Approach and enrollment saturations and enrollment rates during pre-pandemic, fullremote and hybrid. Approach/Eligible is number approached as a fraction of total eligible babies with newborn screening (NBS), Enrolled/Eligible is number enrolled as a fraction of total eligible babies, Enrolled/Approached is number enrolled as a fraction of total approached, Active Decline/ Approached is the proportion who declined participation after being approached. Passive Decline/ Approached is the number who did not return a consent after being approached and agreeing to the study. The latter only exists for periods that had some remote recruitment. Recruitment took place at NewYork-Presbyterian (NYP) Hospitals: Children’s Hospital of New York, Allen, Cornell, and Lower Manhattan Hospital and Queens Hospital and Northwell Hospitals: Long Island Jewish Medical Center, North Shore University Hospital, Lenox Hill Hospital, and Southside Hospital unless otherwise indicated. Pre-pandemic period for NYP and Northwell includes 1 January 2020–15 March 2020. There was no recruitment at Queens between 1 January 2020–1 February 2020 and Southside for 1 January 2020–19 February 2020 and these hospitals are not included in total number for eligible babies for these time periods. The Remote period includes 16 Match 2020–1 September 2020 for NYP and 28 March 2020–12 July 2020 for Northwell. There was recruitment at Lower Manhattan Hospital from 16 Match 2020–20 April 2020 and no recruitment at NYP Queens or Southside for this total period and these hospitals are not included in total number eligible for these time periods. The Hybrid period includes 2 September 2020–31 December 2020 for NYP and 13 July 2020–31 December 2020 for Northwell. There was recruitment at NYP Queens from 2 September 2020–1 December 2020 and Southside from 13 July 2020–20 August 2020 and these hospitals are not included in total number for eligible babies for these dates. p-values for chi square analysis for pre-pandemic compared to remote or hybrid.