Turn up, plug in, rock out: An intervention study to promote hearing protection uptake and sustained use for noisy recreational settings

by | 7 May 2024 | Seminar Series | 0 comments

For the MCHP seminar series in February 2024 Dr. Samuel Couth and Dr. Michael Loughran presented details on a recreational hearing protection intervention deployed at Bluedot music, science, and arts festival 2022/23. Sam was the lead on this unique project with Michael assisting during the design, implementation and analysis. For the purposes of this blog details of the 2022 randomised control trial are discussed. Improved hearing conservation is not only an academic pursuit, but a personal one, as both Sam and Michael are avid music enthusiasts and long-term users of earplugs in music settings (e.g., gigs).


Only 2% of people in the UK regularly use hearing protection (e.g., earplugs) recreationally, even though most gigs can average 100 dBA or more, which can affect our hearing in 15 minutes or less, if unprotected. Preliminary work (Michael’s PhD) found that users of earplugs had greater motivation (automatic and reflective) than non-users, have been influenced by friends/family/peers (social influences), and that most people feel there is a lack of good quality earplugs in music venues. Theoretically, 24 Behaviour Change Techniques (BCTs; the active ingredients of interventions) were identified that may help future interventions, and so we set out to test some of these in the real world at Bluedot.

Outline of the study

Anyone 18+ years attending the festival could take part if they visited the ManCAD public engagement stall, consented, and completed a baseline questionnaire (e.g., previous use of earplugs, behavioural constructs). Both control and experimental groups were provided free, high-quality, reusable “musicians” earplugs (e.g., high fidelity: preferred compared to foam earplugs). Provision of earplugs meant all participants were exposed to a core set of BCTs (e.g., adding object to the environment), while the experimental group had the additional BCT ‘action planning’ built into their questionnaire in the form of constructing a plan of when they would use their earplugs. Mainly, we wanted to find out if:

  1. The provision of high-quality, reusable “musicians’” earplugs leads to uptake and sustained use of recreational hearing protection behaviours.
  1. The use of ‘action planning’ further improves uptake and sustained use of recreational hearing protection behaviours

Uptake of behaviour was measured via a questionnaire emailed one week after the festival, and sustained behaviour was measured six months post festival.


Over the weekend 312 people took part (baseline), 167 completed the week one follow-up, and 129 completed the six month follow-up. Although there were no significant differences between the two groups in terms of uptake (at 1-week) and sustained use (at 6-months) of behaviour, collectively the provision of earplugs did lead to high levels of uptake (82%) and sustained use (85%) compared to baseline (68%). On this occasion action planning didn’t further improve use compared to provision alone. We also measured improved scores for motivation (automatic/reflective) and opportunities (physical/social) to use earplugs compared to baseline.


The high levels of earplugs use found within this study at follow-up are unprecedented within this field, and we feel immensely proud of this fact. However, it must be considered that levels were high at baseline. Potential reasons being that Bluedot festival is predominately a music and science festival, with the average age of participants in the study being 40+ years, and having a high level of education, which may have equated to an already highly aware group of people. Similar interventions need to take place in different settings to compare.  It is also important to note that what made this study unique was that it was embedded within a public engagement stall. This allowed us to have a constant stream of participants over a three day period, and it is potentially an avenue for researchers to utilise in the future.

Future plans

There remains many BCTs to test within different live music environments to further improve earplug use; however, the provision of high quality earplugs to attendees is essential.

Many thanks to everyone that helped make this study happen at Bluedot, it was a real team effort. Special thanks to our industrial collaborator (Advanced Communication Solutions; ACS) for providing us with our earplugs, and to our funders: School of Health Sciences Social Responsibility Dragon’s Den Award; Psychology, Communication and Human Neuroscience Divisional Funding Award; MRC Summer Research Studentship; Manchester Centre for Health Psychology; NIHR Manchester Biomedical Research Council.

About the Authors:

Dr. Samuel Couth is a Lecturer within Manchester Centre for Audiology and Deafness (ManCAD) and Dr. Michael Loughran is a research associate and audiologist with MCHP and ManCAD.