Abstract
Abstract Background - Newborn screening programs have grown over the past 50 years to include screening for more than 40 metabolic and genetic disorders. Technology, or the ability to screen for disorders, is not the sole influence for expansion of screening. The lack of clarity in how facilitators and barriers impact newborn screening programs can affect the stakeholder’s perspective of public health department initiatives and future goals. Method - We developed a logic model in order to help stakeholders establish reasonable expectations, while being aware of the delays and unanticipated consequences which might occur when attempting to expand newborn screening programs. Results and Conclusions - Our logic model emphasizes that expansion of Newborn Screening relies on several interrelated factors that can be identified as Technical, Financial, Policy and Human Capital. Further delineating these factors into a series of checklists promises to be of value to decision-makers in state-operated newborn screening programs, given constrained resources and anticipated barriers.
Highlights
Introduction and BackgroundIt is appropriate, after the first onehalf century of initiation of Newborn Screening (NBS) in the United States, that an examination be made of the factors that helped NBS expand to today's levels, and of potential barriers to future expansion.1.1
After the first onehalf century of initiation of Newborn Screening (NBS) in the United States, that an examination be made of the factors that helped NBS expand to today's levels, and of potential barriers to future expansion
The growth of NBS over the past fifteen years has been driven by advances in technology, the introduction of tandem mass spectrometry (MS/MS) in the late 1990‟s 1
Summary
The growth of NBS over the past fifteen years has been driven by advances in technology, the introduction of tandem mass spectrometry (MS/MS) in the late 1990‟s 1. The ability to expand NBS has raised a number of questions, regarding whether or not to adhere to the classic screening criteria of Wilson-Jungner when adding conditions to the panel 4. I.e., disorders under consideration for inclusion in newborn screening, have been proposed at the state /local level mainly based on clinical aspects of detection, identification and treatment, with at times, only marginal consideration of the impact such expansion would have on the public health infrastructure. Adding conditions due to political reasons has occurred. It is with this in mind that this decision framework of facilitators and potential barriers to expansion of NBS is presented so that all interested parties, legislators, parents and advocacy groups, understand the processes involved for expanding state public health services
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