Introduction The purpose of this study is to evaluate the effectiveness of a community based, multi dimensional noise induced hearing loss (NIHL) and tinnitus prevention program in American Indian elementary school children. NIHL is responsible for 30% of all hearing loss nationally and is almost 100% preventable with simple measures.

Methods Baseline questionnaires identifying knowledge, attitudes and behaviours regarding sound exposures of 4 ^th and 5^th grade student of an Oregon Tribal School were completed. Community intervention includes use of local media modalities, presentation of a classroom education program, and a community/family event and booster intervention with a web-based virtual museum exhibit. Post intervention and 3 month follow-up questionnaires will be collected to evaluate short and long-term changes in parameters

Results Information was provided to the community via Tribal newspaper, radio and web sources. Baseline questionnaires were completed by 130 students. 160 students received the Dangerous Decibels classroom program. 225 children, friends and family attended an evening event furthering the education. Students self-reported a wide range of hazardous sound exposures, most listening to loud music and fireworks. Over 31% reported regular exposure to live gunfire. 18% use hearing protection frequently. 53% reported being around sounds that were loud enough to cause pain or tinnitus.

Conclusions These results indicate that the target population of the study is at risk for NIHL and related tinnitus. This is a first attempt at improving hearing health in a Tribal community through community based intervention.