Hearing Loss Prevention Training for Spanish-Speaking Farmworkers: Protocol for a Community-Engaged Hybrid Type 1 Pilot Study.

Background: 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. Objective: 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. Methods: 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). Results: 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. Conclusions: 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.