Noise-induced hearing loss (NIHL) is the second most common form of hearing deficit, affecting about 26 million American adults. In addition, about one in eight children have NIHL in the US (~5.2 million children), and it is estimated that 20% of US adolescents have hearing loss. We propose the development of a social game to educate teenagers about NIHL, and promote healthy hearing behaviors with the potential to improve hearing health care, by developing and translating technologies that address the following existing barrier listed in RFA-DC-12-004: "Knowledge Barriers-health literacy and language barriers can inhibit healthcare delivery, including the patient's knowledge of their healthcare needs." There is an untapped potential to disseminate healthcare programs through social games (e.g. in Facebook), where the majority of teens spend time online, with the potential to educate and promote healthy behaviors. Our novel social game called "Noisy City" (NC) will leverage the power of social networks, as a program to increase the awareness about NIHL and how to prevent it. NC will contain education on NIHL and gaming components to promote healthy hearing behaviors (e.g. identify noise sources, avoid long exposure to loud sounds, use ear protection, do a hearing test, etc.). NC game story: teen wakes up in the mysterious Noisy City, full of loud noises and dangerous decibels. Player discovers that his/her destiny is to become a Rock Star to change the city, while preserving "hearing power." NC will be "designed to entertain" (content: 70% entertainment | 30% education) by applying fun activities, entertaining storytelling, cool avatars, growing challenges, reinforcing feedback, mystery, comic relief, aesthetic graphics, other game mechanics, and social game strategies. This is expected to increase user motivation, improve knowledge, promote healthy behaviors, and encourage teens to play/share the game. NC integrates an adventure game, social features, and learning modules. NC features a virtual city, where the game character wants to "become a Rock Star" and is exposed to loud sounds (e.g. room with loud music, concerts, sporting events, etc.). Healthy behaviors (e.g. wear ear plugs) will be rewarded with extra points. Game levels will be unlocked by watching NC videos about NIHL, and users will be motivated to invite friends in Facebook to participate (e.g. form a band, help in the game, send virtual gifts like musical instruments, etc.) Teens may have a deeper knowledge of healthy behaviors and be more engaged with games (than listening to a lecture for example), as games help to build character: players experience consequences of good/bad behaviors in the game, which are internalized by players ("they may think/feel as their avatars", e.g. "hearing power damaged due to loud noise"), and no longer limited to an abstract concept that happens to other people. Innovation: research on social game-based interventions is an unexplored field. NC is one of the first Facebook social games for NIHL prevention (if not the first).
Noise-Induced Hearing Loss (NIHL) is a progressive, irreversible, permanent, and preventable condition that tends to occur subtly over the course of several years;and according to the Centers for Disease Control and Prevention (CDC), an estimated 12.5% of children and adolescents aged 6-19 years (approximately 5.2 million) and 17% of adults aged 20-69 years (approximately 26 million) have suffered permanent damage to their hearing from excessive exposure to noise. NIHL is a very important public health problem, particularly for children (~5.2 million children with NIHL), as they are not aware of the problem, and most people don't realize their hearing is damaged until it is seriously enough to impede their ability to communicate (usually when they are much older). As children are at risk for permanent hearing loss by long exposure to high-level sounds (e.g. loud music or video, spectator sports, concerts, etc.), more effective prevention programs are needed, such as the proposed Noisy City social game to increase the awareness of NIHL and how to prevent it, with a high potential for user engagement and dissemination through Facebook (the largest and most adopted online social networking).