Factors Related to Not Following Up with Recommended Testing in the Diagnosis of Newborn Hearing Loss

Abstract

Children's hearing is a public health concern, and universal newborn hearing screenings are the first step in detecting and treating congenital hearing loss. Despite the high rate of participation in such programs, loss to follow-up (LTF) with additional recommended diagnosis and treatment has been a persistent problem. The current research seeks to expand the knowledge base at the point of diagnosis, where there is a large drop-off in parents following through with recommended care. This research was organized around the following question: What biopsychosocial factors are associated with LTF between screenings and diagnostic evaluations? A prospective quantitative longitudinal study tracked 203 families whose newborns were referred for additional testing at discharge from the hospital after birth. Binary logistic regression was used to determine what constellation of factors best predicted LTF. Psychosocial factors related to being lost to follow-up at diagnosis included race and ethnicity and access to health care professionals, with African American babies being most at risk for LTF; however, the impact of race and ethnicity declined when parents believed they had more health care professionals with whom to consult.

Factors Predicating Loss to Follow-Up With Rescreening in Early Hearing Detection and Intervention Programs

“…The results from the SEM indicate that both maternal depression and believing that hearing loss can have serious consequences for their child’s life significantly predicted LTF at rescreening, with social support moderating maternal depression, and effect sizes indicate that these differences may have important practical significance. These results are not consistent with previous research that examined biopsychosocial factors related to LTF at the point of diagnosis, which indicated that LTF was most associated with parents’ race/ethnicity and access to health-care professionals (Zeitlin et al, 2017).…”

“…A prospective study identifying predictors of LTF at diagnosis included race/ethnicity and access to health-care professionals (Zeitlin, Auerbach, Mason, Spivak, & Reiter, 2017). In that study, parents who identified as African American were less likely to return for diagnostic testing than individuals of all other racial/ethnic groups.…”

Disparities in access to pediatric hearing health care

“…17 Regarding follow-up after failed newborn hearing screening, there is also evidence in urban areas that African American babies are at a significant higher risk of being lost to follow-up and have limitations in access to care. 23 …”

A triagem auditiva neonatal no processo de diagnóstico e reabilitação auditiva

“…Embora estatisticamente as crianças que realizaram a TAN tenham concluído mais precocemente o diagnóstico de PA do que as que não a realizaram, As dificuldades de ingresso no atendimento especializado foram relatadas por 30% dos pais/ responsáveis, sendo que o acesso a profissionais de saúde é fator relevante para a adesão das famílias aos procedimentos de diagnóstico e intervenção audiológica, após falha na TAN: quanto maior o acesso, maior a adesão 28 .…”