Community Health Worker Intervention for Newborns Not Passing Initial Universal Hearing Screening
Stephen Leong1, Kristy Medina2, Patricia J Peretz2
1Vagelos College of Physicians & Surgeons, Columbia University, New York, NY, USA.
Insights
Community health workers (CHWs) significantly improved adherence to follow-up hearing screenings for newborns referred from universal newborn hearing screening (UNHS). This intervention enhances critical early detection of hearing loss (HL).
Area of Science:
- Pediatrics
- Public Health
- Audiology
Background:
- Universal newborn hearing screening (UNHS) effectively identifies infants with potential hearing loss (HL).
- Improving outpatient follow-up adherence for referred newborns is crucial for timely intervention.
- Community health worker (CHW) interventions show promise in addressing this follow-up gap.
Purpose of the Study:
- To evaluate the efficacy of a CHW intervention in increasing adherence to outpatient rescreening for newborns referred from UNHS.
- To assess the impact of CHW outreach on follow-up completion rates and timeliness.
Main Methods:
- A mixed prospective-retrospective cohort study compared newborns with and without CHW intervention.
- CHWs provided education on HL and follow-up importance to caregivers of referred newborns.
- Statistical analyses included Chi-square tests, t-tests, and regression models.
Main Results:
- Newborns in the CHW intervention group showed significantly higher follow-up rescreening completion rates (79.5%) compared to the control group (71.4%) (P=.031).
- The CHW intervention resulted in a statistically significant increase in adherence (OR=1.55, P=.04).
- No significant difference was observed in the average time to follow-up between the groups (P=.449).
Conclusions:
- CHW outreach intervention can effectively increase adherence to recommended outpatient follow-up rescreening after initial UNHS.
- Integrating CHWs into nursery teams may improve the completion rates of essential follow-up hearing screens for newborns.
- This strategy supports early identification and management of hearing loss in infants.
Background:
Universal newborn hearing screening (UNHS) is effective in identifying newborns with possible hearing loss (HL). Outpatient follow-up for newborns referred after hospital-based screening remains a potential area of improvement. In this study, we evaluate the efficacy of a community health worker (CHW) intervention in promoting adherence to outpatient rescreening for newborns referred after initial UNHS.
Methods:
A mixed prospective-retrospective cohort study was performed to evaluate a CHW intervention at an academic medical center. Caregivers of referred newborns were contacted by CHWs prior to discharge and educated about HL and the importance of follow-up screening. The CHW outreach intervention was performed for 297 referred newborns between May 2020 and June 2021 and compared to a cohort of 238 newborns without the CHW intervention between March 2019 and June 2021. Statistical analyses were conducted using 2 × 2 Chi-square tests, two-tailed unpaired t-tests, multinomial logistic regression, and multiple linear regression.
Results:
In the intervention group, 236 of 297 newborns (79.5%) completed their outpatient follow-up rescreening; in the comparison group, 170 of 238 newborns (71.4%) completed their follow-up rescreening (P = .031, OR = 1.55 with regression P = .04). In the intervention group, the average time to follow-up was 13.4 days versus 12.5 days for the comparison group (P = .449, multiple R2 = .02 with P = .78).
Conclusions:
CHW outreach intervention may increase adherence to outpatient follow-up rescreening for newborns referred after initial, hospital-based UNHS. Expansion of nursery teams to include CHWs may thus improve completion of recommended follow-up hearing screens.
