“From confusion to clarity…..” Establishing a newborn hearing risk factor brochure.

Ms Judith Mccloskey1Ms Judith Noonan1




To discuss the development of a new SWISH hearing risk factor brochure undertaken by two NSW Local Health District (LHD) in partnership with consumers, to improve readability, engagement and follow-up of the target population.


NSW SWISH protocol recommends VROA on all risk factor newborns who pass AABR screen with a minimum requirement to provide information regarding follow up hearing tests. Prior to the development of the new SWISH hearing risk factor brochure, a risk factor letter was mailed to parents 3- 6 months post SWISH AABR.  Collated data over two SWISH LHDs revealed 60% of parents receiving risk factor letters over a six month period made telephone calls to the LHD manager to clarify what hearing risk factors their baby had and where to go. This prompted the LHD managers to revise the risk factor information and notification process.


Evidence supports that comprehension of health information is influenced by the layout, colour, illustrations, readability and the motivation of the reader (1). A multifaceted approach was used to develop the new risk factor brochure that could be provided at the time of the screen.  This included the use of readability tools, technology in the form of social media and cloud-based software, and consumer collaboration. Consultation occurred with parents, interpreters, hearing organisations, audiologists, hearing screeners and other health professionals, to identify factors that influenced comprehension and readability.


Following implementation of the new brochure a reduction in follow-up phone calls to LHD managers regarding risk factor follow-up has occurred.  This demonstrates the effectiveness of the brochure, and has resulted in a reduction in the management personnel time to address telephone enquiries.

  1. Sameer Badarudeen, MD1 and Sanjeev Sabharwal, MD Assessing Readability of Patient Education Materials: Clin Orthop Relat Res. 2010 Oct; 468(10): 2572–2580. Published online 2010 May 22.


Both authors are from nursing backgrounds and are registered midwives who have been with the NSW SWISH Program since the start in 2002.Both have tertiary qualifications in health management and Judith Mc….is  a Nurse Audiometrist.

… true fact they both have the same first name!