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Updated: May 26, 2026

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Improving communication between doctors and parents after newborn screening
Michael H Farrell1, Stephanie A Christopher, Audrey Tluczek
1Center for Patient Care and Outcomes Research, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI 53226, USA. mfarrell@mcw.edu
Insights
Newborn screening (NBS) quality improvement is feasible for tracking psychosocial outcomes. Communication effectiveness varied, with parents having lower health literacy reporting less favorable experiences.
Area of Science:
- Genetics
- Public Health
- Psychosocial Medicine
Background:
- Newborn screening (NBS) facilitates early intervention but raises concerns about potential psychosocial complications for families identified with carrier status.
- Bioethical considerations necessitate careful communication strategies following genetic screening in infants.
Purpose of the Study:
- To describe the methods and assess the feasibility of a statewide project in Wisconsin focused on improving communication and psychosocial outcomes after newborn screening.
- To evaluate the effectiveness of communication strategies used to inform parents about their infant's carrier status.
Main Methods:
- Contacting primary care providers (PCPs) upon identification of carrier status for cystic fibrosis or sickle cell to rehearse informing parents.
- Following up with parents three months post-screening via telephone to assess knowledge, psychosocial outcomes, and provide resources.
- Administering anonymous evaluation surveys to parents regarding their experience with the communication process.
Main Results:
- Accurate PCP information was obtained for 73% of infants, with an additional 21% identified through other means.
- PCPs were reached in time for rehearsal for 47.3% of cases, with 60% accepting the invitation.
- 50.2% of eligible parents were successfully contacted; 61% recalled a PCP explanation, and 48.5% viewed it favorably, though parents with limited health literacy reported less favorable evaluations.
Conclusions:
- The study demonstrates the feasibility of monitoring parents for psychosocial outcomes following newborn screening.
- Preliminary findings on communication are mixed, indicating a need for further investigation into the associations between communication quality and psychosocial outcomes.
Background:
Newborn screening (NBS) enables early treatment, and some consider it a natural vehicle for genetic screening. Bioethicists argue for caution since families of infants with carrier status can develop psychosocial complications. This paper describes the methods and feasibility of Wisconsin's statewide project for quality improvement of communication and psychosocial outcomes after NBS.
Methods:
When NBS identifies carrier status for cystic fibrosis or sickle cell, we contact primary care providers (PCPs), answer questions, and invite them to rehearse informing the parents. Three months later, we telephone the parents, assess knowledge and psychosocial outcomes, provide counseling, and assist with self-referral to further resources. Afterward, evaluation surveys are provided to the parents, to be returned anonymously.
Results:
Birthing facilities provided accurate PCP names for 73% of 817 infants meeting inclusion criteria; we identified PCPs for 21% more. We reached 47.3% of PCPs in time to invite a rehearsal; 60% of these accepted. We successfully called 50.2% of eligible parents; 61% recalled a PCP explanation, and 48.5% evaluated the explanation favorably. Evaluations by parents with limited health literacy were less favorable.
Conclusion:
It is feasible to follow parents for psychosocial outcomes after NBS. Preliminary data about communication is mixed, but further data will describe psychosocial outcomes and investigate outcomes' associations with communication.
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