• KAMARUL AKMAL ISHAK Department of Audiology and Speech Sciences, Kullliyah of Allied Health Sciences, International Islamic University of Malaysia, 25200 Kuantan, Pahang, Malaysia
  • NORAIDAH ISMAIL Department of Audiology and Speech Sciences, Kullliyah of Allied Health Sciences, International Islamic University of Malaysia,
  • SARAH RAHMAT Department of Audiology and Speech Sciences, Kullliyah of Allied Health Sciences, International Islamic University of Malaysia,
Keywords: Education, Hearing loss, Noise, Leisure activities, Adolescent


Exposure to leisure noise among the youth has grown into a public health concern. It was reported that attitudes and behaviours are essential factors in determining how well someone takes care of their hearing. An educational hearing conservation programme (EdHCP) can be an effective way to educate and to induce behavioural changes. The objective of this study is to develop and to validate a Malay version of EdHCP known as Bisinglah BEB! (in English: HEY! It’s Loud!) targeting the Malaysian youth. The present study comprised of four phases, namely; i) content and module development, ii) content validation, iii) content modification, and iv) pre-testing. Five learning modules were developed; Module One (Sound energy), Module Two (Anatomy and hearing mechanisms), Module Three (Hearing loss), Module Four (How loud the sound), and Module Five (How to protect our hearing). The module and contents of the programme possessed good content validity result (S-CVI/Ave value at 0.935). Several modifications were done accordingly, and agreement among the participants in pre-testing was excellent (95-100%). Bisinglah BEB! was informative and produced a high content-validity result. However, the effectiveness of the programme in changing attitude, knowledge, and behaviour towards noise exposure needs to be investigated before the real implementation in Malaysian youth.


Morata TC. Young people: Their noise and music exposures and the risk of hearing loss. Int J Audiol 2007; 46(3):111-2.

Danhauer JL, Johnson CE, Byrd A, et al. Survey of College Students on iPod Use and Hearing Health. J Am Acad Audiol 2009; 20(1): 5-27.

Zhao F, Manchaiah VK, French D, et al. Music exposure and hearing disorders: An overview. Int J Audiol 2010; 49(1):54-64.

Beach EF, Gilliver M, Williams W. Leisure noise exposure: participation trends, symptoms of hearing damage, and perception of risk. Int J Audiol 2013; 52(Suppl 1):20-5.

Carter L, Williams W, Black D, Bundy A. The leisure-noise dilemma: hearing loss or hearsay? What does the literature tell us? Ear Hear 2014; 35(5):491-505.

Jiang W, Zhao F, Guderley N, Manchaiah V. Daily music exposure dose and hearing problems using personal listening devices in adolescents and young adults: A systematic review. Int J Audiol 2016; 55(4):197-205.

World Health Organization (WHO). 1.1 billion people at risk of hearing loss. Media release 2015. Available from: (accessed 3 February 2020).

Peng JH, Tao ZZ, Huang ZW. Risk of damage to hearing from personal listening devices in young adults. J Otolaryngol 2007; 36(3):181-5.

Lee GJC, Lim MY, Kuan AYW, et al. The music listening preferences and habits of youths in Singapore and its relation to leisure noise-induced hearing loss. Singapore Med J 2014; 55(2):72-7.

Widén SE, Holmes AE, Erlandsson SI. Reported hearing protection use in young adults from Sweden and the USA: Effects of attitude and gender. Int J Audiol 2006; 45(5):273-80.

Warner-Czyz AD, Cain S. Age and gender differences in children and adolescents’ attitudes toward noise. Int J Audiol 2016; 55(2):83-92.

Widén SE, Erlandsson SI. The influence of socio-economic status on adolescent attitude to social noise and hearing protection. Noise Health 2004; 7(25):59-70.

Keppler H, Dhooge I, Vinck B. Hearing in young adults. Part I: The effects of attitudes and beliefs toward noise, hearing loss, and hearing protector devices. Noise Health 2015; 17(78):237-44.

Stansfeld S, Clark C. Health effects of noise exposure in children. Curr Envir Health Rpt 2015; 2(2):171-8.

Su JY, Guthridge S, He VY, Leach A. The impact of hearing impairment on early academic achievement in Aboriginal children living in remote Australia: a data linkage study. BMC Public Health 2020; 20(1):1-13.

Brown CS, Emmett SD, Robler SK, Tucci DL. Global hearing loss prevention. Otolaryngol Clin North Am 2018; 51(3):575-92.

Huddle MG, Goman AM, Kernizan FC, Foley DM, Price C, et al. The economic impact of adult hearing loss: A systematic review. JAMA Otolaryngo Head Neck Surg 2017; 143(10):1040-8.

Folmer RL. Hearing-Loss Prevention Practices Should Be Taught in Schools. Semin Hear 2008; 29(1):67-80.

ichey RC, Klein JD. Design and Development Research. In: Spector J., Merrill M., Elen J., Bishop M. (eds) Handbook of Research on Educational Communications and Technology. Springer, New York, NY: 2014.

Ishak KA, Ismail N, Rahmat S. Classroom-Based Educational Hearing Conservation Programme: Addressing the Contents and Challenges. International Journal of Allied Health Sciences 2021; 4(4): 1644-56.

Rosenstock IM, Strecher VJ, Becker MH. Social learning theory and health belief model. Health Educ Q 1988; 15(2):175-83.

Bandura A. Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice-Hall:1986.

Rogers B, Meyer D, Summey C, et al. What makes a successful hearing conservation program?. AAOHN J 2009; 57(8):321-37.

Lass NJ, Woodford CM, Lundeen C, et al. A hearing-conservation program for a junior high school. Hearing J 1987a; 40:32-40.

Anderson KL. Hearing conservation in the public schools revisited. Semin Hear 1991; 12(4):340-64.

Lawshe CH. A quantitative approach to content validity. Pers Psychol 1975; 28(4):563-75.

Lynn MR. Determination and quantification of content validity. Nurs Res 1986; 35(6):382-5.

Teles LM, Oliveira AS, Campos FC, et al. Development and validating an educational booklet for childbirth campanions. Rev Esc Enferm USP 2014; 48(6):977-84.

Zamanzadeh V, Ghahramanian A, Rassouli M, et al. Design and Implementation Content Validity Study: Development of an instrument for measuring Patient-Centered Communication. J Caring Sci 2015; 4(2):165-78. Keeping the sounds of Kompang alive (updated 2019 29 April 2019; cited 19 January 2020]. Available from:

Wall K, Higgins S, Smith H. ‘The visual helps me understand the complicated things’: Pupil views of teaching and learning with interactive whiteboards. Br J Educ Tech 2005; 36(5):851-67.

Ljubojevic M, Vaskovic V, Stankovic S, et al. Using supplementary video in multimedia instruction as a teaching tool to increase efficiency of learning and quality of experience. International Review of research in Open and Distance Learning 2014; 15(3):275-91.

Martin WH, Griest SE, Sobel JL, Howarth LC. Randomised trial of four noise-induced hearing loss and tinnitus prevention interventions for children. Int J Audiol 2014; 52(sup1):S41-S49.

Beach EF, Nielsen L, Gilliver M. Providing earplugs to young adults at risk encourages protective behaviour in music venues. Glob Health Promot 2016; 23(2):45-56.

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