American Journal of Audiology最新文献

{"title":"Behavior Management Strategies for Pediatric Hearing Aid Use: Provider Practices and Perspectives.","authors":"Julia E Wind, Karen Muñoz, Casey J Clay","doi":"10.1044/2026_AJA-26-00079","DOIUrl":"https://doi.org/10.1044/2026_AJA-26-00079","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to investigate provider practices and perspectives related to including behavior management as a strategy to increase hearing aid use in children.</p><p><strong>Method: </strong>The study used a cross-sectional survey design, and the sample (<i>N</i> = 171) included audiologists, speech-language pathologists, and early interventionists in the United States.</p><p><strong>Results: </strong>Most participants indicated that they view teaching behavior management strategies to caregivers as part of their role, and only 12% often or always collaborate with a behavior analyst to address behaviors that interfere with hearing aid use. Most participants did not receive graduate training in behavior management. Higher confidence scores in behavior management skills were associated with more experience working with children and more training in graduate school. The top reported challenges in teaching behavior management to parents included knowing how to address caregiver hesitancy, knowing how to identify caregiver internal barriers, and having enough time to address behaviors.</p><p><strong>Conclusion: </strong>This study provided insights into opportunities to expand how providers support caregivers to increase hearing aid use, including seeking training in behavior management and collaborating with experts in behavior analysis to assist in solving problems with hearing aid retention.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"1-11"},"PeriodicalIF":1.7,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149013240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socioeconomic and Demographic Trends of Cochlear Implant Recipients Who Use Sign Language: A National Database Analysis.","authors":"Christopher Z Wen, Elizabeth Lee, Charlyn N Gomez, Marcelina Puc, Danielle S Powell, David J Eisenman, Adam C Kaufman","doi":"10.1044/2026_AJA-25-00313","DOIUrl":"https://doi.org/10.1044/2026_AJA-25-00313","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to examine how the socioeconomic and demographic characteristics of American Sign Language (ASL)-communicating people with cochlear implants differ from those of the broader cochlear implant (CI) recipient population.</p><p><strong>Method: </strong>In this cross-sectional study, we identified 39,111 patients receiving CIs between 2015 and 2024 using the Epic Cosmos database. Of those, 1,070 (2.7%) people with cochlear implants indicated ASL as their preferred language. Chi-square, Fisher's exact, and two-sample <i>t</i> tests compared differences between ASL communicators and noncommunicators in terms of age, sex, race, ethnicity, insurance, explantation, socioeconomic status (SES)/social vulnerability index (SVI), and urban/rural categories. Univariate and multivariate analyses evaluated the association between these variables and explantation.</p><p><strong>Results: </strong>Pediatric ASL communicators were significantly older than pediatric noncommunicators, whereas adult ASL users were younger. Female (<i>OR</i> = 1.33), Hispanic (<i>OR</i> = 2.51), and urban (<i>OR</i> = 1.65) patients had increased odds of communicating with ASL. ASL users were more likely to be in the most vulnerable SES (<i>OR</i> = 1.69) and SVI (<i>OR</i> = 1.71) groups and undergo explantation (<i>OR</i> = 2.41). Multivariate analysis identified ASL (<i>OR</i> = 2.55) as the main associated variable with explantation. Pediatric patients were also associated with increased odds of being explanted (<i>OR</i> = 1.31).</p><p><strong>Conclusions: </strong>There are socioeconomic and demographic differences between Deaf people with cochlear implants and the general CI recipient population. Deaf identity may intersect with health considerations such as CI explantation, highlighting the need for culturally informed approaches to patient care.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"1-10"},"PeriodicalIF":1.7,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149013196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Voice Onset Time on Phoneme Perception and Implications for a Language-Agnostic Hearing Assessment.","authors":"Tiffany P Hwa, Christian Jung, Archer R Schaeffer, Natalie Riebe, Shreya Bathula, Jason A Brant, Jianjing Kuang, William J Bologna, Catherine V Palmer","doi":"10.1044/2026_AJA-26-00031","DOIUrl":"https://doi.org/10.1044/2026_AJA-26-00031","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to evaluate the effect of native language on phoneme perception in normal-hearing (NH) adults representing the three most commonly spoken languages in the United States (English, Spanish, and Mandarin Chinese).</p><p><strong>Method: </strong>A prospective cross-sectional study was performed at a tertiary care institution. Ninety-five NH young adults completed Experiment 1: 36 native English, 32 native Mandarin, and 27 native Spanish speakers, with an average age of 21.5 years, recruited from a university population. A subset of 30 NH participants drawn from the Experiment 1 cohort (10 per language group) completed Experiment 2. In Experiment 1, a two-alternative forced-choice (2AFC) same-different paradigm was developed using paired stimuli drawn from an 11-step continuum spanning English /d/-/t/ voice onset time (VOT). Pairs were categorized as subtle, intermediate, or pronounced based on degree of VOT contrast. Experiment 2 utilized a 3AFC odd-one-out paradigm with 16 tasks, with an expanded stimulus library. The stimuli were consonant-vowel (CV) and VCV phrases that were inclusive of voicing contrast but also place, manner, and vowel contrasts.</p><p><strong>Results: </strong>Overall performance in Experiment 1 did not differ significantly across language groups (χ² = 4.81, <i>p</i> = .090). However, when stratified by degree of VOT contrast, a significant group effect emerged for intermediate VOT pairs (χ² = 7.59, <i>p</i> = .023), driven by differences between Mandarin and Spanish speakers (χ² = 7.59, <i>p</i> = .0059, Bonferroni corrected). No significant differences were observed between English speakers and either of the other groups. In Experiment 2, all three language groups achieved 100% accuracy across phoneme pairs spanning multiple contrast types, with no language-related differences detected.</p><p><strong>Conclusions: </strong>While native language affects discrimination of intermediate VOT contrasts in NH adults, performance converges when using a broader set of stimuli. These results provide preliminary support for discrimination-based approaches to speech perception assessment and highlight the importance of stimulus selection and task design in minimizing language-related bias. Further studies are required to evaluate sensitivity and clinical applicability in more challenging listening environments and with hard of hearing populations.</p><p><strong>Supplemental material: </strong>https://doi.org/10.23641/asha.33470986.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"1-14"},"PeriodicalIF":1.7,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spatial Hearing in Individuals With Unilateral Peripheral Vestibular Disorders: An Exploratory Study.","authors":"Halime Sümeyra Sevmez, Meral Didem Türkyılmaz","doi":"10.1044/2026_AJA-26-00014","DOIUrl":"https://doi.org/10.1044/2026_AJA-26-00014","url":null,"abstract":"<p><strong>Purpose: </strong>This preliminary study aimed to examine spatial auditory perception and selected cognitive functions in individuals with unilateral peripheral vestibular disorders and clinically normal hearing.</p><p><strong>Method: </strong>Fifteen individuals with unilateral peripheral vestibular disorders and 18 age-matched healthy controls underwent audiological and cognitive assessments. Spatial hearing was evaluated, and cognitive performance was assessed to account for its potential influence on spatial hearing.</p><p><strong>Results: </strong>Exploratory analyses showed poorer spatial hearing performance in the vestibular group than in the control group. After adjustment for age and pure-tone average, significant group differences remained under the spatially separated condition (SV90) and for spatial advantage, whereas the difference under the co-located condition (SV0) was no longer statistically significant. Although tinnitus prevalence differed between groups, within-group analyses showed no significant association between tinnitus and spatial hearing performance. No statistically significant group differences were observed in cognitive performance.</p><p><strong>Conclusions: </strong>Unilateral peripheral vestibular dysfunction was associated with poorer spatial auditory performance, particularly under spatially separated listening conditions and in spatial advantage. Overall, the findings suggest that unilateral peripheral vestibular dysfunction may influence spatial hearing despite clinically normal hearing.</p><p><strong>Supplemental material: </strong>https://doi.org/10.23641/asha.33477991.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"1-11"},"PeriodicalIF":1.7,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148983845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Survey of U.S. Audiologists' Speech-in-Noise Testing Practice Patterns for Adults.","authors":"Ian B Mertes, Sadie T Braun, Curtis J Billings","doi":"10.1044/2026_AJA-25-00332","DOIUrl":"https://doi.org/10.1044/2026_AJA-25-00332","url":null,"abstract":"<p><strong>Purpose: </strong>Speech-in-noise (SIN) testing can be beneficial for both assessment and treatment of hearing loss in adults. Previous survey studies have suggested that SIN testing is underutilized among U.S. audiologists, but there are limited data on attitudes, facilitators, and barriers to SIN testing. The purpose of this study was to characterize SIN testing practice patterns for adults through a comprehensive survey.</p><p><strong>Method: </strong>This study utilized an anonymous online survey in Qualtrics. Eligible respondents were licensed U.S. audiologists who performed diagnostic testing on adults. Survey questions included demographics, patient populations seen, and SIN testing practices. Responses were analyzed using descriptive statistics, cross-tabulations, and associations.</p><p><strong>Results: </strong>A total of 275 completed responses were analyzed. Most respondents reported high confidence in selecting, performing, and interpreting SIN testing. Most also reported high clinical usefulness of SIN testing. Approximately half of respondents reported frequent usage of SIN testing, but usage depended on workplace setting. Validating patient reports of SIN difficulties was the most common reason for conducting SIN testing, while lack of time was the most common barrier. Confidence in performing SIN testing was significantly correlated with perceived clinical usefulness of SIN testing.</p><p><strong>Conclusions: </strong>Results suggest high confidence and frequent use of SIN testing in this sample of U.S. audiologists. Results also suggest that SIN testing may be used more for assessment than treatment (e.g., verifying outcomes with amplification). However, biases including self-selection bias and social desirability bias cannot be ruled out. Despite this, our characterization of practice patterns, facilitators, and barriers will contribute to future studies and solutions to better incorporate clinical use of SIN testing.</p><p><strong>Supplemental material: </strong>https://doi.org/10.23641/asha.33426493.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"1-18"},"PeriodicalIF":1.7,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148971878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hearing Aid Selection by Audiologists: A Qualitative Exploration of Clinical Decision Making.","authors":"Rachael Pennock, Amelia Van Pelt, Pamela Souza","doi":"10.1044/2026_AJA-26-00063","DOIUrl":"https://doi.org/10.1044/2026_AJA-26-00063","url":null,"abstract":"<p><strong>Purpose: </strong>There is limited evidence available to clearly guide an audiologist's selection of hearing aid technology levels. The purpose of this study was to explore the decision-making process of audiologists for hearing aid selection, with particular attention to the role of a patient's auditory lifestyle.</p><p><strong>Method: </strong>We completed semistructured interviews with 10 clinical audiologists; these audiologists varied in their years of clinical experience and hearing aid patient caseloads. We completed qualitative content analysis using an iterative inductive approach and identified recurrent codes and overarching practice patterns.</p><p><strong>Results: </strong>The data yielded 18 codes, condensed into four themes: (a) patient factors, (b) audiologist factors, (c) hearing aid characteristics, and (d) affordability; within patient factors, we observed a subtheme of auditory lifestyle. We identified two practice patterns followed by the audiologists in this sample: (a) vary technology-level recommendation according to patient characteristics or (b) recommend premium technology to all patients.</p><p><strong>Conclusions: </strong>While previous studies have indicated that audiologists use a patient's auditory lifestyle to guide their technology-level selection, we identified other factors of consideration and an alternative practice pattern. There is supportive and contrary evidence for both practice patterns identified. This invites future research to investigate how these practice patterns may impact patient outcomes, which may inform the development of evidence-based guidelines.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"1-14"},"PeriodicalIF":1.7,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148971957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Traditional and Virtual Reality-Based Vestibular Rehabilitation on Balance and Visual-Motor Skills in Children With Specific Learning Disorders: A Randomized Controlled Trial.","authors":"Melda Acar, Eyyup Kara, Meryem Seçen Yazıcı, Burak Kabiş, Zehra Koyuncu, Halide Çetin Kara, Işık Baltacı, Mesut Yavuz, Hasan Ahmet Özdogan","doi":"10.1044/2026_AJA-26-00030","DOIUrl":"https://doi.org/10.1044/2026_AJA-26-00030","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to determine whether children with specific learning disorders (SLDs) exhibit impairments in vestibular and balance functions compared with typically developing peers and to assess the efficacy of traditional and virtual reality (VR)-based vestibular rehabilitation in improving balance performance, vestibular function, visual-motor integration, and learning-related outcomes.</p><p><strong>Method: </strong>This randomized controlled study included 63 children aged 7-12 years: 42 children with SLD and 21 typically developing children as controls. All participants underwent baseline assessment of vestibular and balance performance using computerized dynamic posturography and videonystagmography (VNG). Children with SLD were randomly assigned to either a traditional or a VR-based vestibular rehabilitation group, administered twice weekly for 8 weeks. Vestibular and balance assessments were repeated in the rehabilitation groups postintervention. Academic performance and perceptual-motor integration were evaluated in children with SLD before and after rehabilitation using the Mathematics, Reading, and Writing Assessment Scale (MOYA) and the Bender-Gestalt Visual Motor Perception Test (BGT).</p><p><strong>Results: </strong>At baseline, children with SLD demonstrated significantly poorer balance performance on the Sensory Organization Test (SOT), Adaptation Test (AT), and Limits of Stability (LOS) compared with controls (<i>p</i> < .05), while VNG findings did not differ between groups (<i>p</i> > .05). Following rehabilitation, both intervention groups showed significant improvements in SOT, AT, and LOS parameters (<i>p</i> < .05). MOYA and BGT scores also improved significantly (<i>p</i> < .001). The VR-based rehabilitation group demonstrated greater improvement in vestibular-related balance scores and leftward saccadic velocity than the traditional group (<i>p</i> < .05).</p><p><strong>Conclusions: </strong>Vestibular rehabilitation may improve balance and functional outcomes in children with SLDs. Both traditional and VR-based approaches appeared beneficial, with VR-based rehabilitation showing a tendency toward further improvements in selected vestibular and oculomotor measures. These findings suggest that vestibular rehabilitation, including VR-assisted methods, may represent a complementary intervention in this population, although further studies are needed to clarify long-term effects.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"1-13"},"PeriodicalIF":1.7,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148971931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Stimulus Rate on Click and CE-Chirp-Evoked Auditory Brainstem Responses in Infants and Adults.","authors":"Sangamanatha Ankmnal Veeranna, Charles G Marx, Caroline Armstrong, Hasitha Wimalarathna","doi":"10.1044/2026_AJA-26-00042","DOIUrl":"https://doi.org/10.1044/2026_AJA-26-00042","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of the present study was to examine the effect of click and CE-Chirp stimulus rate on auditory brainstem responses (ABRs) in infants and adults. Traditional clinical measures were used to examine the responses. Also, the ABR time-frequency characteristics were explored using automated feature engineering.</p><p><strong>Method: </strong>ABRs were recorded from 37 infant ears and in 39 young adults. ABRs were recorded for both click and CE-Chirp stimuli at 70 dB nHL for different rates (23.3/s, 53.3/s, and 83.3/s).</p><p><strong>Results: </strong>Across all rates, both click and CE-Chirp-evoked ABRs showed similar Peak I latencies in infants and adults; however, Peak III and V latencies varied. Click-evoked ABRs were earlier in latencies when compared to CE-Chirp-evoked ABRs in both groups, whereas CE-Chirp-evoked ABRs were larger in amplitude compared to click-evoked ABRs. Stimulus-type-dependent changes in the absolute ABR latencies were observed as the stimulus rate was increased. The ABR time-frequency characteristics varied with stimulus rate and were dependent on the feature extraction method applied.</p><p><strong>Conclusions: </strong>The effect of click stimulus rate on ABRs in infants and adults demonstrated in this study agrees with published literature, but our findings with the CE-Chirp do not. Audiologists and researchers should be aware of differences in ABRs due to the effect of stimulus type and rate.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"1-15"},"PeriodicalIF":1.7,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148945996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distinguishing Misophonia From Nonclinical Sound Aversion: Emotional Response Profiles for Auditory Triggers.","authors":"Hana V Weiss, Kathy R Vander Werff","doi":"10.1044/2026_AJA-25-00333","DOIUrl":"https://doi.org/10.1044/2026_AJA-25-00333","url":null,"abstract":"<p><strong>Purpose: </strong>This study examined how individuals with and without clinically significant misophonia differ in trigger sounds, emotional response types, and reaction intensities to determine whether specific sound-emotion pairings distinguish misophonia from typical sound aversion.</p><p><strong>Method: </strong>A total of 168 participants (84 misophonia, 84 control) completed online surveys including the Duke-Vanderbilt Misophonia Screening Questionnaire (DVMSQ) for group classification and the Selective Sound Sensitivity Syndrome Scale Trigger Checklist, which assessed emotional responses and intensity ratings for 37 sounds. Demographic variables and comorbidities were examined as potential confounds. Heat map visualizations displayed sound-emotion relationships by group.</p><p><strong>Results: </strong>The misophonia group reported significantly more trigger sounds, higher DVMSQ scores, and higher emotional intensity across emotions than controls. While both groups frequently reported irritation, individuals with misophonia exhibited significantly higher frequencies of anger, disgust, distress, and panic, with large effect sizes for anger. Heat maps revealed that misophonia participants reported anger at significantly higher rates for 18 sounds, particularly eating and oral sounds, whereas controls predominantly experienced irritation. Demographic variables and mental health diagnoses showed minimal associations with primary outcomes and did not account for group differences in emotional response patterns.</p><p><strong>Conclusions: </strong>Misophonia was distinguished by experiencing anger and disgust rather than irritation, at substantially higher intensities, particularly to human-produced sounds. These findings suggest that emotional response type and intensity, assessed alongside trigger identification, may help audiologists as part of multidisciplinary teams differentiate clinical misophonia requiring intervention from typical sound aversion.</p><p><strong>Supplemental material: </strong>https://doi.org/10.23641/asha.33334227.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"1-17"},"PeriodicalIF":1.7,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148945966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using the Machine Learning Algorithm XGBoost to Understand the Correlates of Wearing Hearing Protection in Central States' Agricultural Producers.","authors":"Cheryl L Beseler, Ellen G Duysen, Risto H Rautiainen","doi":"10.1044/2026_AJA-25-00283","DOIUrl":"10.1044/2026_AJA-25-00283","url":null,"abstract":"<p><strong>Purpose: </strong>Hearing loss is a common work-related condition. Estimates suggest that 46%-86% of agricultural workers have hearing loss. Agricultural safety programs have been working to increase the use of personal protective equipment (PPE) to protect against noise, respiratory, and chemical exposures, but PPE use remains sporadic. The purpose of this study was to assess factors that might explain the use of hearing protection in agricultural operators working in seven states in the Central United States.</p><p><strong>Method: </strong>The Farm and Ranch Health and Safety Survey data collected in 2018, 2020, and 2023 were used for this study. We examined 24 potential correlates of wearing hearing protection. Bivariate analyses were conducted using a Wilcoxon two-sample test based on dichotomizing the frequency of hearing protection use at the median of 10%. We used XGBoost with training and testing data sets to identify the most important factors that explain wearing hearing protection.</p><p><strong>Results: </strong>The strongest predictors of wearing hearing protection was wearing respiratory and chemical PPE, followed by age. Noise exposure was low in importance. The use of hearing, respiratory, and chemical PPE followed a similar pattern over the age spectrum with chemical PPE use showing the most frequent use. Younger operators more frequently wore PPE.</p><p><strong>Conclusions: </strong>Wearing hearing PPE is more likely to be related to personality traits related to risk perception and less likely due to noise exposures. This is an important consideration when designing hearing loss prevention programs because messaging needs to address safety motivation and unrealistic optimism.</p><p><strong>Supplemental material: </strong>https://doi.org/10.23641/asha.32513328.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"955-964"},"PeriodicalIF":1.7,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148177081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}