{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T20:55:18Z","timestamp":1791233718282,"version":"4.1.0"},"reference-count":56,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Res Protoc"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Noise-induced hearing loss is permanent yet preventable. Agricultural workers routinely experience hazardous noise exposure, and hearing protection use 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 a multilevel noise-induced hearing loss prevention intervention for farmworkers. This pilot focuses on refining and testing a brief digitally delivered novella.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n 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 United States, using community-based participatory research; and (2) pilot test the adapted intervention to assess acceptability, feasibility, and appropriateness and to estimate preliminary effect sizes for changes in objective hearing protector fit.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This is a single-arm, pre-post, Hybrid Type 1 effectiveness-implementation pilot study. Phase 1 includes formative interviews with farmworkers and farm supervisors (n=30), informed by the Consolidated Framework for Implementation Research, to guide adaptation of training content and delivery. Phase 2 involves a single training session delivered to farmworkers not involved in the formative work (n=15). The primary exploratory outcome is pre-post change in the Personal Attenuation Rating, an objective measure of hearing protector fit. Secondary outcomes include changes in hearing protection beliefs and implementation outcomes (acceptability, feasibility, and appropriateness).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Funding for this study was obtained in July 2025, and the study was registered on ClinicalTrials.gov in December 2025 (NCT07271290). Phase 1 recruitment began in July 2025, and data collection concluded in January 2026, with 30 participants enrolled. Phase 2 pilot recruitment began in July 2026, and 1 participant had been enrolled as of July 2026. Phase 2 data collection is expected to conclude in Spring 2027. Data analysis will follow completion of data collection, and study findings are expected to be published in 2028.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n This protocol describes a community-engaged adaptation and pilot evaluation of a culturally tailored, digitally delivered hearing protection microtraining 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 that integrates supervisor and organizational components.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/93134","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T20:21:31Z","timestamp":1791231691000},"page":"e93134-e93134","source":"Crossref","is-referenced-by-count":0,"title":["Hearing Loss Prevention Training for Spanish-Speaking Farmworkers: Protocol for a Community-Engaged Hybrid Type 1 Pilot Study"],"prefix":"10.2196","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2426-2710","authenticated-orcid":false,"given":"Laura","family":"Coco","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2457-4183","authenticated-orcid":false,"given":"Tracy L","family":"Finlayson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8385-1334","authenticated-orcid":false,"given":"Nicolas","family":"L\u00f3pez-G\u00e1lvez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-3570-5835","authenticated-orcid":false,"given":"Priscila","family":"Ruedas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6042-1469","authenticated-orcid":false,"given":"Ana","family":"L Rosiles","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3501-790X","authenticated-orcid":false,"given":"Briana","family":"Toji Ruiz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1854-1671","authenticated-orcid":false,"given":"Brianna","family":"Angel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8333-4863","authenticated-orcid":false,"given":"Emma","family":"Torres","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7324-3914","authenticated-orcid":false,"given":"Mar\u00eda Luisa","family":"Z\u00fa\u00f1iga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"issue":"3","key":"R1","doi-asserted-by":"publisher","first-page":"325","DOI":"10.13031\/2013.18575","article-title":"Farm noise emissions during common agricultural activities","volume":"11","author":"Depczynski","journal-title":"J Agric Saf Health"},{"issue":"2","key":"R2","doi-asserted-by":"publisher","first-page":"101","DOI":"10.13031\/jash.19.9540","article-title":"Task-based noise exposures for farmers involved in grain production","volume":"19","author":"Humann","journal-title":"J Agric Saf Health"},{"issue":"12","key":"R3","doi-asserted-by":"publisher","first-page":"1281","DOI":"10.1097\/01.jom.0000100001.86223.20","article-title":"Noise exposure and hearing loss in agriculture: a survey of farmers and farm workers in the Southland region of New Zealand","volume":"45","author":"McBride","journal-title":"J Occup Environ Med"},{"issue":"1","key":"R4","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1002\/ajim.1068","article-title":"Predictors of hearing loss in New York farmers","volume":"40","author":"Hwang","journal-title":"Am J Ind Med"},{"issue":"40","key":"R5","doi-asserted-by":"publisher","first-page":"90","DOI":"10.4103\/1463-1741.44347","article-title":"The relationship between noise frequency components and physical, physiological and psychological effects of industrial workers","volume":"10","author":"Mahendra Prashanth","journal-title":"Noise Health"},{"issue":"4","key":"R6","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1002\/ajim.20214","article-title":"Hearing loss as a risk factor for agricultural injuries","volume":"48","author":"Choi","journal-title":"Am J Ind Med"},{"issue":"1","key":"R7","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17010248","article-title":"Health and occupational injury experienced by Latinx Child Farmworkers in North Carolina, USA","volume":"17","author":"Arcury","journal-title":"Int J Environ Res Public Health"},{"issue":"9","key":"R8","first-page":"196","volume":"71","author":"Hager","journal-title":"Occup Health Saf"},{"issue":"14","key":"R9","doi-asserted-by":"publisher","first-page":"1522","DOI":"10.1001\/archinte.168.14.1522","article-title":"Prevalence of hearing loss and differences by demographic characteristics among US adults: data from the National Health and Nutrition Examination Survey, 1999-2004","volume":"168","author":"Agrawal","journal-title":"Arch Intern Med"},{"issue":"5","key":"R10","doi-asserted-by":"publisher","first-page":"661","DOI":"10.1093\/geront\/43.5.661","article-title":"The impact of hearing loss on quality of life in older adults","volume":"43","author":"Dalton","journal-title":"Gerontologist"},{"issue":"6","key":"R11","doi-asserted-by":"publisher","first-page":"670","DOI":"10.1002\/ajim.22082","article-title":"Prevalence of hearing loss in the United States by industry","volume":"56","author":"Masterson","journal-title":"Am J Ind Med"},{"issue":"6","key":"R12","doi-asserted-by":"publisher","first-page":"1201","DOI":"10.1044\/1092-4388(2001\/093)","article-title":"A comparison of self-reported hearing loss and audiometry in a cohort of New York farmers","volume":"44","author":"Gomez","journal-title":"J Speech Lang Hear Res"},{"issue":"4","key":"R13","doi-asserted-by":"publisher","first-page":"431","DOI":"10.1002\/ajim.10286","article-title":"Perceived and measured hearing ability in construction laborers and farmers","volume":"44","author":"Kerr","journal-title":"Am J Ind Med"},{"issue":"4","key":"R14","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s10903-024-01592-8","article-title":"Hearing difficulties among farmworkers in the M\u00e9xico-US Southwest border region","volume":"26","author":"Coco","journal-title":"J Immigr Minor Health"},{"issue":"10","key":"R15","doi-asserted-by":"publisher","first-page":"878","DOI":"10.1002\/ajim.23163","article-title":"Effectiveness of safety training interventions for supervisors: a systematic review and narrative synthesis","volume":"63","author":"Sinelnikov","journal-title":"Am J Ind Med"},{"issue":"1","key":"R16","doi-asserted-by":"publisher","first-page":"49","DOI":"10.13031\/2013.25415","article-title":"Planning a multilevel intervention to prevent hearing loss among farmworkers and managers: a systematic approach","volume":"15","author":"Fernandez","journal-title":"J Agric Saf Health"},{"issue":"4","key":"R17","doi-asserted-by":"publisher","first-page":"320","DOI":"10.56454\/YYTK2021","article-title":"OSHA noise regulations and agriculture, including cotton gins","volume":"21","author":"Wakelyn","journal-title":"J Cotton Sci"},{"issue":"3","key":"R18","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1044\/2017_AJA-16-0069","article-title":"A preliminary study of a Spanish graphic novella targeting hearing loss prevention","volume":"26","author":"Guiberson","journal-title":"Am J Audiol"},{"issue":"4","key":"R19","doi-asserted-by":"publisher","first-page":"225","DOI":"10.13031\/jash.15164","article-title":"Evaluation of a point source intervention for preventing hearing loss on farmers\u2019 attitudes and beliefs: a randomized controlled trial","volume":"29","author":"Ehlers","journal-title":"J Agric Saf Health"},{"issue":"1","key":"R20","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-020-08972-3","article-title":"Community-based program to increase use of hearing conservation practices among farm and rural youth: a cluster randomized trial of effectiveness","volume":"20","author":"McCullagh","journal-title":"BMC Public Health"},{"issue":"6","key":"R21","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1111\/j.1525-1446.2007.00667.x","article-title":"A pilot study to prevent hearing loss in farmers","volume":"24","author":"Gates","journal-title":"Public Health Nurs"},{"issue":"1","key":"R22","doi-asserted-by":"publisher","first-page":"57","DOI":"10.13031\/2013.22312","article-title":"Screening events to reduce farmers\u2019 hazardous exposures","volume":"13","author":"Jenkins","journal-title":"J Agric Saf Health"},{"issue":"4","key":"R23","doi-asserted-by":"publisher","first-page":"209","DOI":"10.3109\/14992027.2013.860487","article-title":"Development and evaluation of a questionnaire to assess knowledge, attitudes, and behaviors towards hearing loss prevention","volume":"53","author":"Saunders","journal-title":"Int J Audiol"},{"issue":"2","key":"R24","first-page":"176","volume":"96","author":"Crandell","journal-title":"J Natl Med Assoc"},{"issue":"6","key":"R25","doi-asserted-by":"publisher","first-page":"899","DOI":"10.1097\/MAO.0b013e31825d640a","article-title":"Prevalence of leisure noise-induced tinnitus and the attitude toward noise in university students","volume":"33","author":"Gilles","journal-title":"Otol Neurotol"},{"issue":"6","key":"R26","doi-asserted-by":"publisher","first-page":"518","DOI":"10.1016\/j.ergon.2012.07.002","article-title":"Assessing the use of hearing protection in industrial settings: a comparison between methods","volume":"43","author":"Arezes","journal-title":"Int J Ind Ergon"},{"issue":"2","key":"R27","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1097\/00006199-200203000-00006","article-title":"Explaining Mexican American workers\u2019 hearing protection use with the health promotion model","volume":"51","author":"Kerr","journal-title":"Nurs Res"},{"key":"R28","doi-asserted-by":"publisher","DOI":"10.1080\/14992027.2025.2598645","article-title":"Interventions to prevent noise-induced hearing loss in farmworkers: a scoping review","author":"Coco","journal-title":"Int J Audiol"},{"issue":"2","key":"R29","doi-asserted-by":"publisher","first-page":"124","DOI":"10.1080\/14992027.2017.1374568","article-title":"Efficacy of technology-based interventions to increase the use of hearing protections among adolescent farmworkers","volume":"57","author":"Khan","journal-title":"Int J Audiol"},{"issue":"3","key":"R30","doi-asserted-by":"publisher","first-page":"297","DOI":"10.13031\/2013.9055","article-title":"Preservation of hearing among agricultural workers: a review of literature and recommendations for future research","volume":"8","author":"McCullagh","journal-title":"J Agric Saf Health"},{"key":"R31","doi-asserted-by":"publisher","DOI":"10.3109\/14992027.2015.1122239","article-title":"Effects of interventions on use of hearing protectors among farm operators: A randomized controlled trial","volume":"55 Suppl 1","author":"McCullagh","journal-title":"Int J Audiol"},{"key":"R32","unstructured":"Gold A Fung W Gabbard S Carroll D . Findings from the National Agricultural Workers Survey (NAWS) 2019\u20132020: a demographic and employment profile of united states farmworkers. US Department of Labor, Employment and Training Administration, Office of Policy Development and Research; 2022. URL: https:\/\/www.dol.gov\/sites\/dolgov\/files\/ETA\/publications\/ETAOP2022-16_NAWS_Research_Report_16_508c.pdf [Accessed 25-08-2026]"},{"key":"R33","unstructured":"Ornelas I Fung W Gabbard S Carroll D . California findings from the National Agricultural Workers Survey (NAWS) 2015\u20132019: a demographic and employment profile of california farmworkers. US Department of Labor, Employment and Training Administration, Office of Policy Development and Research; 2015. URL: https:\/\/www.dol.gov\/sites\/dolgov\/files\/ETA\/publications\/ETAOP2022-15_NAWS_Research_Report_15_508c.pdf [Accessed 25-08-2026]"},{"issue":"4","key":"R34","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1300\/J013v25n04_04","article-title":"Gender differences in blue collar workers\u2019 use of hearing protection","volume":"25","author":"Lusk","journal-title":"Women Health"},{"issue":"5","key":"R35","doi-asserted-by":"publisher","first-page":"611","DOI":"10.1080\/15298660108984660","article-title":"Is acculturation related to use of hearing protection?","volume":"62","author":"Rabinowitz","journal-title":"AIHAJ"},{"issue":"4","key":"R36","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1177\/216507990705500404","article-title":"Noise and hearing protection: Latino construction workers\u2019 experiences","volume":"55","author":"Robertson","journal-title":"AAOHN J"},{"key":"R37","doi-asserted-by":"publisher","DOI":"10.5888\/pcd9.110344","article-title":"Engaging a community in developing an entertainment-education Spanish-language radio novella aimed at reducing chronic disease risk factors, Alabama, 2010-2011","volume":"9","author":"Frazier","journal-title":"Prev Chronic Dis"},{"issue":"2","key":"R38","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1177\/1090198104263660","article-title":"Health promotion by social cognitive means","volume":"31","author":"Bandura","journal-title":"Health Educ Behav"},{"key":"R39","unstructured":"Bandura A . Social Learning Theory. Prentice Hall; 1977. ISBN: 9780138167448"},{"key":"R40","unstructured":"M\u00e1s vale usar protectores auditivos [Article in Spanish]. Mark Guiberson YouTube. Jun 18, 2015. URL: https:\/\/www.youtube.com\/watch?v=pBkROHDj2TA [Accessed 25-08-2026]"},{"issue":"2","key":"R41","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1080\/13576280110051055","article-title":"Community-based participatory research: policy recommendations for promoting a partnership approach in health research","volume":"14","author":"Israel","journal-title":"Educ Health (Abingdon)"},{"issue":"1","key":"R42","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1146\/annurev.publhealth.19.1.173","article-title":"Review of community-based research: assessing partnership approaches to improve public health","volume":"19","author":"Israel","journal-title":"Annu Rev Public Health"},{"key":"R43","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-4-50","article-title":"Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science","volume":"4","author":"Damschroder","journal-title":"Implement Sci"},{"issue":"1","key":"R44","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-019-0898-y","article-title":"The FRAME: an expanded framework for reporting adaptations and modifications to evidence-based interventions","volume":"14","author":"Wiltsey Stirman","journal-title":"Implement Sci"},{"key":"R45","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g1687","article-title":"Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide","volume":"348","author":"Hoffmann","journal-title":"BMJ"},{"key":"R46","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i6795","article-title":"Standards for Reporting Implementation Studies (StaRI) Statement","volume":"356","author":"Pinnock","journal-title":"BMJ"},{"key":"R47","unstructured":"QuickFacts: imperial county, California. US Census Bureau. 2026. URL: https:\/\/www.census.gov\/quickfacts\/fact\/table\/imperialcountycalifornia [Accessed 22-06-2026]"},{"key":"R48","unstructured":"Imperial valley agriculture. Imperial County Farm Bureau. 2026. URL: https:\/\/www.icfb.net\/imperial-valley-agriculture [Accessed 22-06-2026]"},{"key":"R49","doi-asserted-by":"crossref","unstructured":"Arcury TA Quandt SA . Community-based participatory research (CBPR) and other community-engaged research with latinx farmworker communities in the eastern United States. In: Justice TAA Quandt SA , editors. Latinx Farmworkers in the Eastern United States: Health, Safety, and Justice. Springer International Publishing; 2020:197-226. [doi: 10.1007\/978-3-030-36643-8_8]","DOI":"10.1007\/978-3-030-36643-8_8"},{"issue":"Suppl 1","key":"R50","doi-asserted-by":"publisher","first-page":"33S","DOI":"10.1097\/AUD.0000000000001183","article-title":"Community-Based Participatory Research and Human-Centered Design Principles to Advance Hearing Health Equity","volume":"43","author":"Marrone","journal-title":"Ear Hear"},{"issue":"3","key":"R51","doi-asserted-by":"publisher","first-page":"23","DOI":"10.29333\/ajqr\/14887","article-title":"Inter-coder agreement in qualitative coding: considerations for its use","volume":"8","author":"Halpin","journal-title":"Am J Qual Res"},{"issue":"1","key":"R52","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-017-0635-3","article-title":"Psychometric assessment of three newly developed implementation outcome measures","volume":"12","author":"Weiner","journal-title":"Implement Sci"},{"issue":"1","key":"R53","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-021-01111-5","article-title":"Rapid versus traditional qualitative analysis using the Consolidated Framework for Implementation Research (CFIR)","volume":"16","author":"Nevedal","journal-title":"Implement Sci"},{"issue":"1","key":"R54","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-019-0853-y","article-title":"Comparison of rapid vs in-depth qualitative analytic methods from a process evaluation of academic detailing in the Veterans Health Administration","volume":"14","author":"Gale","journal-title":"Implement Sci"},{"issue":"1","key":"R55","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-025-01450-7","article-title":"The Consolidated Framework for Implementation Research (CFIR) user guide: a five-step guide for conducting implementation research using the framework","volume":"20","author":"Reardon","journal-title":"Implement Sci"},{"key":"R56","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2025.1502489","article-title":"Noise-induced hearing loss in farmworkers: a scoping review","volume":"13","author":"Coco","journal-title":"Front Public Health"}],"container-title":["JMIR Research Protocols"],"original-title":[],"language":"en","deposited":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T20:21:41Z","timestamp":1791231701000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.researchprotocols.org\/2026\/1\/e93134"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,5]]},"references-count":56,"URL":"https:\/\/doi.org\/10.2196\/93134","relation":{},"ISSN":["1929-0748"],"issn-type":[{"value":"1929-0748","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,5]]},"article-number":"v15i3e93134"}}