Expansion policies of newborn screening programs in the 21st century: Facilitators and barriers

Technology used in newborn screening (NBS) programs have grown over the past 50 years to include screening for more than 40 metabolic and genetic disorders. 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. A key goal of the policy process is to inform stakeholders about the implementation of screening program initiatives and thus, reduce or eliminate the potential disconnect between public health departments, the general public and key stakeholders.  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.  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.  State Department of Public Health managers can use this systematic approach to assess how and when to include new tests in state-operated newborn screening programs, given constrained resources and potential barriers.