Accepted for/Published in: JMIR Research Protocols
Date Submitted: Feb 8, 2026
Date Accepted: Aug 10, 2026
Hearing Loss Prevention Training for Spanish-Speaking Farmworkers: Protocol for a Community-Engaged Hybrid Type 1 Pilot Study
ABSTRACT
Background:
Noise-induced hearing loss (NIHL) is permanent yet preventable. Agricultural workers experience routine hazardous noise exposure, and hearing protection use among farmworkers in the United States (U.S.) remains low. Existing interventions emphasize individual knowledge and intentions and have rarely been tested using objective outcome measures. This protocol describes the adaptation and pilot evaluation of an individual-level component of Proyecto Oídos Protegidos (POP), a multilevel NIHL prevention intervention for farmworkers. This pilot focuses on refining and testing a brief digitally delivered novella.
Objective:
The objectives of this study are to (1) culturally and linguistically adapt a digitally delivered, Spanish-language entertainment–education hearing protection training (digital novella with facilitated discussion and coached earplug fitting) for farmworkers in the southwest U.S., using community-based participatory research; and (2) pilot test the adapted intervention to estimate preliminary effectiveness on objective hearing protector fit and assess implementation outcomes.
Methods:
This is a single-arm, pre-post, Hybrid Type 1 effectiveness-implementation pilot. Phase 1 includes formative interviews with farmworkers and farm supervisors, informed by the Consolidated Framework for Implementation Research (CFIR), to guide adaptation of training content and delivery. Cultural and linguistic adaptations will be documented using the Framework for Reporting Adaptations and Modifications-Enhanced (FRAME). Phase 2 involves a single-session micro-training delivered to farmworkers not involved in formative work. The primary effectiveness outcome is pre-post change in Personal Attenuation Rating (PAR), an objective measure of hearing protector fit. Secondary outcomes include changes in hearing protection beliefs and implementation outcomes (acceptability, feasibility, appropriateness).
Results:
Anticipated results include a community-informed, culturally and linguistically adapted digital novella addressing noise-induced hearing loss in agricultural settings, along with pilot estimates of pre–post change in objective hearing protector fit, hearing protection beliefs, and implementation outcomes to inform scale-up within the multilevel POP intervention.
Conclusions:
This protocol describes a community-engaged adaptation and pilot evaluation of a culturally tailored, digitally delivered hearing protection micro-training for farmworkers. By pairing objective fit testing with pragmatic implementation measures and systematic adaptation tracking, the study will assess feasibility and estimate preliminary effect sizes to inform a subsequent multilevel trial integrating supervisor and organizational components. Clinical Trial: NCT07271290
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