title: Long-term follow-up culture in state newborn screening programs.
abstract: OBJECTIVE
  Long-term follow-up is an increasing focus as newborn screening expands in the United States. The present study informs this issue by examining the role played by organizational culture in shaping the scope and substance of long-term follow-up in state newborn screening programs.
  
  
  METHODS
  Qualitative interviews were conducted with 38 state newborn screening programs.
  
  
  RESULTS
  Several key cultural norms were identified within state newborn screening programs that may undermine proactive attempts to conduct long-term follow-up. These include (a) beliefs that place direct patient care and specialist care versus a public health orientation at the center of long-term follow-up; (b) an everyday emphasis on short-term follow-up that obscures the longer-term follow-up focus; and (c) the perception that others are engaged in long-term follow-up at the state level.
  
  
  CONCLUSIONS
  The findings support the importance of understanding state newborn screening program culture and how that culture may shape the scope and substance of long-term follow-up in a given state, regardless of the level of staff and resources made available to conduct these activities.
authors.affiliation: Department of Health Policy and Management, School of Public Health, University at Albany, Rensselaer, New York, USA. thoff@albany.edu
authors.forename: Timothy
authors.initials: T
authors.lastname: Hoff
mesh_terms: D001294:Attitude to Health; D003466:Cultural Characteristics; D003695:Delivery of Health Care; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D008403:Mass Screening; D015997:Neonatal Screening / Q000379:methods*; D017060:Patient Satisfaction; D016730:Program Development; D015397:Program Evaluation; D011634:Public Health; D014481:United States