BackgroundMost farmers are exposed to potentially hazardous noise levels through many of their work activities, such as operating tractors, grain dryers, and chain saws. Rates of noise-induced hearing loss in this group are high. Although this condition is preventable through the use of hearing protection, rates of protective device use are low. Understanding factors influencing the use of hearing protection devices will provide direction for programs to increase their use and decrease risk of noise-induced hearing loss.ObjectivesA study was designed using the Pender Health Promotion Model to identify factors affecting farmers’ use of hearing protection devices.MethodModel testing was conducted with a convenience sample of 139 farmers. Prior to model testing, existing instruments designed to measure concepts from the Health Promotion Model were modified for use with farmers through interviews, validity testing with an expert panel, and reliability testing with first a small (n= 36) then a second larger (n= 139) convenience sample of farmers. Instruments measuring cognitive and affective factors related to hearing protection device use were administered to farmers at a regional farm show in the Midwest.ResultsA logistic regression analysis identified interpersonal support, barriers, and situational influences as statistically significant predictors of this health behavior, correctly predicting 78% of the cases. Results of model testing were consistent with results of previous studies of Health Promotion Model variables with other worker groups’ use of hearing protection.ConclusionsInformation from this study can be used to design and evaluate interventions to promote hearing protection device use among farmers and reduce the level of noise-induced hearing loss in this high-risk and underserved worker group.