scholarly journals Adolescent and Adult HIV Providers' Definitions of HIV-Infected Youths' Successful Transition to Adult Care in the United States

2017 ◽  
Vol 31 (10) ◽  
pp. 421-427 ◽  
Author(s):  
Morgan M. Philbin ◽  
Amanda E. Tanner ◽  
Alice Ma ◽  
Brittany D. Chambers ◽  
Samuella Ware ◽  
...  
Keyword(s):  
United States ◽  
The United States ◽  
Transition To Adult Care ◽  
Adult Care ◽  
Successful Transition

scholarly journals Outcomes of a Comprehensive Retention Strategy for Youth With HIV After Transfer to Adult Care in the United States

2019 ◽  
Vol 38 (7) ◽  
pp. 722-726 ◽  
Author(s):  
David Griffith ◽  
Lillian Jin ◽  
Jocelyn Childs ◽  
Roberto Posada ◽  
Jennifer Jao ◽  
...  
Keyword(s):  
United States ◽  
The United States ◽  
Adult Care ◽  
Retention Strategy

scholarly journals Improving Transitions of Care for Young Adults With Congenital Heart Disease: Mobile App Development Using Formative Research (Preprint)

2018 ◽  
Author(s):  
Keila N Lopez ◽  
Michael O'Connor ◽  
Jason King ◽  
James Alexander ◽  
Melissa Challman ◽  
...  
Keyword(s):  
Best Practices ◽  
Technology Use ◽  
Congenital Heart ◽  
Formative Research ◽  
Mobile App ◽  
Transition To Adult Care ◽  
Adult Care ◽  
Transition Readiness ◽  
Successful Transition ◽  
App Development

BACKGROUND Congenital heart diseases (CHDs) are the most common type of birth defects. Improvements in CHD care have led to approximately 1.4 million survivors reaching adulthood. Successful transition and transfer from pediatric to adult care is crucial. Unfortunately, less than 30% of adolescents with CHD successfully transition to adult care; this number is lower for minority and lower socioeconomic status populations. Few CHD programs exist to facilitate successful transition. OBJECTIVE The goal of our study was to describe the formative research used to develop a prototype mobile app to facilitate transition to adult care for adolescents with CHD. METHODS A literature search about best practices in transition medicine for CHD was conducted to inform app development. Formative research with a diverse group of CHD adolescents and their parents was conducted to determine gaps and needs for CHD transition to adult care. As part of the interview, surveys assessing transition readiness and CHD knowledge were completed. Two adolescent CHD expert panels were convened to inform educational content and app design. RESULTS The literature review revealed 113 articles, of which 38 were studies on transition programs and attitudes and 3 identified best practices in transition specific to CHD. A total of 402 adolescents aged 15 to 22 years (median 16 years) participated in semistructured interviews. The group was racially and ethnically diverse (12.6% [51/402] African American and 37.8% [152/402] Latino) and 42.0% (169/402) female; 36.3% (146/402) received public insurance. Most adolescents (313/402, 76.7%) had moderate or severe CHD complexity and reported minimal CHD understanding (79.0% [275/348] of those aged 15 to 17 years and 61.1% [33/54] of those aged 18 to 22 years). Average initial transition readiness score was 50.9/100, meaning that transition readiness training was recommended. When participants with moderate to severe CHD (313/402, 77.9%) were asked about technology use, 94.2% (295/313) reported having access to a mobile phone. Interviews with parents revealed limited interactions with the pediatric cardiologist about transition-related topics: 79.4% (331/417) reported no discussions regarding future family planning, and 55.2% (230/417) reported the adolescent had not been screened for mental health concerns (depression, anxiety). Further, 66.4% (277/417) reported not understanding how health care changes as adolescents become adults. Adolescents in the expert panels (2 groups of 3 adolescents each) expressed interest in a CHD-specific tailored app consisting of quick access to specific educational questions (eg, “Can I exercise?”), a CHD story-blog forum, a mentorship platform, a question and answer space, and a checklist to facilitate transition. They expressed interest in using the app to schedule CHD clinic appointments and receive medication reminders. Based on this data, a prototype mobile app was created to assist in adolescent CHD transition. CONCLUSIONS Formative research revealed that most adolescents with CHD had access to mobile phones, were not prepared for transition to adult care, and were interested in an app to facilitate transition to adult CHD care. Understanding adolescent and parent needs, interests, and concerns helped in the development of a mobile app with a broader, tailored approach for adolescents with CHD.

scholarly journals Does caring for your spouse harm one's health? Evidence from a United States nationally-representative sample of older adults

2009 ◽  
Vol 29 (2) ◽  
pp. 277-293 ◽  
Author(s):  
KRISTI RAHRIG JENKINS ◽  
MOHAMMED U. KABETO ◽  
KENNETH M. LANGA
Keyword(s):  
United States ◽  
Older Adult ◽  
The United States ◽  
Independent Effect ◽  
Adult Care ◽  
Self Rated Health ◽  
Care Givers ◽  
Care Giving ◽  
Nationally Representative ◽  
The Relationship

ABSTRACTThe purpose of this article is to investigate the relationship between spousal care-giving and declines in functioning and self-rated health among older care-givers. The authors used data from the 2000 and 2002 waves of the United States Health and Retirement Study, a biennial longitudinal survey of a nationally representative cohort of adults aged 50 or more years. Two outcomes were examined, declines in functioning and declines in self-rated health. Care-givers were classified into three groups: no care-giving, less than 14 hours of care-giving per week, and 14 or more hours care-giving per week. To assess declines in functioning, two summary scores were created of limitations in basic and instrumental Activities of Daily Living. To assess declines in self-rated health, we compared responses from 2000 and 2002. In the fully adjusted models, care-giving hours did not have an independent effect on declines in functioning or self-rated health. The relationship between care-giving hours and declines in functioning and self-rated health is probably attributable to socio-demographic characteristics, mainly age. The findings suggest that spousal care-giving does not of itself harm functional health or perceived health among older adult care-givers. Understanding the differential effects of these socio-economic characteristics with care-giving hours on health will be useful in promoting the health of older adult care-givers and treating their disorders.

scholarly journals Social Isolation and COVID-19 Mitigation: Perspectives of Key Informants in the United States and Japan

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 441-441
Author(s):  
Emily Ihara ◽  
Megumi Inoue ◽  
Cortney Hughes Rinker ◽  
Naoru Koizumi
Keyword(s):  
United States ◽  
Older Adults ◽  
Social Isolation ◽  
Older Adult ◽  
Adult Population ◽  
The United States ◽  
Mitigation Measures ◽  
Adult Care ◽  
Key Informant ◽  
The Many

Abstract The deleterious health effects of social isolation and loneliness among older adults have been well-established and were exacerbated by the forced separation for those at health risk of contracting the COVID-19 virus. Both the United States and Japan are experiencing phenomenal growth of the older adult population; Japan is considered a “super-aged” society, with the highest proportion of people aged 65 and older in the world. This study examined how COVID-19 and mitigation measures may have affected services for older adults. We conducted key informant interviews with specialists in aging and older adult care in both Japan (n=5) and the United States (n=14). All interviews were conducted over Zoom and lasted 30-60 minutes. The research team transcribed and checked the interviews for accuracy and conducted multiple coding sessions to identify, sort, and consolidate the codes using Atlas.ti. Key themes in both countries that emerged included the many cracks in the system of programs and services for older adults, the inaccessibility to technology and the internet, and the particular difficulties of socioeconomic inequities, especially for those living alone. Older adults were motivated to become more technologically proficient and local communities came forward to help provide support. One key informant from the U.S. noted that their organization experienced a 600% increase in interest among volunteers as a result of the pandemic. Despite the many challenges of the pandemic, many silver linings emerged. One participant poetically stated, “I think that's human nature – when you have no other choice, you find a way.”

scholarly journals Transition to Adult IBD Care: A Pilot Multi-Site, Telehealth Hybrid Intervention

2020 ◽  
Author(s):  
Wendy N Gray ◽  
Scott T Wagoner ◽  
Megan R Schaefer ◽  
Bonney Reed ◽  
Pamela Morgan ◽  
...  
Keyword(s):  
United States ◽  
Skill Acquisition ◽  
The United States ◽  
Self Management ◽  
Management Skill ◽  
Adult Care ◽  
Program Satisfaction ◽  
Disease Knowledge ◽  
Transition Readiness ◽  
Transfer Readiness

Abstract Objective  Transition to adult IBD care continues to be a challenge. Efficacious models of improving transition to adult care in the United States are lacking. We present data from a pilot, prospective, non-randomized, intervention implemented at IBD centers in the Midwest and Southeast United States. Design and Methods  Adolescents and young adults (AYAs; 16–20 years) with IBD and their parents completed a 4- to 5-month transition program (1 in-person group session; 4 individual telehealth sessions). Primary outcomes were feasibility (i.e., recruitment, retention, fidelity) and acceptability (i.e., program satisfaction). Secondary outcomes were changes in transition readiness, self-management skill acquisition, perceived readiness to transfer to adult care, and disease knowledge. Results  The study exceeded goals for recruitment (target N = 20; actual: 36) and retention (target: 80%; actual: 86.11%). On average, it took participants 20.91 ± 3.15 weeks to complete our 4- to 5-month intervention and there were no deviations from the study protocol. Participant ratings for overall program satisfaction, perceived helpfulness, and program length and format were positive. Increases in transition readiness, t(30) = 8.30, d = 1.49, p < .001, self-management skill acquisition, t(30) = 3.93, d = 0.70, p < .001, and disease knowledge, t(30) = 8.20, d = 1.58, p < .001 were noted. AYA- and parent-perceived transfer readiness also improved (p’s < .05; d’s = 0.76–1.68). Conclusions  This article presents feasibility and acceptability data for a 4- to 5-month transition intervention. Improvements in AYA transition readiness, self-management skill acquisition, IBD knowledge, and AYA/parent perceived transfer readiness were also observed.

scholarly journals An evaluation of the effectiveness, facilitators and barriers of HIV Teen Clubs in achieving successful transition from teen to adult care in Blantyre, Malawi using the RE‐AIM Framework.

2020 ◽  
Author(s):  
Jerome Galagade ◽  
Victor Mwapasa
Keyword(s):  
Service Providers ◽  
Implementation Fidelity ◽  
Health Facilities ◽  
Transition Time ◽  
Transition To Adult Care ◽  
Care Transition ◽  
Adult Care ◽  
Factors Associated ◽  
Successful Transition ◽  
Living With Hiv

Abstract Background: High attrition is a major problem for Adolescent Living with HIV (ALHIV) transitioning from pediatric to adult care. Although the HIV Teen Club model has been shown to promote antiretroviral (ARV) adherence and viral suppression among ALHIV, its effect on promoting transitioning ALHIV from pediatric to adult care has not been formally evaluated. We sought to estimate the proportion of ALHIV enrolled in HIV Teen Clubs who successfully transitioned to adult care within six months of the expected transition time and assess health facilities’ fidelity in implementing HIV Teen Clubs’ adult care transition protocols and factors associated with successful transition to adult Care.Methods: From September 2018 to June 2019, we conducted a retrospective descriptive cohort study involving ALHIV attending HIV Teen Clubs in 14 primary health facilities in Blantyre, Malawi who had reached the recommended transition age of 18/19 years between July - December 2017. After obtaining consent, we reviewed their records to assess the proportion who successfully transitioned and also factors associated with transitioning. Checklist was used to ascertain fidelity of implementation of HIV Teen Club transition protocols. In-depth interviews were conducted with service providers (SP) in health facilities providing HIV Teen Club to get their perspectives on reasons for successful or unsuccessful transition.Results: Of the 131 eligible ALHIV enrolled in the study, only 6.9% (n=9) successfully transitioned to adult care within six months of the expected transition time. The overall fidelity in implementing adult care transition protocols in health facilities was medium. There was an association between implementation fidelity and ALHIV successful transition with 2 out of 3 health facilities with high implementation fidelity also successfully transitioning ALHIV into adult care. Successful ALHIV transitioning was associated with urban location of health facilities and ownership of the facilities by NGOs. SPs reported that lack of training in transitioning ALHIV, lack of clear guidelines, inadequate human resource and refusal of ALHIV to transition were some of the health system factors negatively influencing successful transition.Conclusions: Training and mentorship of SP in implementing transitioning protocols and adequately resourcing HIV teen clubs may improve their operations and facilitate successful transitioning.

scholarly journals An evaluation of the effectiveness, facilitators and barriers of HIV Teen Clubs in achieving successful transition from teen to adult care in Blantyre, Malawi using the RE‐AIM Framework.

2020 ◽  
Author(s):  
Jerome Galagade ◽  
Victor Mwapasa
Keyword(s):  
Service Providers ◽  
Implementation Fidelity ◽  
Health Facilities ◽  
Transition Time ◽  
Transition To Adult Care ◽  
Care Transition ◽  
Adult Care ◽  
Factors Associated ◽  
Successful Transition ◽  
Living With Hiv

Abstract Background: High attrition is a major problem for Adolescent Living with HIV (ALHIV) transitioning from pediatric to adult care. Although the HIV Teen Club model has been shown to promote antiretroviral (ARV) adherence and viral suppression among ALHIV, its effect on promoting transitioning ALHIV from pediatric to adult care has not been formally evaluated. We sought to estimate the proportion of ALHIV enrolled in HIV Teen Clubs who successfully transitioned to adult care within six months of the expected transition time and assess health facilities’ fidelity in implementing HIV Teen Clubs’ adult care transition protocols and factors associated with successful transition to adult Care. Methods: From September 2018 to June 2019, we conducted a retrospective cohort study involving ALHIV attending HIV Teen Clubs in 14 primary health facilities in Blantyre, Malawi who had reached the recommended transition age of 18/19 years between July - December 2017. After obtaining consent, we reviewed their records to assess the proportion who successfully transitioned and also factors associated with transitioning. Checklist was used to ascertain fidelity of implementation of HIV Teen Club transition protocols. In-depth interviews were conducted with service providers (SP) in health facilities providing HIV Teen Club to get their perspectives on reasons for successful or unsuccessful transition.Results: Of the 131 eligible ALHIV enrolled in the study, only 6.9% (n=9) successfully transitioned to adult care within six months of the expected transition time. The overall fidelity in implementing adult care transition protocols in health facilities was medium. There was an association between implementation fidelity and ALHIV successful transition with 2 out of 3 health facilities with high implementation fidelity also successfully transitioning ALHIV into adult care. Successful ALHIV transitioning was associated with urban location of health facilities and ownership of the facilities by NGOs. SPs reported that lack of training in transitioning ALHIV, lack of clear guidelines, inadequate human resource and refusal of ALHIV to transition were some of the health system factors negatively influencing successful transition. Conclusions: Training and mentorship of SP in implementing transitioning protocols and adequately resourcing HIV teen clubs may improve their operations and facilitate successful transitioning.

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