Pediatric Hearing Healthcare in Kentucky’s Appalachian Primary Care Setting

Matthew L. Bush, David Alexander, Bryce Noblitt, Cathy Lester, Jennifer B. Shinn

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


Diagnosis and intervention for infant hearing loss is often delayed in areas of healthcare disparity, such as rural Appalachia. Primary care providers play a key role in timely hearing healthcare. The purpose of this study was to assess the practice patterns of rural primary care providers (PCPs) regarding newborn hearing screening (NHS) and experiences with rural early hearing diagnosis and intervention programs in an area of known hearing healthcare disparity. Cross sectional questionnaire study. Appalachian PCP’s in Kentucky were surveyed regarding practice patterns and experiences regarding the diagnosis and treatment of congenital hearing loss. 93 Appalachian primary care practitioners responded and 85 % reported that NHS is valuable for pediatric health. Family practitioners were less likely to receive infant NHS results than pediatricians (54.5 versus 95.2 %, p < 0.01). A knowledge gap was identified in the goal ages for diagnosis and treatment of congenital hearing loss. Pediatrician providers were more likely to utilize diagnostic testing compared with family practice providers (p < 0.001). Very rural practices (Beale code 7–9) were less likely to perform hearing evaluations in their practices compared with rural practices (Beale code 4–6) (p < 0.001). Family practitioners reported less confidence than pediatricians in counseling and directing care of children who fail newborn hearing screening. 46 % felt inadequately prepared or completely unprepared to manage children who fail the NHS. Rural primary care providers face challenges in receiving communication regarding infant hearing screening and may lack confidence in directing and providing rural hearing healthcare for children.

Original languageEnglish
Pages (from-to)762-768
Number of pages7
JournalJournal of Community Health
Issue number4
StatePublished - Aug 1 2015

Bibliographical note

Funding Information:
This publication was supported by funding from the National Institutes of Health (MLB, 8 KL2 TR000116-02) and the National Institute of Deafness and Other Communication Disorders (MLB, 1U24-DC012079-01). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. Matthew L. Bush is a consultant for Med El Corporation. None of the authors have any conflicts of interest to report.

Publisher Copyright:
© 2015, Springer Science+Business Media New York.


  • Congenital hearing loss
  • Health disparity
  • Rural healthcare

ASJC Scopus subject areas

  • Health(social science)
  • Public Health, Environmental and Occupational Health


Dive into the research topics of 'Pediatric Hearing Healthcare in Kentucky’s Appalachian Primary Care Setting'. Together they form a unique fingerprint.

Cite this