19th ANNUAL EARLY HEARING DETECTION & INTERVENTION MEETING
March 8-10, 2020 • Kansas City, MO
3/10/2020 | 10:10 AM - 10:40 AM | Maternal Risk Factors Associated with Loss to Follow-Up for Diagnosing Hearing Loss in Georgia Infants Who Failed Newborn Hearing Screening, 2015-2018 | Empire A
Maternal Risk Factors Associated with Loss to Follow-Up for Diagnosing Hearing Loss in Georgia Infants Who Failed Newborn Hearing Screening, 2015-2018
Background: Permanent hearing loss in children <5 years is a neurological emergency requiring timely diagnosis and intervention. Infants who fail hearing screening are referred to an audiologist, but some are lost to follow-up (LFU). This study investigated maternal risk factors associated with LFU among Georgia infants who failed hearing screening, to reduce LFU among infants with these risk factors through tailored follow-up strategies. Methods: Georgia infants born during 2015-2018 who had a “Refer” screening result for >=1 ear were identified. Screening records were linked to birth certificate records to obtain maternal risk factors, and to diagnostic records to determine LFU. Infants who were LFU were stratified by maternal age, race/ethnicity, country of maternal birth, primary language, education, marital status, insurance, county of residence, and WIC enrollment. A multivariate logistic regression model was used to calculate odds ratios and 95% confidence intervals of LFU adjusted for each risk factor. Multicollinearity and interaction between risk factors were evaluated. Results: Of 5,910 Georgia infants born during 2015-2018 who failed hearing screening, 2,205 (37.3%) were LFU. Compared to White non-Hispanic infants in the 29-county Atlanta Metropolitan Statistical Area (MSA), Black non-Hispanic infants had 2.5 times (p<.0001) and Hispanic infants 1.5 times (p<.0001) greater odds of being LFU. Among infants with unmarried mothers, infants whose mothers were on Medicaid had 2.3 times greater odds of being LFU than infants whose mothers had private insurance (p=.006). Infants whose mothers received WIC had 29% decreased odds of being LFU than infants whose mothers did not (p<.0001). Conclusions: Risk factors associated with LFU among Georgia infants are complex. Behavioral economic strategies are needed to increase follow-up among Black non-Hispanic and Hispanic infants in the Atlanta MSA, and among infants with unmarried mothers on Medicaid. Families with children needing audiological follow-up are currently flagged in WIC records, mitigating LFU.
- Identify risk factors associated with loss to follow-up for diagnosing hearing loss after a failed newborn hearing screening.
- Apply the methods and findings of this study to identify populations with greater odds of being lost to follow-up for diagnosing hearing loss.
- Discuss follow-up strategies that may reduce loss to follow-up for diagnosing hearing loss.
Presentation:
21060_12785MichaelLo.pdf
Handouts:
Handout is not Available
Transcripts:
CART transcripts are NOT YET available, but will be posted shortly after the conference
Presenters/Authors
Michael Lo
(), Georgia Department of Public Health, michael.lo@dph.ga.gov;
Michael Lo is a Newborn Surveillance Epidemiologist supporting the EHDI Program at the Georgia Department of Public Health. Prior to working in EHDI, he was an Injury Epidemiologist at the Florida Department of Health and an Injury Epidemiologist Contractor at the U.S. Army Aeromedical Research Laboratory, where he collaborated with research audiologists on a retrospective cohort study of hearing loss and tinnitus in military personnel with deployment-related mild traumatic brain injury. He received a B.A. in Biology from Johns Hopkins University and an M.S.P.H. in Epidemiology from the University of South Florida.
ASHA DISCLOSURE:
Financial -
• Receives Grants for Other activities from Centers for Disease Control and Prevention (CDC).
Nonfinancial -
No relevant nonfinancial relationship exist.
Jerusha Barton
(), Georgia Department of Public Health, jerusha.barton@dph.ga.gov;
Jerusha E. Barton is the Newborn Surveillance Team Lead and Birth Defects Epidemiologist at the Georgia Department of Public Health.
ASHA DISCLOSURE:
Financial -
No relevant financial relationship exist.
Nonfinancial -
No relevant nonfinancial relationship exist.
Joseph Bryan
(), Georgia Department of Public Health, michael.bryan@dph.ga.gov;
Dr. J. Michael Bryan is the Director of Maternal and Child Health Epidemiology at the Georgia Department of Public Health.
ASHA DISCLOSURE:
Financial -
Nonfinancial -
Brandt Culpepper
(), Georgia Department of Public Health , brandt.culpepper@dph.ga.gov;
Dr. Brandt Culpepper is the Early Hearing Detection and Intervention Program Team Lead at the Georgia Department of Public Health. She received her B.S. and M.S. degrees from the University of Georgia and her Ph.D. from the University of Washington. She has more than 30 years of experience as an audiologist with interest in infant and pediatric audiology. She has worked in public health, clinical, medical, and academic environments. Dr. Culpepper has no financial interests in corporate organizations with products that may be relevant to presentation.
ASHA DISCLOSURE:
Financial -
No relevant financial relationship exist.
Nonfinancial -
No relevant nonfinancial relationship exist.
Judith Kerr
(), Georgia Department of Public Health , judith.kerr@dph.ga.gov;
Judith Kerr is the Child Health Screening Senior Manager at the Georgia Department of Public Health. In this role, she oversees programs for newborn screening (metabolic screening, screening for hearing loss and critical congenital heart defects) and developmental screening during early childhood, to strengthen the system of identification and referral for children at risk for poor health, behavioral or developmental outcomes. The goal of these programs is that children are identified and linked to care as early as possible so they may start school healthy and ready to learn.
ASHA DISCLOSURE:
Financial -
Nonfinancial -
Cherie Drenzek
(), Georgia Department of Public Health, cherie.drenzek@dph.ga.gov;
Dr. Cherie L. Drenzek is the State Epidemiologist and Chief Science Officer at the Georgia Department of Public Health.
ASHA DISCLOSURE:
Financial -
Nonfinancial -