Evaluation of Hearing Conservation In-Processing Procedures at a U.S. Marine Corps Accession Point

Purpose: Recent Department of Defense policy changes for hearing conservation programs mandate hearing protector fit testing (HPFT) for many noise-exposed populations. However, the implementation of this requirement across various clinical scenarios is not yet defined. This Quality Improvement (QI) study evaluated the efficacy of current educational procedures at a U.S. Marine Corps (USMC) accession point by performing HPFT before and after small-group training. Method: The QI study employed a pre- and postgroup design to evaluate the effectiveness of training. HPFT was conducted on 122 USMC recruits before and after small-group instruction during hearing conservation in-processing. A field microphone-in-real-ear system was used to calculate the personal attenuation rating for each participant. Additionally, 48 recruits returned for a 1-month follow-up to repeat the fit test procedure. Results: Small-group HPD training resulted in a mean personal attenuation rating improvement of 14.6 dB among a cohort of USMC recruits. One month after training, a decrease in PAR was observed, yet outcomes remained notably higher than baseline, indicating sustained training effectiveness. Conclusions: This study highlights the utility of small-group HPD training in improving immediate fit-test outcomes. Implementing these procedures at large-scale in-processing events, such as military accession points, should be considered a viable option. Future research should focus on long-term maintenance strategies, as sustaining these outcomes over time remains a challenge.