar yearf'beginning with
the approval date shown above. Investigators planning to
continue a project beyond one year must use the green renewal
form (enclosed with t e original approval letter or when a
project is renewed) to seek u date certification. There is a
maximum of four such expedite renewals possible. Investigators
wishing to continue a progect beyond that time need to submit it
again or complete reView.

REVISIONS: UCRIHS must review any changes in procedures involving human
subjects, rior to initiation of t e change. If this is done at
the time o renewal, please use the green renewal form. To
reVise an approved protocol at an other time during the year,
send your written request to the_ CRIHS Chair, requesting revised
approval and referenCing the prOJect's IRB # and title. Include
in your request a description of the change and any revised
instruments, consent forms or advertisements that are applicable.

PROBLEMS/

CHANGES: Should either of the following arise during the course of the
work, investigators must noti y UCRIHS promptly: (1) roblems
(unexpected Side effects, comp aints, etc.) involving uman
subjects_or (2) changes in the research environment or new
information indicating greater risk to the human subiects than
eXisted when the protocol was preViously reviewed an approved.

If we can be of any future help, please do not hesitate to contact us
at (517)355-2180 or FAX (517M 2-1171.

was}

S
D id B. Wright, Ph.D.
UCRIHS Chair

DEW : bed

cedaéice S. Brady

133

APPENDIX G

134

 

APPENDIX G

@WWWWZWMW

 

SCHOOL OF NURSING 400 N. lngalls, Rm. 3160
HEALTH PROMOTION AND RISK REDUCTION PROGRAMS Ann Arbor, Michigan 48109-0482
Community Health Nurssng/Parent-Child Nursing (313) 763-5597

Fax: (313) 647-0351

May 7. 1998

David E. Wright. PhD, Chair
UCRIHS - Michigan State University

Dear Dr. Wright

This letter is to afﬁrm that I have given Ms. Jan Brady permission to use the aggregated
data from my research project 'Preventing Noise-induced Hearing Loss in Construction
Workers', NIOSH grant number R01 0H03136, for her“dissertation at Michigan State
University. She will be using only the computer data ﬁles and will not have access to
the participants' names. Enclosed is a copy of the most recent copy of the Institutional
Review Board approval from The University of Michigan for my project

If you have any questions or need further information, please feel free to contact me at
734-647-0347 or via email at Iusk@umich.edu.

Sincerely,

Qt, 5% (9.3L.
Sally L. LUSK, PhD, RN, FAAN

Professor and Director
Occupational Health Nursing

SLLzswl

coores.sll206.doc

135

APPENDIX G

 

(continued)
SCHOOL OF NURSING 400 N. Ingalls. Rm. 3160
HEALTH PROMOTION AND RISK REDUCTION PROGRAMS Ann Arbor, Michigan 48109-0482
Community Health Nursing/Parent-Child Nursing (313) 763-5597
Fax: (313) 647-0351
MEMORANDUM

T 0: Jan Brady, Doctoral Student
FROM: Sally Lusk, PhD, RN, FAAN Stages/Ia.
DATE: December 1, 1998

RE: Reproduction of Questionnaire Items

You have my permission to reproduce questionnaire items from my study,
Preventing Noise-induced Hearing Loss in Construction Workers (NIOSH grant number
R01 0H03136), in your dissertation, Training to Promote Workers” Use of Hearing
Protection: The Inﬂuence of Work Climate Factors on Training Eﬂecriveness, which
involved performing secondary analysis of the data resulting from my study.

136

APPENDIX G

 

(continued)
an a {/ZJMZJJI/ @[WP‘W
SCI-1001. OF NURSING 400 N. Ingalls. Rm. 3160
HEALTH PROMOTION AND RISK REDUCTION PROGRAMS Ann Arbor. Michigan 48109-0482
Community Health NursmyParenl-Child Nursrng I734) 763-3397
Fax: 1734) 647-0331
MEMORANDUM
TO: Jan Brady, PhD Candidate
FROM: Sally L. Lusk, PhD, RN, FAAN {It (5%

DATE: April 13, 1999
SUBJECT: Reproduction of Questionnaire Items

This memo is to re-conﬁrrn that you have my permission to reproduce
questionnaire items from my study, Preventing Noise-induced Hearing Loss in
Construction Workers (NIOSH grant number R01 0H03136), in your
dissertation, Training to Promote Workers’ Use of Hearing Protection: The
Inﬂuence of Work Climate Factors on Training Effectiveness, which involved
performing secondary analysis of the data resulting from my study.

I understand that UMI Dissertation Services may make single copies of your
dissertation on demand. UMI will not be held responsible for any damages that
may arise from copyright violations.

Brady 41399memodoc

137

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