title: Pediatric Hearing Healthcare in Kentucky's Appalachian Primary Care Setting.
abstract: Diagnosis and intervention for infant hearing loss is often delayed in areas of healthcare disparity, such as rural Appalachia. Primary care providers play a key role in timely hearing healthcare. The purpose of this study was to assess the practice patterns of rural primary care providers (PCPs) regarding newborn hearing screening (NHS) and experiences with rural early hearing diagnosis and intervention programs in an area of known hearing healthcare disparity. Cross sectional questionnaire study. Appalachian PCP's in Kentucky were surveyed regarding practice patterns and experiences regarding the diagnosis and treatment of congenital hearing loss. 93 Appalachian primary care practitioners responded and 85% reported that NHS is valuable for pediatric health. Family practitioners were less likely to receive infant NHS results than pediatricians (54.5 versus 95.2%, p < 0.01). A knowledge gap was identified in the goal ages for diagnosis and treatment of congenital hearing loss. Pediatrician providers were more likely to utilize diagnostic testing compared with family practice providers (p < 0.001). Very rural practices (Beale code 7-9) were less likely to perform hearing evaluations in their practices compared with rural practices (Beale code 4-6) (p < 0.001). Family practitioners reported less confidence than pediatricians in counseling and directing care of children who fail newborn hearing screening. 46% felt inadequately prepared or completely unprepared to manage children who fail the NHS. Rural primary care providers face challenges in receiving communication regarding infant hearing screening and may lack confidence in directing and providing rural hearing healthcare for children.
authors: Department of Otolaryngology - Head and Neck Surgery, University of Kentucky Medical Center, 800 Rose Street, Suite C-236, Lexington, KY, 40536-0293, USA, matthew.bush@uky.edu.
authors: Matthew L
authors: ML
authors: Bush
authors: David
authors: D
authors: Alexander
authors: Bryce
authors: B
authors: Noblitt
authors: Cathy
authors: C
authors: Lester
authors: Jennifer B
authors: JB
authors: Shinn
mesh_terms: D001061:Appalachian Region; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006310:Hearing Aids; D034381:Hearing Loss / Q000175:diagnosis* / Q000628:therapy; D006320:Hearing Tests / Q000706:statistics & numerical data*; D006801:Humans; D007231:Infant, Newborn; D007629:Kentucky; D008297:Male; D015997:Neonatal Screening; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012424:Rural Population