Psychological correlates of hearing protective behaviors in adolescents and young adults: a systematic review.

Background: Noise-induced hearing loss is both irreversible and preventable. However, only a minority of adolescents and young adults engage in hearing protective behaviors (HPBs) that reduce their exposure to noise, such as wearing earplugs at music venues. To promote HPBs it is imperative to know the most influential, and potentially modifiable, psychological factors that in this age group stimulate or hinder these protective behaviors. Objective: The present study aims to offer a systematic literature overview of psychological correlates of HPBs in persons aged 12 to 25 years, and identify the correlates with most potential as behavioral intervention targets. Conclusions: A total of 82 studies were included in the present review, of which data of 24 studies could be used to assess the strength of the association between one or more psychological factors and HPB. Heterogeneity between studies hindered synthesis. In particular, psychological constructs and HPBs were rarely defined and measured in a uniform manner. Studies were further characterized by a lack of research on psychological factors related to other HPBs than earplug use, such as sound volume control (e.g. the use of a volume limiter). Due to this relative absence of data, associations could not be assessed for specific HPB, and HPBs were aggregated in one variable. Taking into account both the strength of their associations with HPB and their univariate distributions, five psychological factors possessed the greatest potential as behavioral intervention targets: attitude toward recreational noise, perceived barriers, capacity, perceived norms, and perceived threat susceptibility. These results can help the development of new interventions. Additional research is however needed.