Barriers and facilitators to neurodevelopmental follow-up among at-risk newborns across Washington State

Identify barriers and facilitators to neurodevelopmental follow-up (NDFU) for high-risk neonates in Washington (WA).

Cross-sectional, mixed-methods study of NDFU centers and neonatal intensive care units (NICUs) across WA to characterize NDFU referral and scheduling practices and identify barriers and facilitators to NDFU attendance.

Response rates were 84% for NDFU centers and 94% for NICUs. Barriers to NDFU attendance included logistical limitations (n=10, 63%) and scheduling processes (n=10, 63%), while facilitators included provider relationships and communication (n=8, 50%) and community-based access (n=8, 50%). No NICU respondent reported receiving any post-discharge communication from NDFU centers regarding patient developmental outcomes.

Integrating anticipatory guidance and family education before NICU discharge with home-based services and telehealth may improve access to essential developmental follow-up care in this high-risk population. Interventions to increase NDFU attendance should prioritize family-centered communication, reduced logistical burdens, and flexible models of care delivery.