PROJECT ABSTRACT
Project Title: Guam EHDI: System Enhancement and Refinement: Project Guam EHDI-SER
Project Number: CDC-RFA-DD08-803
Project Investigator: Heidi E. San Nicolas, Ph.D.    Project Director: Vclma A. Sablan, Ph.D.
Organization Name: University or Guam, Center for Excellence in Developmental Disabilities Education,
Research, and Service (Guam CEDDERS)
Address: Office of Academic Affairs, University of Guam, UOG Station, Mangilao, Guam 96923
Contact Person: Heidi E. San Nicolas, Ph.D.	Phone: (671)735-2481    Fax:(671)734-5709
E-Mail: heidisan@ite.net           Project Period: 3 Years   From: July 1,2008 to August 31,2010
Since 2003 significant progress has been made in establishing and maintaining a Universal Newborn Hearing Screening (UNHS) program on Guam with the support from the CDC for data tracking, surveillance and integration. Guam is a U.S. Territory and located the furthest distance from the United States. The population is very ethnically, racially, and linguistically diverse. A transient military population and the continuous influx of citizens from the freely associated Federated States of Micronesia, Republic of Belau and the Marshall Islands, makes centralized EDHI surveillance and tracking a complex and challenging task. Despite many obstacles, UNHS was enacted into law on Guam in 2004, and the relevant agencies are continuing to comply with the mandates of the legislation. University of Guam CEDDERS serves as the lead agency in the area of EHDI on Guam and is fully endorsed by the Guam Department of Public Health and Social Services and is supported by partnerships with the local hospital, early intervention program and birthing center.
Guam EHDI outlines a conceptual plan utilizing SMART (Specific, Measurable, Attainable, Realistic, and Time-Phased) goals, objectives and activities across the three years of the cooperative agreement to continue and expand and refine the EHDI tracking and surveillance system resulting in improved methods to identify, match, collect and report standardized unduplicated individual identifiable hearing data for each child born on Guam. A complete formative and summative evaluation plan drives decision making; ensures that milestones and outcomes are realized each year of the plan; and ensures that quality assurance and improvement plans are in place to monitory the accuracy and quality of data. Goals of this Cooperative Agreement align with outcomes outlined in the CDC Early Hearing Detection and Intervention Program Guidelines. In Year 1 the Guam ChildLink system will be refined, enhanced and upgraded so that electronic linkages arc complete and fully operational with all protocols developed at all levels (screening diagnostics, early intervention, and medical home) and in use throughout the Guam EHDI system. A major focus will be on using the database system to assist with lost to follow up and monitoring of high risk/late onset of hearing loss. In Year 2, the focus will be on continued system refinement and developing on-line access and web-based data entry, as well as access to updated reports for on-line viewing by stakeholders, especially for parents. In Year 3 the development of analysis plan will be finalized and a quality assurance plan put into place to insure continued upgrade, maintenance, and continued expansion based on relevant needs and issues of the Guam ChildLink system. This application aligns with the Healthy People 2010, with the evaluation system following the recommendations set forth in "Updated Guidelines for Evaluating Public Health Surveillance System" of July 27, 2001