Communities Helping the Hearing of Infants by Reaching Parents: The CHHIRP Navigator Trial

社区通过接触父母来帮助婴儿听力：CHHIRP Navigator 试验

• 批准号: 10600021
• 负责人: Matthew Lee Bush
• 金额: $ 64.5万
• 依托单位: UNIVERSITY OF KENTUCKY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-04-01 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10600021
• 关键词: Address; Adherence; Adoption; Age Months; Behavior Disorders; Birth; Caring; Characteristics; Child; Clinic; Collaborations; Communication impairment; Communities; Community Health; Complex; Congenital Disorders; Consolidated Framework for Implementation Research; Cost Savings; Cost effectiveness research; Data; Detection; Development; Diagnosis; Diagnostic; Diagnostic tests; Early Diagnosis; Early Intervention; Education; Effectiveness; Emotional; Employment; Environment; Failure; Family; Feedback; Funding; Health Services Accessibility; Healthcare; Healthcare Systems; Healthcare promotion; Hearing; Hearing Tests; Impairment; Improve Access; Incidence; Individual; Infant; Intervention; Joints; Kentucky; Language Development; Late Effects; Learning; Learning Disorders; Measures; Medical; Methods; Modality; Neonatal Screening; Newborn Infant; Occupational; Outpatients; Parents; Patient Care; Patients; Penetration; Process; Public Health; Randomized, Controlled Trials; Recommendation; Recording of previous events; Reporting; Research; Research Methodology; Research Personnel; Self Efficacy; Sensory; Social Development; Speech; System; Testing; Third-Party Payer; Training; Translational Research; United States; United States Preventative Services Task Force; cancer care; childhood hearing loss; cognitive development; community clinic; community intervention; community setting; cost; cost effective; cost effectiveness; cost estimate; deafness; disparity reduction; early childhood; economic cost; effectiveness evaluation; effectiveness research; effectiveness testing; effectiveness trial; effectiveness/implementation design; effectiveness/implementation trial; falls; hearing impairment; hearing loss treatment; hearing screening; hybrid type 1 trial; implementation cost; implementation determinants; implementation evaluation; implementation intervention; implementation outcomes; implementation research; implementation strategy; implementation/effectiveness; improved; innovation; intervention program; navigator intervention; neonatal sensory disorder; patient navigation; patient navigator; peer support; prevent; programs; randomized trial; recruit; research to practice; scale up; screening; social; socioeconomics; standard care; standard of care; trial design

PROJECT SUMMARY As the most common neonatal sensory disorder in the United States, infant hearing loss has an incidence of 1.7 per 1000 births. The consequences of delayed diagnosis and failure to obtain timely intervention include significant communication impairment and negative socioeconomic effects. The overall lifetime medical, educational, and occupational costs due to deafness is estimated to be over $2.1 billion. Early detection of hearing may prevent language development and learning disorders. National standards dictate that all infants should be screened by 1 month of age, diagnosed by 3 months of age, and initiate treatment by 6 months of age (1-3-6 rule) and no more than 10% of infants should be non-adherent to diagnosis within 3 months after birth. In 2015, 59.4% of U.S. infants failed to obtain a diagnosis within 3 months after abnormal screening. There is a need for the development and implementation of interventions that promote adherence to timely diagnosis and treatment standards. Early infant hearing detection and intervention (EHDI) programs are coordinated on a state level, and the diagnostic process is complex and difficult for parents to navigate. Families of children with hearing loss report that they lack confidence and support in obtaining care for their child. Patient navigator (PN) programs have improved adherence to recommended diagnostic testing in cancer care after the detection of a screening abnormality, resulting in substantial healthcare system cost savings. PNs are trained individuals who mitigate barriers to promote healthcare adherence by educating patients and improving self-efficacy. We have recently demonstrated the PN efficacy to decrease non-adherence with infant hearing diagnostic care; however, PN has yet to be tested in diverse communities or implemented into EHDI programs, and there is a gap in this field regarding effectiveness and implementation research on interventions to reduce non-adherence. The proposed research is a community-engaged, type 1 hybrid effectiveness- implementation trial of a PN intervention aimed at decreasing infant hearing diagnosis non-adherence after failed newborn hearing screening, delivered in state-funded EHDI clinics. Guided by our community advisory board and partners, we aim to 1) to test the effectiveness of PN to decrease non-adherence to receipt of infant hearing diagnosis within 3 months after birth using a stepped-wedge trial design, 2) investigate implementation outcomes and factors influencing implementation, and 3) determine the cost-effectiveness of PN from the perspective of third party payers. This study is significant because it aims to reduce non-adherence to timely infant diagnostic hearing testing to prevent life-long negative consequences. This research is innovative in testing an intervention not previously assessed in hearing healthcare within a state-funded EHDI program, and in integrating implementation research and cost-effectiveness methods with our effectiveness aim. Our results will impact the field by partnering with communities to inform the scale-up of this and other innovative patient supportive interventions to create efficient and effective EHDI programs and maximize public health impact.

项目总结

项目成果

Communities Helping the Hearing of Infants by Reaching Parents (CHHIRP) through patient navigation: a hybrid implementation effectiveness stepped wedge trial protocol.

通过患者导航，通过与父母联系（CHHIRP）来帮助婴儿的社区：一种混合实施有效性逐步楔形试验方案。

• DOI: 10.1136/bmjopen-2021-054548
• 发表时间: 2022-04-19
• 期刊: BMJ OPEN
• 影响因子: 2.9
• 作者: Bush, Matthew;Hatfield, Miranda;Schuh, Marissa;Balasuriya, Beverly;Mahairas, Anthony;Jacobs, Julie;Studts, Christina;Westgate, Philip;Schoenberg, Nancy;Shinn, Jennifer;Creel, Liza
• 通讯作者: Creel, Liza

Defining Disparities in Cochlear Implantation through the Social Determinants of Health.

• DOI: 10.1055/s-0041-1739282
• 发表时间: 2021-11
• 期刊: Seminars in hearing
• 作者: Schuh M;Bush ML
• 通讯作者: Bush ML

Evaluating Equity Through the Social Determinants of Hearing Health.

• DOI: 10.1097/aud.0000000000001188
• 发表时间: 2022-07-01
• 期刊: Ear and hearing
• 影响因子: 3.7

Does Adherence to Early Infant Hearing Detection and Intervention Guidelines Positively Impact Pediatric Speech Outcomes?

遵守早期婴儿听力检测和干预指南是否会对儿科言语结果产生积极影响？

• DOI: 10.1002/lary.28994
• 发表时间: 2021
• 期刊: The Laryngoscope
• 作者: Bush,MatthewL;McNulty,Beth;Shinn,JenniferB
• 通讯作者: Shinn,JenniferB