International journal of pediatric otorhinolaryngology · 2026
Effect of social determinants of health on adherence to the early hearing detection and intervention 1-3-6 benchmarks at University of Rochester Medical Center.
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Pauley Jordan, Jeoung Sarah, Rieth Katherine K S, Allen Paul, Ashrafioun Christina, Faria John
Аннотация
INTRODUCTION: Loss to follow-up is a significant barrier to successful implementation of Early Hearing Detection and Intervention (EHDI) 1-3-6 benchmarks. This study evaluated adherence to EHDI 1-3-6 benchmarks and explored predictors of delayed or incomplete follow-up.
METHODS: This was a retrospective cohort study with patients born between January 1, 2020, and December 31, 2024, at two hospitals within one health system. Patients admitted to the neonatal intensive care unit were excluded. Demographic, audiologic outcome, and social determinants of health information were collected. The primary outcome was on-time completion, and secondary outcome was completion at any time.
RESULTS: A total of 22,451 patients were included. 22,433 (99.92%) completed the initial newborn hearing screen (NBHS). Out of 194 patients who were recommended follow-up, 159 (82%) completed all milestones with 49 (25%) completed them on time. The highest rate of loss to follow-up occurred at the 1-month outpatient screening milestone. Younger maternal ages (p = 0.01), Black race (p = 0.004), and increased Area Deprivation Index (ADI) scores (p = 0.02) were associated with delayed completion. Maternal use of American Sign Language (p = 0.02) and Black race (p = 0.02) ) were associated with not completing milestones.
CONCLUSION: Timely adherence of EDHI milestones was significantly lower. Higher ADI was associated with delayed completion. Black race and maternal use of American Sign Language were associated with not completing milestones. These findings highlight a need for targeted interventions to improve timely completion of EHDI milestones.
METHODS: This was a retrospective cohort study with patients born between January 1, 2020, and December 31, 2024, at two hospitals within one health system. Patients admitted to the neonatal intensive care unit were excluded. Demographic, audiologic outcome, and social determinants of health information were collected. The primary outcome was on-time completion, and secondary outcome was completion at any time.
RESULTS: A total of 22,451 patients were included. 22,433 (99.92%) completed the initial newborn hearing screen (NBHS). Out of 194 patients who were recommended follow-up, 159 (82%) completed all milestones with 49 (25%) completed them on time. The highest rate of loss to follow-up occurred at the 1-month outpatient screening milestone. Younger maternal ages (p = 0.01), Black race (p = 0.004), and increased Area Deprivation Index (ADI) scores (p = 0.02) were associated with delayed completion. Maternal use of American Sign Language (p = 0.02) and Black race (p = 0.02) ) were associated with not completing milestones.
CONCLUSION: Timely adherence of EDHI milestones was significantly lower. Higher ADI was associated with delayed completion. Black race and maternal use of American Sign Language were associated with not completing milestones. These findings highlight a need for targeted interventions to improve timely completion of EHDI milestones.