Date of Conferral

8-18-2025

Degree

Ph.D.

School

Public Health

Advisor

Simone Salandy

Abstract

Newborn screening (NBS) is a vital U.S. public health initiative that identifies medical conditions shortly after birth. Patients with positive screenings are referred for medical follow-up or evaluation. However, many patients do not receive the recommended long-term follow-up, posing concerns for healthcare providers and public health professionals working to ensure timely treatment and care continuity. Based on the Social Determinants of Health framework, this quantitative, retrospective cohort study aimed to examine demographic and clinical factors associated with follow-up adherence among 691 infants identified through NBS in Colorado and Wyoming. The purpose of the study was to determine whether race, ethnicity, geographic location, language preference, insurance type, age, and NBS condition category significantly predicted being up to date on 2024 follow-up visits. Binary and multiple logistic regression were used to evaluate these predictors. Adjusted analyses indicated that infants with endocrine disorders (Adjusted OR = 2.91, 95% CI [1.44, 5.88], p = .003) had significantly higher odds of being up to date. In contrast, non-English language preference, Black/African American race, multiracial participants, and residence in smaller metro counties were not statistically significant predictors. Other variables, including age, ethnicity, and insurance type, also did not significantly predict follow-up adherence. These findings promote positive social change by identifying potential gaps in care and informing initiatives to improve long-term follow-up adherence and advance health equity among vulnerable infant populations.

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