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Original Investigation |

Parent Perception of Newborn Hearing Screening Results of a US National Survey

Melissa A. Pynnonen, MD, MSc1; Jaynee A. Handelsman, PhD2; Ericka F. King, MD2,3; Dianne C. Singer, MPH4,5; Matthew M. Davis, MD, MAPP4,5,6,7; Marci M. Lesperance, MD2
[+] Author Affiliations
1Divisions of Laryngology, Rhinology, and General Otolaryngology, University of Michigan Health System, Ann Arbor
2Division of Pediatric Otolaryngology, Department of Otolaryngology–Head and Neck Surgery, University of Michigan Health System, Ann Arbor
3Department of Otolaryngology–Head and Neck Surgery, Oregon Health & Science University, Portland
4Division of Child Health Evaluation and Research Unit, University of Michigan Health System, Ann Arbor
5Department of Pediatrics and Communicable Diseases, University of Michigan Health System, Ann Arbor
6Department of Internal Medicine, University of Michigan Health System, Ann Arbor
7Gerald R. Ford School of Public Policy, University of Michigan, Ann Arbor
JAMA Otolaryngol Head Neck Surg. 2016;142(6):538-543. doi:10.1001/jamaoto.2015.3948.
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Importance  An unacceptably high number of children who do not pass universal newborn hearing screening (UNHS) are lost to follow-up.

Objectives  To provide insight into parent recall of UNHS.

Design, Setting, and Participants  In this nationally representative cross-sectional survey, 2144 US parent households were surveyed in May 2012 using the Knowledge Panel. Responses of parents whose children were born before vs after UNHS implementation were compared.

Main Outcomes and Measures  Outcome measures included recall of hearing screen at birth, hearing screen results, and recommendations for follow-up. All outcome measures were based on parent recall and report. Descriptive statistics and multiple logistic regression analyses were used.

Results  The study participants included 1539 parent households and 605 nonparent households. Of the 1539 parent households surveyed, the mean age of the parents was 38.8 years (range, 18-88 years), the mean age of the children was 10.2 years (range, 0-17 years), and the mean age of children with hearing loss was 12.1 years (range, 0-17 years). A total of 1539 parents (55.8%) were women. Only 62.9% of parents (unweighted n = 950) recalled a newborn hearing screen, and among those children with risk indicators for hearing loss (n = 587), only 68.6% (unweighted n = 385) recalled a hearing screen. Higher parent educational level (odds ratio [OR], 2.27; 95% CI, 1.17-4.41, for some college and OR, 2.41; 95% CI, 1.22-4.78, for a bachelor’s degree; P = .03), younger age of the child (OR, 1.16; 95% CI, 1.11-1.23; P < .001), and the presence of any risk indicator for hearing loss (OR, 1.5; 95% CI, 1.13-2.13; P = .007) were associated with parent recall of hearing screen. Reported pass rates were higher than expected. Parent recall of follow-up recommendations was not always consistent with guidelines.

Conclusions and Relevance  Although this study is inherently limited by recall bias, the findings indicate a lack of parent awareness of UNHS. Changes in the system of reporting UNHS results are necessary to improve parent recall of screen results and improve follow-up for children who do not pass the screen.

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Figure.
Newborn Hearing Implementation by State

The temporal dispersion of universal newborn hearing screening as it was implemented across the United States from 1994 to 2009.

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