Research & Publications
Disability and Health Journal Article
American Society of Pediatric Otolaryngology Poster Abstract
Community Health Worker Intervention for Newborns Failing Initial Universal Hearing Screening
Stephen Leong, BA, Kristy Medina, MPH, Patricia J. Peretz, MPH, Maria I. Olmeda-Jenkins, MA, CCC-A, Melissa A. Oliver, MED, Megan Kuhlmey, AuD, CCC-A, Stacey A. Bernstein, MS, CCC-SLP, Luz Adriana Matiz, MD, Anil K. Lalwani, MD
Universal newborn hearing screening (UNHS) is effective in identifying infants with possible hearing loss (HL). Initial inpatient UNHS has been universally implemented in hospital systems, but outpatient follow-up for newborns failing initial screening remains an area for improvement. In this study, we evaluate the effectiveness of community health worker (CHW) intervention in promoting adherence to outpatient rescreening for newborns failing UNHS.
A retrospective cohort study was performed to evaluate CHW intervention at a tertiary care center. Families of newborns who had failed initial UNHS were contacted by CHWs prior to discharge, educated about HL, importance of follow-up screening, and of their scheduled rescreening appointments. Outreach intervention was performed for 297 newborns failing initial screening between May 2020 and June 2021 and compared to cohort of 238 newborns without CHW intervention between March 2019 and June 2021. Clinical and demographic data for all newborns failing initial UNHS was collected. Statistical analyses were conducted using 2x2 chi-square tests and two-tailed unpaired t-tests.
In the intervention group, 236 of 297 infants (79.5%) completed their outpatient follow-up rescreening; in the control group, 170 of 238 infants (71.4%) completed their follow-up rescreening (p=0.031). In the intervention group, the average time to follow-up was 13.4 days vs. 12.5 days for the historical group (p=0.449). Follow-up screening identified 10 infants with SNHL in the intervention group (3.4%) vs. 11 infants in the control group (4.6%)(p=0.458); continued CHW assistance to meet the social, medical, and educational need of the child were offered to these families.
CHW outreach intervention increases adherence to outpatient follow-up rescreening for newborns failing initial UNHS. Expansion of nursery teams to include CHWs may thus improve completion of recommended follow-up hearing screens.