Promoting Early Congenital Hearing Loss Diagnosis with Patient Navigation

Pediatric hearing loss is the most common neonatal sensory disorder in the United States. During the early years of life, the sense of hearing is vital for the optimal development of speech, language, and cognition. Deafness in early childhood can result in lifelong learning delay and disability leading to adulthood challenges in education, employment, and social life. Early identification and intervention can prevent these adverse consequences. National standards dictate that infants who are deaf or hard of hearing should be diagnosed by 3 months of age. Unfortunately, many infants from rural regions, such as Appalachia, fail to obtain or are delayed in receiving this diagnostic testing after abnormal infant screening at birth. This research seeks to rectify this health disparity by addressing non-adherence and delays in infant hearing loss detection through a patient navigator program (PNP). PNP have successfully decreased non-adherence to clinical testing in other healthcare settings but have not been utilized in early infant diagnostic testing. The hypothesis of this study is that a PNP will significantly reduce the non-adherence to and timing of diagnostic audiological testing. The specific aims are to 1) examine the efficacy of a PNP to decrease non-adherence to and subsequent timing of recommended infant audiological testing within 3 months after birth, in Appalachian subjects and 2) determine the maternal socioeconomic, educational, demographic and infant factors involved in non-adherence and delay to testing and treatment. We will accomplish these aims by enrolling mother-child dyads, in which the children fail newborn hearing screening, into a randomized prospective study. The navigator group will have weekly phone contact with a patient navigator after birth while the standard practice group will have no contact with a navigator. This research seeks to establish the efficacy of a PNP to improve adherence to pediatric hearing testing.