In Pursuit of Successful Hearing Screening: An Exploration of Factors Associated with Follow-Up Return Rate in a Risk-Based Newborn Hearing Screening Programme

Background: One of the most common problems noted in newborn hearing screening (NHS) programmes is the high rate of infants that are lost to follow-up at various stages of the programme. Objectives: The current study aimed to explore factors associated with follow-up return rate in a risk-based newborn hearing screening programme. Methods: A longitudinal, repeated measures research design was employed. Caregivers of participants who did not keep appointments while enrolled in a NHS programme were contacted to determine reasons for non-attendance. Results: Two hundred and sixteen of the 325 participants (66.5%) returned for the repeat screening. Follow-up return rate decreased significantly to below 50% for follow up diagnostic assessment. Reasons for non-attendance varied, with the most common reason being change of residential location. Results indicated a significant, but weak association between the hospital and whether or not infants returned for the repeat screening. The mean maternal age of mothers who returned with their newborns for diagnostic assessment was significantly higher than that of those who did not return. Conclusions: Reasons for follow-up default are influenced by contextual challenges, but may be improved by aligning appointments with other medical follow-up services. Follow-up return rate in the current study highlights the need to explore the need for risk-based surveillance programmes, as well as why follow-up return rates may differ between hospitals.