Abstract:Background: Occupational noise-related hearing disorders (ONRHD) remain a critical health concern in the palm oil industry. Despite regulatory frameworks, implementation gaps persist due to limited targeted interventions. This study aims to develop and validate a culturally tailored Hearing Conservation Program (HCP) for palm oil mill workers using a multi-method approach. Methods: The development of the HCP involved triangulation of various data sources. A literature review was conducted to understand the local and international regulatory requirements and to review various research on the HCP. A walk-through survey and document review were carried out to understand work processes, work practices, and organisational behaviour in the palm oil mills. An in-depth interview with program users, implementers, and policymakers was also conducted to explore the barriers and facilitators to various strategies for preventing occupational noise-related hearing disorders in the mills. Content validation of the HCP was conducted by five expert panel members, who assessed its relevance, comprehensiveness, and clarity. The Hearing Conservation Program Training component was pre-tested among 30 palm oil mill workers. Results: A comprehensive HCP was developed incorporating seven key elements. The content validation demonstrated excellent agreement among experts. The Scale-Content Validity Index/Average (S-CVI/Ave) scores for comprehensiveness and relevance were 1.000 and 0.975 for clarity. Corrections were made based on feedback before pre-testing. In the pre-test phase, more than 96% of participants agreed that the materials were clear and comprehensive. Minor refinements were made, but the training materials were retained in their final form based on overall positive feedback. Conclusion: The development and validation of the HCP demonstrated strong content validity and acceptability among end users. These findings support its implementation in later stages of the study and emphasise the importance of evidence-informed occupational health interventions in the palm oil industry. This contributes to global efforts to prevent ONRHD and to promote workers’ health equity.
Keywords: Non-Communicable Diseases (NCDs), hearing disorders, hearing loss, hearing conservation program, occupational noise, palm oil mill
