Communities Helping the Hearing of Infants by Reaching Parents
Communities Helping the Hearing of Infants by Reaching Parents
Hearing loss is the most common sensory congenital disorder and this condition is diagnosable
 and treatable. Children that are born with hearing loss have to undergo several hearing tests
 to diagnose the condition and many families are delayed in receiving this testing or never
 obtain the needed testing. This research employs a new method for helping children with
 hearing loss receive timely care by using a patient navigator, who is someone who teaches and
 provides emotional/social support for the families of these children.

 The hypothesis of this study is that a patient navigator will hasten the timing of pediatric
 audiological testing, improve compliance with scheduled appointments, and expand parental
 knowledge of pediatric hearing loss.
For Specific Arm 1:

 The investigators will (1) use a stepped-wedge trial design to deliver patient navigation
 (PN) sequentially in 10 state-funded Kentucky Commission for Children with Special Healthcare
 Needs (CCSHCN) clinics randomized to cross from usual care to PN in steps of 6-month
 intervals over the project period. Prior to initiation of PN at each clinic, the control
 condition will be the standard of care. The overall effectiveness of PN will be tested by
 comparing non-adherence rates during the PN condition to those during the standard of care
 condition. Simultaneously, the investigators will (2) assess preliminary implementation
 outcomes (i.e., acceptability, adoption, recruitment/retention, and fidelity) as well as
 multilevel factors influencing implementation of PN in each clinic.

 For Specific Arm 2:

 Patient navigators will not be used for all subjects at participating clinics.
Inclusion Criteria:

 Inclusion criteria for parent-infant dyads:

 1. Infant failed a hearing screening in one or both ears before postnatal hospital
 discharge

 2. Infant was referred for follow-up diagnostic testing at one of the 10 participating
 CCSHCN clinics.

 3. Parent able to speak either English or another language using Cyracom phone
 interpreting services.

 Exclusion Criteria:

 1. Children and parents live outside Kentucky or who will be moving out of Kentucky within
 the first three months of life.