Identifying barriers and facilitators of hearing protection use in early-career musicians: a basis for designing interventions to promote uptake and sustained use

Objective: The current study aimed to: i) determine the patterns of hearing protection device (HPD) use in early-career musicians, ii) identify barriers to and facilitators of HPD use, and iii) use the Behaviour Change Wheel (BCW) to develop an intervention to increase uptake and sustained use of HPDs. Design: A mixed-methods approach using questionnaires and semi-structured interviews. Study sample: Eighty early-career musicians (age range = 18–26 years; women n = 39), across all categories of musical instrument. Results: 42.5% percent of participants reported using HPDs at least once a week, 35% less than once a week, and 22.5% reported never using HPDs for music-related activities. Six barriers and four facilitators of HPD use were identified. Barriers include the impact of HPDs on listening to music and performing, and a lack of concern about noise exposure. Barriers/facilitators were mapped onto the Theoretical Domains Framework. Following the systematic process of the BCW, our proposed intervention strategies are based on ‘Environmental Restructuring’, such as providing prompts to increase awareness of noisy settings, and ‘Persuasion/Modelling’, such as providing credible role models. Conclusions: For the first time, the present study demonstrates the use of the BCW for designing interventions in the context of hearing conservation.