Understanding the factors influencing targeted congenital CMV screening: perspectives from hearing screening staff

OBJECTIVE: To identify barriers and enablers influencing targeted congenital cytomegalovirus (cCMV) screening delivery from hearing screening staff's perspective. DESIGN: Mixed-methods study comprising focus groups and a survey. Focus groups were analysed using thematic analysis and deductive coding of categories into the Theoretical Domains Framework (TDF) domains. Survey measures were analysed descriptively. STUDY SAMPLE: Focus groups: Hearing screening staff (23 screeners, seven managers). Survey: Hearing screening staff and three early support staff. RESULTS: Focus groups revealed two main themes: (1) the need for more education/training in delivering cCMV information to families and (2) the challenges of balancing cCMV screening with audiology referral. Eight key TDF domains were identified. Enablers included staff support for families completing cCMV swabs, integration of cCMV screening with audiology processes, and increased staff confidence through experience. Barriers included limited cCMV knowledge among staff and families, screeners' lack of decision-making autonomy with timing of cCMV screening and communication with families, and families' emotional distress from audiology referral. Survey results indicated most felt competent delivering cCMV screening but emphasised continued training needs. CONCLUSIONS: The study highlights vital enablers and barriers to implementing targeted cCMV screening in hearing screening programs. Addressing these challenges is essential for enhancing feasibility and acceptability.