Efficacy of technology-based interventions to increase the use of hearing protections among adolescent farmworkers.

This was a pilot with 50 participants analysed after follow-up, and 20 or fewer in each group, so it had limited power to detect differences between training formats. Loss to follow-up was substantial: 70 students enrolled and 50 completed follow-up. Only two schools were randomised to each arm, and the analysis did not account for clustering by school. There was no no-training control group, so pre-to-post changes cannot be separated from time, seasonal farm work or receiving hearing protection devices. All groups received earplugs and earmuffs, so the contribution of training format versus device provision cannot be separated. Hearing-protection use was self-reported and measured over only six weeks, while baseline questions covered two full farming seasons. The composite hearing-protection-use outcome was newly created and not previously validated. Missing values for specific farm tasks were not imputed. Participants' correct insertion of hearing protection was not supervised or verified during the follow-up period. Findings are from rural Iowa FFA students and may not generalise elsewhere.

Do not conclude that computer training or classroom plus app training are superior because they showed the largest changes. The between-group differences were not significant, the study was a small pilot with 50 participants analysed, and every participant also received earplugs and earmuffs, so training format cannot be separated from device provision.