Safe Listening Beliefs, Attitudes, and Practices Among Gamers and Esports Participants: International Web-Based Survey (Preprint)

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BACKGROUND The global rise of video gaming and esports has raised significant concerns about hearing loss due to loud sound exposure. While these activities provide entertainment and have applications in health care, the auditory health risks and behavioral factors influencing listening habits among gamers remain underexplored. Research is needed to develop tailored interventions that address the unique barriers, attitudes, and beliefs of gamers and esports participants, promoting safer listening practices and minimizing auditory health risks. OBJECTIVE This study aimed to explore listening behaviors, attitudes, and awareness regarding hearing health risks among video gamers and esports participants. The findings are intended to guide the design and implementation of technological features that encourage safer listening practices, in alignment with the World Health Organization’s Safe Listening initiative. METHODS An open web-based survey was conducted from September 2022 to January 2023, targeting video gamers and esports enthusiasts. Participants were recruited via World Health Organization social media platforms and outreach to stakeholders. The survey assessed gaming behaviors, listening habits, awareness about hearing health, beliefs, readiness to change listening behaviors, and communication preferences. Data were analyzed using descriptive statistics and multinomial logistic regression. RESULTS A total of 488 responses were collected, with 67.2% (n=328) of participants identifying as male, and 56.4% (n=275) having a college degree or higher. Of the respondents, 90.8% (n=443) were actively engaged in video gaming, while 54.9% (n=268) viewed esports, and 13.9% (n=68) participated in esports events. Notably, 24.8% (n=110) of gamers, 18.3% (n=49) of esports viewers, and 37.1% (n=23) of esports players reported using high or very high volume settings. Despite around half of the participants experiencing symptoms indicative of hearing damage (eg, ringing in the ears), only 34.3% (n=152) of gamers, 35.8% (n=92) of esports players, and 39.7% (n=27) of esports viewers reported taking sound breaks every hour. The study identified a balanced distribution across readiness-to-change stages, with 30.3% (n=148) in the precontemplation stage, 35.3% (n=173) in the contemplation stage, and 34.2% (n=167) in the action stage. Factors such as perceived susceptibility to hearing loss, perceived benefits of preventive action, and self-efficacy significantly influenced readiness to change. Communication preferences indicated that 51% (n=249) of participants were interested in receiving more information on hearing health, with health care professionals and governmental agencies being the most trusted sources. CONCLUSIONS The findings highlight an urgent need for interventions to promote safe listening practices among gamers, emphasizing a gap between awareness and preventive action. The integration of safe listening features into video games and esports platforms, along with targeted communication strategies, can enhance auditory health awareness and protective behaviors. Future research should evaluate the effectiveness of these interventions to ensure comprehensive auditory health protection in the digital entertainment sector.

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