Journal Article

Using Formative Research to Develop a Hospital-Based Perinatal Public Health Intervention in the United States: The Thirty Million Words Initiative Newborn Parent Education Curriculum

Journal of Early Hearing Detection and Intervention | February 01, 2017
Eileen Graf, PhD, Livia Garofalo, MA, Alison C. Hundertmark, MA,Glenda L. Montague, BA, Nicole M. Polash, MS, Elizabeth Suskind, BS, Kristin R. Leffel, BS, Robert J. Webber, BA, Dana L. Suskind, MD


Parents and caregivers do not exist in a vacuum and, with regard to crafting impactful interventions, it is increasingly being recognized that there are no one-size-fits-all approaches to behavior change. Implementing research to practice is a complex endeavor and requires the adaptation of basic research findings to different cultural and environmental contexts of intended beneficiaries (Sepinwall, 2002; Weisner & Hay, 2014). The practice of formative research allows for the systematic assessment of diverse implementation contexts and provides insights into responsive adaptations of content and delivery. In this study, we detail the use of formative testing to inform the development of a curriculum designed to support the Universal Newborn Hearing Screening (UNHS). The Thirty Million Words Initiative Newborn (TMW-Newborn) Parent Education Curriculum provides caregivers of newborns with information on the UNHS. The curriculum also illustrates the importance of identifying newborns who are deaf or hard of hearing (DHH) to ensure that caregivers learn how to promote early language development. The information provided could potentially reduce lost-to-follow up (LFU) rates for newborns who may be DHH. Using qualitative methods, we collected and responded to feedback obtained from caregivers of newborns and were able to gear content, messaging, and delivery of the intervention to stakeholder needs. A subsample of participants also completed a knowledge survey testing their understanding of intervention content prior to receiving the intervention, as well as the day after. The results showed that participant scores increased significantly post-intervention.