title: Informing parents about expanded newborn screening: influences on provider involvement.
abstract: OBJECTIVE
  Expanded newborn screening (NBS) identifies some disorders for which clinical benefit is uncertain, as well as "incidental" findings (eg, carrier status), thus enhancing the need to inform parents about NBS before sample collection.
  
  
  METHODS
  A self-complete survey was sent to a cross-sectional, stratified, random sample of 5 provider groups in Ontario (obstetricians, midwives, family physicians, pediatricians, and nurses). Univariate and multivariate analyses were used to investigate the effects of core beliefs, perceived barriers, and demographic characteristics on the reported frequency of informing parents about NBS before sample collection.
  
  
  RESULTS
  Virtually all of the midwives and almost half of the nurses reported discussing NBS with parents, whereas less than one sixth of the physicians did so. Providers who perceived a responsibility to inform parents were 3 times more likely to report doing so than those who did not perceive this responsibility (odds ratio: 2.9 [95% confidence interval: 2.1-4.1]). Those who lacked confidence to inform parents were 70% less likely to discuss NBS with parents compared with those who did not experience this cognitive barrier (odds ratio: 0.3 [95% confidence interval: 0.2-0.4]). Controlling for these covariates, family physicians and obstetricians were more likely than pediatricians to inform parents.
  
  
  CONCLUSIONS
  These results provide guidance for capacity building among providers who are positioned to inform parents about NBS before sample collection. Our findings call for targeted educational interventions that consider patterns of provider practice related to prenatal and NBS care, seek to redress confidence limitations, and engage key provider groups in the importance of this professional responsibility.
authors.affiliation: Department of Health Policy, Management, and Evaluation, Mount Sinai Hospital, University of Toronto, Ontario, Canada.
authors.forename: Robin Z
authors.initials: RZ
authors.lastname: Hayeems
authors.forename: Fiona A
authors.initials: FA
authors.lastname: Miller
authors.forename: Julian
authors.initials: J
authors.lastname: Little
authors.forename: June C
authors.initials: JC
authors.lastname: Carroll
authors.forename: Judith
authors.initials: J
authors.lastname: Allanson
authors.forename: Pranesh
authors.initials: P
authors.lastname: Chakraborty
authors.forename: Brenda J
authors.initials: BJ
authors.lastname: Wilson
authors.forename: Jessica P
authors.initials: JP
authors.lastname: Bytautas
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Christensen
mesh_terms: D001291:Attitude of Health Personnel; D006801:Humans; D007231:Infant, Newborn; D033181:Information Dissemination; D015997:Neonatal Screening; D010290:Parents