Better late than never? Maternal biopsychosocial predictors of late follow-up from new Jersey's early hearing detection and intervention program

Zeitlin, Wendy; McInerney, Maryrose; Aveni, Kathryn; Scheperle, Rachel A.; Chontow, Kira

doi:10.1016/j.ijporl.2021.110708

Cited by 6 publications

(10 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Multiple studies reported variability in diagnostic test batteries, leading to the need for multiple tests to confirm hearing loss (Windmill & Windmill 2006; Muñoz et al 2011; Findlen et al 2019). Given that repeated testing contributes to loss-to-follow-up (Zeitlin et al 2021), an evidence-based, effective, and efficient test battery is critical at the diagnostic stage. Finally, some of the LTFU reported by state EHDI programs can be attributed to loss-to-documentation, as some diagnostic centers may be completing testing but not reporting results to their state EHDI program (Soto et al 2016).…”

Section: Resultsmentioning

confidence: 99%

“…The quality of the diagnostic assessment and the preparation of families for the diagnostic appointment can significantly improve diagnostic assessment completion and timing. Facilitation of quality testing can be achieved by using an evidence-based test battery with proactive scheduling (scheduling the diagnostic at the time of referred screening or scheduling follow-up testing before families leave medical facilities) (Findlen et al 2019; Sapp et al 2021; Zeitlin et al 2021), using more experienced clinicians, and providing preappointment instructions to families to maximize the natural sleep state (Awad et al 2019; Shanker et al 2019; Zeitlin et al 2021). Ultimately, these approaches can lead to fewer appointments needed for confirmation of hearing loss and earlier diagnosis.…”

Section: Resultsmentioning

confidence: 99%

“…Lack of economic stability places infants at higher risk for either not completing the EHDI process or having delays in their completion across all steps in the journey, for example, if they came from families with low income (Hoffman et al 2011; Bush et al 2015b; Elpers et al 2016; Cunningham et al 2018; Roman et al 2021) or who used public assistance programs or public insurance (Auerbach et al 2013; Cunningham et al 2018; Zeitlin et al 2021). Public insurance was a significant factor specifically at the diagnostic step of the EHDI journey (Liu et al 2008; Deem et al 2012; Auerbach et al 2013; Crouch et al 2017; Meyer et al 2020; Sapp et al 2021) while financial concerns arose for funding hearing technology during the management step (Holte et al 2012; Muñoz et al 2013).…”

Section: Resultsmentioning

confidence: 99%

“…Related to care coordination is the idea of colocating services. This review found that pairing follow-up services with other medical appointments (Christensen et al 2008) or social services (Hunter et al 2016; Zeitlin et al 2021) contributed to reducing LTFU. This is consistent with previous reports from the Vermont EHDI Program, which facilitated a quality improvement study to reduce LTFU for outpatient rescreening by partnering with physicians throughout Vermont to complete needed follow-up in each county (Jordan & Hazard 2015).…”

Section: Discussionmentioning

confidence: 99%

“…Transient middle ear dysfunction contributes to delays in diagnosis and timely management (Muñoz et al 2011;Holte et al 2012;Larsen et al 2012;Awad et al 2019;Findlen et al 2019). Higher maternal depression ratings after birth are associated with higher likelihood of loss-to-follow-up (Zeitlin et al 2019(Zeitlin et al , 2021. Lastly, a general lack of adherence to follow-up recommendations leads to delays or noncompletion of EHDI steps (Muñoz et al 2011;Stuart 2016;Findlen et al 2019).…”

Section: Barriers To Effective Ehdi Entire Ehdi Journey Individual/fa...mentioning

confidence: 99%

See 4 more Smart Citations

Barriers to and Facilitators of Early Hearing Detection and Intervention in the United States: A Systematic Review

et al. 2022

View full text Add to dashboard Cite

Objectives: Early hearing detection and intervention (EHDI) is guided by the 1-3-6 approach: screening by one month, diagnosis by 3 mo, and early intervention (EI) enrollment by 6 mo. Although screening rates remain high, successful diagnosis and EI-enrollment lag in comparison. The aim of this systematic review is to critically examine and synthesize the barriers to and facilitators of EHDI that exist for families, as they navigate the journey of congenital hearing loss diagnosis and management in the United States. Understanding barriers across each and all stages is necessary for EHDI stakeholders to develop and test novel approaches which will effectively reduce barriers to early hearing healthcare.Design: A systematic literature search was completed in May and August 2021 for empirical articles focusing on screening, diagnosis, and EI of children with hearing loss. Two independent reviewers completed title and abstract screening, full-text review, data extraction, and quality assessments with a third independent reviewer establishing consensus at each stage. Data synthesis was completed using the Framework Analysis approach to categorize articles into EHDI journey timepoints and individual/family-level factors versus system-level factors.Results: Sixty-two studies were included in the narrative synthesis. Results revealed that both individual/family-level (e.g., economic stability, medical status of the infant including middle ear involvement) and system-level barriers (e.g., system-service capacity, provider knowledge, and program quality) hinder timely diagnosis and EI for congenital hearing loss. Specific social determinants of health were noted as barriers to effective EHDI; however, system-level facilitators such as care coordination, colocation of services, and family support programs have been shown to mitigate the negative impact of those sociodemographic factors. Conclusions:Many barriers exist for families to obtain appropriate and timely EHDI for their children, but system-level changes could facilitate the process and contribute to long-term outcomes improvement. Limitations of this study include limited generalizability due to the heterogeneity of EHDI programs and an inability to ascertain factor interactions.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Barriers To Effective Ehdi Entire Ehdi Journey Individual/fa...mentioning

confidence: 99%

See 3 more Smart Citations

Barriers to and Facilitators of Early Hearing Detection and Intervention in the United States: A Systematic Review

et al. 2022

View full text Add to dashboard Cite

show abstract

Newborn Hearing Screening Success… Patient Care Failure

Jennings,

Isaacson

2024

The Laryngoscope

View full text Add to dashboard Cite

ObjectiveTo assess the efficacy of a newborn hearing screening program in an urban hospital 24 years after a longitudinal study identified failings in its program and recommended solutions.MethodsA hospital‐specific, Pennsylvania database was queried to determine rates of in‐hospital testing, referral, and diagnosis for Temple University Hospital (TUH), and to compare these with reporting sites statewide. At TUH, interviews with newborn hearing screeners and audiologists were conducted to identify barriers to care.ResultsIn the year 2022, 2,006/2,069 newborns (97%) were successfully screened prior to hospital discharge at TUH. (63 babies were never tested). There were 73 who did not pass automated auditory brainstem response testing (ABR) in at least one ear. All of these 73 infants returned for repeat automated ABR testing and 50/73 passed in both ears. 23/2006 (1%) were referred to diagnostic testing. 13/23 were successfully scheduled. 11/23 passed in both ears. 2/13 were found to have hearing losses. 10 infants (43%) were lost to follow‐up and were never diagnosed. Examining lost‐to‐follow‐up rates statewide, we identified a relationship between successful follow‐up and local median family income.ConclusionLegislation on the state level and improvements in audiometric technology have led to highly successful in‐hospital screening with relatively low false‐positive rates. Despite this, inadequate outpatient follow‐up testing and inequities in the American health care system continue to delay audiometric diagnosis and habilitation of congenital hearing loss. Lack of transportation, childcare for siblings, and newborn insurance status impede access to diagnostic testing.Level of evidence: Level 3 evidence—retrospective review comparing cases and controls. Laryngoscope, 2024

show abstract

Examining Barriers to Early Hearing Diagnosis

Findlen,

Gerth,

Zemba

et al. 2024

Am J Audiol

View full text Add to dashboard Cite

Purpose: Many factors create barriers for early hearing detection and intervention (EHDI), especially those related to unfavorable social determinants of health (SDOH). The primary aim of this study was to evaluate diagnostic timing of infants at risk for congenital hearing loss in consideration of known barriers. Understanding the specific barriers to early diagnosis can inform interventions to improve timeliness of diagnosis and subsequent habilitation. Method: A retrospective chart review was completed for infants referred for diagnostic audiologic testing at a tertiary urban-setting Children's Hospital from 2018 to 2021. After exclusion criteria were applied, 1,488 infants were included in the analysis. Various factors were recorded from electronic medical records including those specific to SDOH. Time to diagnosis was derived and compared across five factors of interest that have previously been shown to impact diagnostic timeline, including (a) insurance type, (b) race/ethnicity, (c) presence of middle ear dysfunction at first auditory brainstem response (ABR), (d) proximity to diagnostic center, and (e) diagnostic timing before and during/after the COVID-19 pandemic. Results: Across the study time period, 77% of infants referred for diagnostic testing had confirmed diagnosis by the EHDI benchmark of 3 months. Analysis of time to diagnosis across factors of interest revealed no clinically significant differences for insurance type, race/ethnicity, proximity to diagnostic center, or timing in reference to the COVID-19 pandemic. Presence of middle ear dysfunction on first ABR was found to significantly protract final diagnostic timing. Conclusions: Although some known barriers for EHDI can be universal, other factors may have a differential impact on an infant's timeline to diagnosis based on their specific location, which can interact differently with additional known barriers. Understanding local challenges will serve to better guide programs in implementing facilitators that will address their specific needs for improved outcomes.

show abstract

Better late than never? Maternal biopsychosocial predictors of late follow-up from new Jersey's early hearing detection and intervention program

Cited by 6 publications

References 38 publications

Barriers to and Facilitators of Early Hearing Detection and Intervention in the United States: A Systematic Review

Barriers to and Facilitators of Early Hearing Detection and Intervention in the United States: A Systematic Review

Newborn Hearing Screening Success… Patient Care Failure

Examining Barriers to Early Hearing Diagnosis

Contact Info

Product

Resources

About