Getting ready for transition to adult care: Tool validation and multi‐informant strategy using the Transition Readiness Assessment Questionnaire in pediatrics

2021 ◽  
Author(s):  
Pascale Chapados ◽  
Jennifer Aramideh ◽  
Kristopher Lamore ◽  
Émilie Dumont ◽  
Tziona Lugasi ◽  
...  
Keyword(s):  
Transition To Adult Care ◽  
Adult Care ◽  
Readiness Assessment ◽  
Transition Readiness ◽  
Assessment Questionnaire

Measuring Transition Readiness of Young Adults with Sickle Cell Disease Using the Transition Readiness Assessment Questionnaire

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 3534-3534
Author(s):  
Lauren Brown ◽  
Amy Sobota
Keyword(s):  
Young Adults ◽  
Medication Management ◽  
Health Issues ◽  
Care Needs ◽  
Adult Care ◽  
Readiness Assessment ◽  
Special Health Care ◽  
Transition Readiness ◽  
Appointment Keeping ◽  
Assessment Questionnaire

Abstract Background The transition from pediatric to adult care can be a difficult time for young adults with sickle cell disease (SCD) who experience increased rates of acute care utilization and worse health outcomes. An important aspect of transition preparation includes an assessment of transition readiness. Data show that adolescents with SCD have suboptimal transition readiness, however most studies use disease specific measures which do not allow for comparisons between patient populations. The Transition Readiness Assessment Questionnaire (TRAQ) is a validated tool for youth with a variety of medical diagnoses. We have been collecting TRAQ data on our patients for the past 6 months as part of an ongoing quality improvement initiative. The purpose of this study is to analyze transition readiness scores among patients with SCD in our program, and to compare their scores with other populations of youth with special health care needs. Methods We administered the TRAQ to patients with SCD ages 13 to 22 seen in general pediatric hematology clinic or our specialized transition clinic from December 2015 to June 2016. The TRAQ contains 20 questions which measure transition readiness in five domains: managing medication, appointment keeping, tracking health issues, talking with providers, and managing daily activities. Each question is answered on a 5-point scale based on the transtheoretical model from 1 = "No, I do not know how to do this" to 5 = " Yes, I always do this when I need to". Mean TRAQ scores were analyzed by age and compared to reported TRAQ scores among other diagnostic groups in the literature. Results Fifty patients completed the TRAQ during the study period. One patient was ineligible due to cognitive delay. This represents 58% of eligible patients in our practice. Respondents were 50% female with a mean age of 17 years 9 months. The majority (70%) have HbSS. The mean overall TRAQ score was 3.5 (SD 0.72) with the highest scores in the domains of communication with providers and managing daily activities. As has previously been reported mean TRAQ scores were higher among young adults compared with older and younger adolescents. (Table 1) Our patients reported high readiness in certain aspects of medication management, with 69% of respondents stating that they always take medications correctly. However, respondents were less likely to favorably report filling needed prescriptions or reordering medications when they run out (only 22% and 27% of respondents respectively reported always completing these tasks). Questions related to insurance coverage had low scores overall; 65% of patients responded that they do not know how to apply for insurance if they lose their coverage, and 47% do not know what their insurance covers. Compared to reported TRAQ scores among patients with chronic health conditions other than SCD, our patients had lower scores in the domains of managing medications (3.63 vs 3.93), appointment keeping (2.98 vs 3.41) and tracking health issues (3.03 vs 3.33) Conclusions: By using a non-disease specific transition readiness tool we were able to analyze transition readiness in our clinic population of adolescents and young adults with SCD and compare our findings with the literature on youth with special health care needs. While it is encouraging that TRAQ scores were higher among older patients, mean scores still show room for improvement even among 18-22 year olds. Lower scores in medication management and appointment keeping in our population are particularly concerning as these aspects of chronic disease self-management are key to a successful transition to adult care. Additional work is needed to determine how transition readiness changes with time, and how we can help improve self-management and self-advocacy skills among our patients with SCD. Disclosures No relevant conflicts of interest to declare.

The Transition Readiness Assessment Questionnaire (TRAQ): Its Factor Structure, Reliability, and Validity

2014 ◽  
Vol 14 (4) ◽  
pp. 415-422 ◽  
Author(s):  
David L. Wood ◽  
Gregory S. Sawicki ◽  
M. David Miller ◽  
Carmen Smotherman ◽  
Katryne Lukens-Bull ◽  
...  
Keyword(s):  
Factor Structure ◽  
Reliability And Validity ◽  
Readiness Assessment ◽  
Transition Readiness ◽  
Structure Reliability ◽  
Assessment Questionnaire

TRAQ changes: Improving the measurement of transition readiness by the Transition Readiness Assessment Questionnaire

2021 ◽  
Vol 59 ◽  
pp. 188-195
Author(s):  
Kiana Johnson ◽  
Matthew McBee ◽  
John Reiss ◽  
William Livingood ◽  
David Wood
Keyword(s):  
Readiness Assessment ◽  
Transition Readiness ◽  
Assessment Questionnaire

scholarly journals Transition to adult care: Exploring factors associated with transition readiness among adolescents and young people in adolescent ART clinics in Uganda

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249971
Author(s):  
Scovia Nalugo Mbalinda ◽  
Sabrina Bakeera-Kitaka ◽  
Derrick Amooti Lusota ◽  
Philippa Musoke ◽  
Mathew Nyashanu ◽  
...  
Keyword(s):  
Young People ◽  
Tertiary Education ◽  
Multivariate Logistic Regression Analysis ◽  
Hiv Treatment ◽  
Hiv Care ◽  
Transition To Adult Care ◽  
People Living With Hiv ◽  
Adult Care ◽  
Transition Readiness ◽  
Factors Associated

Background Transition readiness refers to a client who knows about his/her illness and oriented towards future goals and hopes, shows skills needed to negotiate healthcare, and can assume responsibility for his/ her treatment, and participate in decision-making that ensures uninterrupted care during and after the care transition to adult HIV care. There is a paucity of research on effective transition strategies. This study explored factors associated with adolescent readiness for the transition into adult care in Uganda. Methods A cross-sectional study was conducted among 786 adolescents, and young people living with HIV randomly selected from 9 antiretroviral therapy clinics, utilizing a structured questionnaire. The readiness level was determined using a pre-existing scale from the Ministry of Health, and adolescents were categorized as ready or not ready for the transition. Bivariate and multivariate analyses were conducted. Results A total of 786 adolescents were included in this study. The mean age of participants was 17.48 years (SD = 4). The majority of the participants, 484 (61.6%), were females. Most of the participants, 363 (46.2%), had no education. The majority of the participants, 549 (69.8%), were on first-line treatment. Multivariate logistic regression analysis found that readiness to transition into adult care remained significantly associated with having acquired a tertiary education (AOR 4.535, 95% CI 1.243–16.546, P = 0.022), trusting peer educators for HIV treatment (AOR 16.222, 95% CI 1.835–143.412, P = 0.012), having received counselling on transition to adult services (AOR 2.349, 95% CI 1.004–5.495, P = 0.049), having visited an adult clinic to prepare for transition (AOR 6.616, 95% CI 2.435–17.987, P = < 0.001) and being satisfied with the transition process in general (AOR 0.213, 95% CI 0.069–0.658, P = 0.007). Conclusion The perceived readiness to transition care among young adults was low. A series of individual, social and health system and services factors may determine successful transition readiness among adolescents in Uganda. Transition readiness may be enhanced by strengthening the implementation of age-appropriate and individualized case management transition at all sites while creating supportive family, peer, and healthcare environments.

scholarly journals Measuring the Transition Readiness of Adolescents With Type 1 Diabetes Using the Transition Readiness Assessment Questionnaire

2019 ◽  
Vol 37 (4) ◽  
pp. 347-352 ◽  
Author(s):  
Jacqueline T. Chan ◽  
Jinal Soni ◽  
Deepank Sahni ◽  
Stelios Mantis ◽  
Claudia Boucher-Berry
Keyword(s):  
Type 1 Diabetes ◽  
Readiness Assessment ◽  
Transition Readiness ◽  
Assessment Questionnaire

scholarly journals Measuring Transition Readiness in Adolescents and Young Adults with Sickle Cell Disease Using the Transition Readiness Assessment Questionnaire

2021 ◽  
Author(s):  
Anjali Oberoi ◽  
Alyssa Patterson ◽  
Amy Sobota
Keyword(s):  
Young Adults ◽  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Medical Center ◽  
Self Report ◽  
Adolescents And Young Adults ◽  
Cell Disease ◽  
Readiness Assessment ◽  
Transition Readiness ◽  
Assessment Questionnaire

Background/Objectives: Adolescents and young adults (AYA) with sickle cell disease (SCD) face challenges related to the disease and its treatment. The Transition Readiness Assessment Questionnaire (TRAQ) is a self-report tool for assessing transition readiness for youth with special health care needs (YSHCN), including SCD. This study uses the TRAQ to understand transition readiness in patients with SCD treated at the Boston Medical Center, evaluates associations between TRAQ scores and transition outcomes (e.g., EDr, EDu), and compares TRAQ scores in this population with other YSHCN. Methods: We reviewed electronic medical records of AYA with SCD who completed the TRAQ in the pediatric hematology clinic between January 1, 2019, and March 1, 2020, and categorized healthcare encounters to calculate EDu and EDr. We used t-tests and ANOVA models to analyze mean TRAQ scores, sex, age, genotype, EDu, and EDr. Results: The sample was 45 AYA patients with SCD between 13 and 22 years old. The mean TRAQ score for the overall patient sample was 3.67. Mean TRAQ scores did not significantly vary by sex or genotype but did significantly increase with age. TRAQ scores were lower in the SCD population than in other YSHCN. TRAQ scores did not correlate to EDu or EDr. Conclusions: AYA patients with SCD have lower transition readiness than other populations of YSHCN. The age of 18 may not be the most reliable attribute of readiness, though older patients do have higher readiness. The relationship between TRAQ scores, EDr, and EDu is not clear and requires further evaluation.

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.

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