Comparing Vocal Health and Attitudes to Voice care in Primary Teachers and Voiceover Artists – A Survey Study Using the Health Belief Model

A range of professions experience high demands on their voices and are potentially at risk of developing voice disorders. Teachers have been studied extensively in this respect, while voiceover artists are a growing professional group with unknown levels of voice training, voice problems and voice care attitudes. To better understand profession-specific voice care requirements, we compared voice training, voice care habits and self-reported voice problems of these two professional groups and measured attitudes to voice care, informed by the Health Belief Model (HBM). The study was a cross-sectional survey study with two cohorts. We surveyed 264 Scottish primary school teachers and 96 UK voiceover artists . Responses were obtained with multiple-choice and free-text questions. Attitudes to voice care were assessed with Likert-type questions that addressed five dimensions of the HBM. Most voiceover artists had some level of voice training, compared to a minority of teachers. Low numbers of teachers reported regular voice care, compared to over half of voiceover artists. Higher numbers of teachers reported work-related voice problems. Voiceover artists reported greater awareness for vocal health and perceived potential effects of voice problems on their work as more severe. Voiceover artists also saw voice care as more beneficial. Teachers perceived barriers to voice care as substantially higher and felt less confident about voice care. Teachers with existing voice problems showed increased perceptions of voice problem susceptibility and severity and saw more benefit in voice care. Cronbach's alpha was below 0.7 for about half of the HBM-informed survey subsets, suggesting that reliability could be improved. Both groups reported substantial levels of voice problems, and different attitudes to voice care suggest that the two groups require different approaches to preventative intervention. Future studies will benefit from the inclusion of further attitude dimensions beyond the HBM.