{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:14:59Z","timestamp":1787022899689,"version":"build-2736575974"},"reference-count":16,"publisher":"American Academy of Pediatrics (AAP)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2011,11,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVES:<\/jats:title>\n                    <jats:p>We had the rare opportunity to conduct a cluster-randomized controlled trial to observe the long-term (16-year) effects of a well-designed hearing conservation intervention for rural high school students. This trial assessed whether the intervention resulted in (1) reduced prevalence of noise-induced hearing loss (NIHL) assessed clinically and\/or (2) sustained use of hearing protection devices.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>In 1992\u20131996, 34 rural Wisconsin schools were recruited and 17 were assigned randomly to receive a comprehensive, 3-year, hearing conservation intervention. In 2009\u20132010, extensive efforts were made to find and contact all students who completed the original trial. Participants in the 16-year follow-up study completed an exposure history questionnaire and a clinical audiometric examination. Rates of NIHL and use of hearing protection were compared.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>We recruited 392 participants from the original trial, 200 (53%) from the intervention group and 192 (51%) from the control group. Among participants with exposure to agricultural noise, the intervention group reported significantly greater use of hearing protection compared with the control group (25.9% vs 19.6%; P = .015). The intervention group also reported significantly greater use of hearing protection for shooting guns (56.2% vs 41.6%; P = .029), but the groups reported similar uses of protection in other contexts. There was no significant difference between groups with respect to objective measures of NIHL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION:<\/jats:title>\n                    <jats:p>This novel trial provides objective evidence that a comprehensive educational intervention by itself may be of limited effectiveness in preventing NIHL in a young rural population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1542\/peds.2011-0770","type":"journal-article","created":{"date-parts":[[2011,10,10]],"date-time":"2011-10-10T22:11:26Z","timestamp":1318284686000},"page":"e1139-e1146","source":"Crossref","is-referenced-by-count":15,"title":["Randomized Trial of a Hearing Conservation Intervention for Rural Students: Long-term Outcomes"],"prefix":"10.1542","volume":"128","author":[{"given":"Barbara","family":"Marlenga","sequence":"first","affiliation":[{"name":"National Farm Medicine Center and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James G.","family":"Linneman","sequence":"additional","affiliation":[{"name":"Biomedical Informatics Research Center, Marshfield Clinic Research Foundation, Marshfield, Wisconsin;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Pickett","sequence":"additional","affiliation":[{"name":"Departments of Emergency Medicine and"},{"name":"Community Health and Epidemiology, Queen's University, Kingston, Ontario, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas J.","family":"Wood","sequence":"additional","affiliation":[{"name":"Departments of Audiology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven R.","family":"Kirkhorn","sequence":"additional","affiliation":[{"name":"Occupational Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven K.","family":"Broste","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Data Management, Medtronics Neuromodulation, Minneapolis, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary Jo","family":"Knobloch","sequence":"additional","affiliation":[{"name":"Division of Education, Marshfield Clinic, Marshfield, Wisconsin; 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