Better late than never? Maternal biopsychosocial predictors of late follow-up from new Jersey's early hearing detection and intervention program

Objectives: Early hearing detection and intervention programs are designed to mitigate consequences of hearing loss in infants. Most research examining compliance with program protocols has examined factors related to being lost to follow-up. Another group that warrants study are babies who return for follow-up outside the timelines recommended by public health organizations. This research seeks to identify maternal factors that are associated with late follow-up at the point of diagnosis of hearing loss. Study design: The sampling frame for this study included all babies born in New Jersey in a two-year period. Our final sample consisted of 716 babies who needed diagnostic evaluations and completed them. Five hundred twenty-six babies completed their exams on-time while 190 completed them late. Logistic regression was completed to identify maternal factors related to late follow-up, and additional statistics were utilized to understand characteristics of babies who were late. Results: In the final modeling, maternal education (OR = 0.52), WIC participation (OR = 2.11), and health insurance status (OR = 2.04) were significantly predictive of being late (X² (6) = 77.71; p < 0.01). Mothers for whom postpartum depression (OR = 1.89) was a concern were more also likely to have babies who were late. Needing to repeat a diagnostic audiologic exam was most predictive of lateness (OR = 5.32). Over one-third of babies who had confirmed hearing loss completed their testing late. Conclusions: Late completion of diagnostic hearing tests may contribute to delays in children hitting developmental milestones in a timely manner. Low socioeconomic status mothers and those with postpartum depression may have difficulty following up with recommended hearing tests. Limitations include data quality issues inherent in using administrative data.