Preferred and commonly reported modes of delivering hearing conservation information among construction workers in a low- and middle-income context

Abstract

Hearing conservation programs rely on effective communication to translate risk information into protective behavior. Little empirical evidence exists on how hearing conservation information (HCI) is delivered and received within low- and middle-income country (LMIC) construction settings. Drawing on principles from occupational health communication and health literacy, this study examined commonly reported modes through which HCI is delivered to construction workers in South Africa and explored workers’ preferred methods of receiving such information. A cross-sectional mixed-methods design was employed, using a structured paper-based questionnaire. Quantitative data were analyzed using descriptive and exploratory inferential statistics, while qualitative responses were analyzed thematically. Verbal communication emerged as both the most commonly reported (67.7%) and most preferred (73.3%) mode of HCI delivery. Written materials and mobile app-based digital methods were infrequently used and perceived as inaccessible or impractical. Preferences were shaped by language diversity, literacy constraints, and the communicative demands of construction work, with lower levels of formal education significantly associated with a preference for verbal communication (χ2 = 5.01, p = 0.03). These findings suggest communication mode is a key determinant of accessibility and engagement, rather than demonstrating effectiveness. Verbal, multilingual, and participatory communication approaches should therefore be prioritized in such contexts, with written and mobile application-based digital communication tools used as supplementary supports.