Assessing Needs for System Improvements: Highlights from the AAP Arizona Chapter EHDI Project

Background

In 2025 the American Academy of Pediatrics (AAP) Early Hearing Detection and Intervention (EHDI) Provider Education Center (PEC) awarded a grant to the Arizona Chapter of the AAP (AzAAP) to increase the capacity of the Chapter to enhance partnerships between pediatric providers and other EHDI system partners. AzAAP efforts included conducting an EHDI system needs assessment/gap analysis and using findings from the assessment to develop a comprehensive resource list to improve EHDI system navigation for families/caregivers.

Key Partners

AzAAP engaged several partners to support their work including:

• Pediatrician members/leaders within AzAAP
• Arizona Department of Health Services
• The Ear Foundation
• Arizona State EHDI Program
• Family/caregivers of children who are identified as deaf or hard of hearing (DHH)
• Audiologists
• Early Intervention Specialists

Project Successes: Establishing the Foundation for EHDI Work and Needs Assessment

• AzAAP established a Hearing and Vision Health priority area which consists of a full-time program manager, physician medical director (pediatric otolaryngologist and EHDI Chapter Champion), and member committee. This helped build capacity within the Chapter for EHDI efforts.
• AzAAP developed a needs assessment for providers within the EHDI system to gather qualitative and quantitative insights on challenges related to screening follow-ups, access to providers and community resources, and service coordination. The assessment also evaluated provider knowledge of and engagement with EHDI initiatives.
• After a pilot of the needs assessment, the AzAAP Chapter integrated further revisions based on input from AzAAP members, the AzAAP Medical Director,and the AzEHDI Coordinator.
• The Chapter distributed the needs assessment (in the form of a questionnaire) to its members, and at the time of this summary development is actively collecting responses. The questionnaire will remain open and be redistributed to encourage additional participation and feedback. The questionnaire is also available upon request as a template for other state/territories. Please reach out to [AK1.1]Nathan Page, MD, FAAP at [email protected] with any questions.

Preliminary Results

• Preliminary findings identified opportunities for additional provider education and system improvement.
  • 30% of providers felt somewhat confident in explaining newborn hearing screening results and next steps when needed to families.
  • Most respondents indicated that they do not have a clearly defined standard follow-up process for infants that do not pass newborn hearing screenings.
  • 18% of providers stated that they do report follow-up screening or diagnostic outcomes to the Newborn Hearing Screening Follow Up / EDHI Program.
  • The biggest barriers preventing timely follow up were missed appointments and challenges with insurance coverage for follow up services.
• These initial findings highlight the need for increased awareness, provider education, and standardized follow-up protocols within the EHDI system.

Lessons Learned

• Co-Design Project Activities with Intended End Users: The AzAAP needs assessment questionnaire underwent multiple revisions based on feedback and input from
  pediatricians who have experience with the state’s EHDI system. Co-designing the questionnaire with end users ensures that the data gathered is relevant, targeted, and collects accurate data.
• Consistent Communication Keeps Members Engaged: Through this project, the Chapter identified opportunities to improve communication with its members by more consistently sharing project updates, highlights, and questionnaire findings. Members frequently express interest in learning more about ongoing initiatives, and increased communication can help strengthen engagement and awareness of EHDI-related efforts.

Next Steps

• Once the questionnaire results have been received and evaluated, AzAAP will share results with AzAAP members, the state EHDI program, and other EHDI state partners. AzAAP plans to leverage existing networks to share these results more broadly, including via their bi-monthly newsletters to chapter members and their social media channels.  
• AzAAP will use the data gathered during the needs assessment to create a community resource list aimed at improving coordination, increasing access to diagnostic and support services, and strengthening information sharing amongst EHDI system partners.
• Once a community resource list has been developed, AzAAP will disseminate the list and create a piece of digital content focused on training individuals on how to use the resource.