Health Care Transitions最新文献

{"title":"Reflections on directing 25 years of the annual transition conference","authors":"Albert C. Hergenroeder","doi":"10.1016/j.hctj.2024.100092","DOIUrl":"10.1016/j.hctj.2024.100092","url":null,"abstract":"<div><div>Albert C. Hergenroeder, MD, Professor of Pediatrics, Chief, Adolescent Medicine and Sports Medicine, Baylor College of Medicine The paper is based on the author’s opening address for the 25th annual Chronic Illness and Disability: Transition from Pediatric to Adult-based care conference at Baylor College of Medicine/Texas Children’s Hospital conference delivered October 10, 2024</div></div>","PeriodicalId":100602,"journal":{"name":"Health Care Transitions","volume":"3 ","pages":"Article 100092"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143141995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pushing forward: Understanding physical activity in adults with medical complexity","authors":"Valerie Perkoski Ph.D., RD ,&nbsp;Mary Shotwell Ph.D., OTR/L, FAOTA, NBC-HWC ,&nbsp;Charlotte Chatto PT, Ph.D., NCS ,&nbsp;Judy Chandler Ph.D.","doi":"10.1016/j.hctj.2025.100102","DOIUrl":"10.1016/j.hctj.2025.100102","url":null,"abstract":"<div><h3>Background</h3><div>Adults with severe and profound intellectual disabilities (SPIDs) often encounter more significant healthcare needs than those without disabilities. People with SPIDs are more likely to have mobility impairments (MIs), yet little is known about physical activity (PA) experiences among those with SPIDs and MIs once they transition out of pediatric and school-based settings. This study explores the experience of PA in adults with SPIDs and MIs based on clinician perspectives.</div></div><div><h3>Methods</h3><div>Eight clinicians engaged in a semi-structured interview and described their experiences with PA in adults with SPIDs/MIs. Interviews were analyzed to determine common themes, and a reflexivity journal and field notes were used to corroborate and supplement findings. Data was organized according to the 5 socio-ecological model (SEM) levels and 16 a priori themes (1) intrapersonal: attitudes, physical factors, knowledge, and values, (2) interpersonal: supports outside the home, supports within the home, and home environment considerations, (3) organizational: disability-inclusive organizations, academic institutions, and medical institutions, (4) community: environment and priorities, and (5) policy: home and community-based services (HCBS), financial, academic and programming, and accessibility policies. Clinician-identified barriers and facilitators to PA were grouped under these 16 themes.</div></div><div><h3>Results</h3><div>The 5 most prevalent PA facilitators included (1) PA preferences as uniquely individualized, (2) organizations providing PA for adults with multiple disabilities, (3) building, outdoor, and transportation accessibility, (4) the importance of allyship and socialization among those with SPIDs/MIs and between caregivers, and (5) advocacy for promoting monies toward prevention instead of illness. The 5 most prevalent barriers to PA were (1) building, outdoor, and transportation inaccessibility, (2) necessity of education on needs and opportunities for PA, (3) diagnosis, bodily structure, weakness, or pain in adults with SPIDs/MIs, (4) lack of competitive billing structure to support PA programs or clinician reimbursement, and (5) lack of HCBS education and support.</div></div><div><h3>Implications</h3><div>Recognizing the interplay of each SEM level and factors influencing PA engagement may improve access and health outcomes among adults with SPIDs/MIs. Clinicians play a significant role in assessing, educating, and promoting PA opportunities for people with disabilities as they transition into and age within adult and community settings.</div></div>","PeriodicalId":100602,"journal":{"name":"Health Care Transitions","volume":"3 ","pages":"Article 100102"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143844633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of insurance on adolescent transition to adult care","authors":"Diane V. Murrell ,&nbsp;Cassandra J. Enzler ,&nbsp;Lauren Bretz ,&nbsp;Beth H. Garland ,&nbsp;Albert C. Hergenroeder ,&nbsp;Christine Markham ,&nbsp;Constance M. Wiemann","doi":"10.1016/j.hctj.2025.100108","DOIUrl":"10.1016/j.hctj.2025.100108","url":null,"abstract":"<div><h3>Background</h3><div>This study sought to examine how adolescents and young adults with special health care needs (AYA) prepare for managing medical insurance (private and public) as an adult and the role of insurance in locating an adult provider and engaging in care.</div></div><div><h3>Methods</h3><div>Twenty-eight AYA aged 18–24 years with renal, inflammatory bowel, or rheumatologic diseases completed individual semi-structured interviews designed to evaluate the impact of insurance (private vs. public) on their health care transition experiences. An interdisciplinary team of coders analyzed transcripts using The Framework Method.</div></div><div><h3>Results</h3><div>Three themes emerged: continuum of accepting health insurance responsibility; the impact of insurance on managing health while transitioning to an adult provider; and how insurance systems affect transition. AYA described a continuum of the adolescent increasing health insurance responsibility, which was paralleled by their parent/caregiver’s continuum of decreasing insurance responsibility. Both publicly and privately insured AYA faced difficulties in transition related to insurance and reported that insurance was a key deciding factor in locating providers and centers to receive care. Regardless of insurance type, some AYA also described financial difficulties affording care.</div></div><div><h3>Conclusions</h3><div>Health insurance is a complex system that affects AYA’s ability to manage their health and transition to adult-based care. Evidence-based interventions to improve AYA and parent/caregiver health literacy knowledge and skills about health insurance prior to transition to adult-based care are needed. Improvement in health insurance literacy could improve transition readiness for entering adult care, which could in turn improve health outcomes.</div></div>","PeriodicalId":100602,"journal":{"name":"Health Care Transitions","volume":"3 ","pages":"Article 100108"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144329775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From pediatrics to adult care – Experiences of transition among youth with a chronic medical condition: A meta-ethnography","authors":"Bettina Trettin RN, MScN, PhD (Assistant Professor) ,&nbsp;Nina Hyltoft RN, MScN ,&nbsp;Hanne Agerskov RN, MScN, PhD (Professor) ,&nbsp;Charlotte Nielsen RN, MScN, PhD (Assistant Professor) ,&nbsp;Christina Egmose Frandsen RN, MScN, PhD (Assistant Professor)","doi":"10.1016/j.hctj.2025.100118","DOIUrl":"10.1016/j.hctj.2025.100118","url":null,"abstract":"<div><h3>Background</h3><div>Approximately 10–30 % of the youth (aged 15–24) have a diagnosed chronic medical condition. Effective transition from pediatric to adult care is thus essential for disease management. The growing interest in the transition of young people with chronic medical conditions has led to numerous international studies revealing diverse and often inadequate transition practices. Thus, the aim was to gain a new understanding and deeper insight into youths´ experiences of their transition from paediatric to adult care.</div></div><div><h3>Methods</h3><div>Utilizing the meta-ethnographic method by Noblit and Hare, a structured literature search</div><div>was conducted in CINAHL and PubMed.</div></div><div><h3>Results</h3><div>Ten articles were included. The meta-ethnography found that youth – despite their chronic medical condition – define themselves as primarily young and secondarily chronically ill. Furthermore, youth transitioning to adult care are being the Captain of Their Own Life and hence stand alone with the responsibility of managing their illness, lacking the competence to master it fully, and facing an unorganized healthcare system that does not adequately support their needs. Thus, youth find they are Navigating in the Dark.</div></div><div><h3>Conclusion</h3><div>Adopting a rigorously systematic approach to conducting a meta-ethnography provides new and valuable knowledge into the transition process from pediatric to adult care. Youth with chronic medical conditions encounter multiple challenges in their transition from pediatric to adult care, which has not systematically been integrated into patient care pathways in clinical practice. This review provides a new understanding of youths’ transition experiences, on which further research regarding the organization of effective and evidence-based process can be based.</div></div>","PeriodicalId":100602,"journal":{"name":"Health Care Transitions","volume":"3 ","pages":"Article 100118"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144902462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of social problem-solving in emerging adult healthcare transition","authors":"Christina M. Sharkey ,&nbsp;Frances Cooke ,&nbsp;Taylor M. Dattilo ,&nbsp;Alexandra M. DeLone ,&nbsp;Larry L. Mullins","doi":"10.1016/j.hctj.2025.100099","DOIUrl":"10.1016/j.hctj.2025.100099","url":null,"abstract":"<div><h3>Objective</h3><div>Transitioning to independent self-management is an observed challenge for emerging adults with chronic medical conditions (CMCs). Strong healthcare management skills are linked with better health-related quality of life (HRQoL). Social problem-solving skills also contribute to HRQoL, but limited research exists on the role of these skills among emerging adults with CMCs. Therefore, the current study examines the potential mediating role of problem-solving abilities between healthcare management skills and HRQoL among emerging adults with CMCs.</div></div><div><h3>Methods</h3><div>Emerging adults (N = 279; Mean Age=19.37, SD=1.33; 84.9 % Female; 79.2 % White; 26.9 % first generation student) with a CMC completed online measures of demographics, transition readiness, social problem-solving, and HRQoL. A path analysis estimated the direct and indirect effects of transition readiness on HRQoL, with demographic and illness-related covariates (e.g., sex, illness controllability, COVID time).</div></div><div><h3>Results</h3><div>The overall path analysis was significant (<em>p</em> &lt; 0.001) and accounted for 28.0 % of the variance in mental (M=-1.46, SD=1.12) and 20.5 % of the variance in physical HRQoL (M=-0.65, SD=0.96). Transition readiness had a significant indirect effect through dysfunctional problem-solving skills on mental (β=0.07, SE=0.03, <em>p</em> = 0.02) and <em>p</em>hysical HRQoL (β=0.04 SE=0.02, <em>p</em> = 0.04). Constructive problem-solving did not mediate the relationships (<em>ps</em>&gt;0.05).</div></div><div><h3>Conclusions</h3><div>Findings indicate that dysfunctional problem-solving may impede emerging adults’ ability to effectively apply healthcare management skills, and interventions that reduce dysfunctional problem-solving may be needed to improve HRQoL. College campuses may be a suitable environment for providing problem-solving training, and future research should explore opportunities to engage these communities in healthcare transition support.</div></div>","PeriodicalId":100602,"journal":{"name":"Health Care Transitions","volume":"3 ","pages":"Article 100099"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143777639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reflections on developing a hospital-wide health care transition program","authors":"Ellen Iverson ,&nbsp;Caitlin S. Sayegh ,&nbsp;Courtney Porter ,&nbsp;Diane Tanaka ,&nbsp;Roberta Williams","doi":"10.1016/j.hctj.2024.100090","DOIUrl":"10.1016/j.hctj.2024.100090","url":null,"abstract":"<div><h3>Background</h3><div>Despite the importance of an organized, planned transition to adult healthcare for adolescents with chronic health conditions, pediatric hospitals have struggled to adequately support this process. Particularly over the past two decades, pediatric hospitals have taken different tactics in their efforts to provide systematic transition support and faced unique challenges developing comprehensive, sustainable programs.</div></div><div><h3>Objective</h3><div>The purpose of this article is to reflect on the experience of building transition services through the 2010s decade at a large quaternary pediatric hospital, Children's Hospital Los Angeles (CHLA), which serves a diverse and largely socioeconomically disadvantaged population.</div></div><div><h3>Results</h3><div>At CHLA, hospital-wide efforts began with informal gatherings of advocates who championed transition support. This led to collaboration and pooling of resources to develop a collective approach to transition. CHLA’s transition efforts matured over the 2010’s decade, coinciding with national advances in transition frameworks and transition-focused research. Ultimately, CHLA received a large philanthropic gift which provided resources to expand transition support throughout the institution by creating a cross-disciplinary, formalized program and infrastructure designed to support all adolescents to successfully transition to adult healthcare.</div></div><div><h3>Conclusion</h3><div>This article archives CHLA’s unique path toward developing hospital-wide transition services and lessons learned during these efforts may be informative to others striving to improve transition services.</div></div>","PeriodicalId":100602,"journal":{"name":"Health Care Transitions","volume":"3 ","pages":"Article 100090"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143141994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Youth feedback through emotional mapping in the Transition to Adulthood through Coaching and Empowerment study","authors":"Tina J. Liu ,&nbsp;Karen Beattie ,&nbsp;Katherine Prowse ,&nbsp;Heather McKean ,&nbsp;Sheri Nsamenang ,&nbsp;Michelle Batthish","doi":"10.1016/j.hctj.2025.100110","DOIUrl":"10.1016/j.hctj.2025.100110","url":null,"abstract":"<div><h3>Background</h3><div>Youth with inflammatory bowel disease (IBD) and juvenile idiopathic arthritis (JIA) face challenges transitioning to adult care due to physiological and psychosocial impacts of their disease. Current transition care models vary, and few have been comprehensively evaluated. Previously, we conducted a feasibility randomized-controlled trial (TRACE – Transition to Adulthood through Coaching and Empowerment) testing a Transition Coach Intervention (TCI) supporting youth with JIA and IBD transitioning to adult care. Involving youth as research partners is critical in developing and evaluating transition interventions.</div></div><div><h3>Objective</h3><div>To evaluate youth satisfaction and feedback on the TCI to inform future study methodology.</div></div><div><h3>Methods</h3><div>We conducted an emotional mapping exercise to identify emotions youth felt regarding the feasibility study and TCI. In virtual focus groups, participants answered questions about study recruitment, logistics, and transition coaching sessions. To support explaining and recalling their experiences, participants selected responses including: comfortable, supported, safe, worried, confused, frustrated and other. Identifying their emotions supports participants in explaining their experiences.</div></div><div><h3>Results</h3><div>Eight individuals (n = 4 female, ages 18–19 years, n = 5 IBD) participated in two focus groups (n = 4 each). Participants felt comfortable with the study’s recruitment process. All TCI group participants reported positive feelings, though one felt overwhelmed by the amount of information in one session, and two found the psychologist sessions redundant.</div></div><div><h3>Conclusions</h3><div>Feedback from the emotional mapping exercise indicates the acceptability of the TRACE study among youth with JIA and IBD. This feedback is critical for planning a larger trial to evaluate the effectiveness of transition coaching in youth with chronic diseases.</div></div>","PeriodicalId":100602,"journal":{"name":"Health Care Transitions","volume":"3 ","pages":"Article 100110"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144366937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and design of a Blueprint for structured transitional care in adolescents and young adults in the academic hospital setting","authors":"Vivi Buijs ,&nbsp;Martha A.C. van Gaalen ,&nbsp;Irene K. Schokker-van Linschoten ,&nbsp;AnneLoes van Staa ,&nbsp;Johanna C. Escher","doi":"10.1016/j.hctj.2025.100109","DOIUrl":"10.1016/j.hctj.2025.100109","url":null,"abstract":"<div><h3>Background and purpose</h3><div>A generic, structured transitional care pathway dedicated to patients in the academic setting is currently lacking. This study aimed to identify the key factors influencing a successful transition from pediatric to adult care for adolescents and young adults and to develop a generic, hospital-wide Blueprint for transitional care in such settings, using intervention mapping as the guiding method</div></div><div><h3>Method</h3><div>A combination of literature review, focus groups, and semi-structured interviews was carried out, leading to a logical model of the problem in a situation where transition is poorly managed or when transitional care is absent in the academic setting. This model helped outline the behavioral objectives, determinants, and change goals, which were then transformed into practical applications. Key interventions were identified and integrated into a coherent Blueprint for transitioning from pediatric to adult healthcare. A Transition Programme Development Working Group and a Transition Patient Council have been involved in every step of the Blueprint's development.</div></div><div><h3>Results</h3><div>The Blueprint for structured transitional care promotes pediatric and adult collaboration through eight key interventions, including two joint consultations, one double-time consultation, and appointing a transition coordinator who annually prepares and updates individual transition plans.</div></div><div><h3>Conclusion</h3><div>Intervention mapping helped designing a structured, personalized Blueprint as an evidence based example for transitioning patients with rare and chronic conditions in an academic hospital. The Blueprint described in this article is currently being implemented and evaluated across six pilot departments. If proven effective, it can be disseminated more widely.</div></div>","PeriodicalId":100602,"journal":{"name":"Health Care Transitions","volume":"3 ","pages":"Article 100109"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144482418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reflections on youth partnership in a randomized controlled trial of an intervention to optimize transition from pediatric to adult care in inflammatory bowel disease","authors":"Brooke Allemang PhD, MSW, RSW ,&nbsp;Ashleigh Miatello MA ,&nbsp;Pranshu Maini ,&nbsp;Joshua Eszczuk ,&nbsp;Claudia Tersigni MSc ,&nbsp;Samantha Micsinszki PhD ,&nbsp;Sneha Dave ,&nbsp;Natasha Bollegala MD, MSc, FRCPC ,&nbsp;Nancy Fu MD, MHSc ,&nbsp;Kate Lee PhD, MBA ,&nbsp;Samantha J. Anthony PhD, MSW, RSW ,&nbsp;Melanie Barwick PhD ,&nbsp;Eric I. Benchimol MD, PhD","doi":"10.1016/j.hctj.2025.100111","DOIUrl":"10.1016/j.hctj.2025.100111","url":null,"abstract":"<div><h3>Background</h3><div>Patient engagement allows for developing health interventions and research studies that align with the needs of people living with chronic diseases. Actively involving people with lived experience as partners in the design and governance of interventional trials is gaining prominence. However, there is a dearth of literature exploring the processes and procedures of patient partnership in various stages of randomized controlled trials (RCTs) with adolescents and young adults (AYAs) with inflammatory bowel disease (IBD), specifically.</div></div><div><h3>Methods</h3><div>This reflective viewpoint outlines how AYA patient partners were involved in a RCT of an intervention to optimize transition from pediatric to adult care in IBD through a Youth Advisory Panel. To achieve this objective, we: i) gathered information from eight members of the study team via virtual discussions, ii) reflected on our experiences collaborating with patient partners in the RCT, and iii) reviewed relevant documents, including meeting minutes. Discussion transcripts, reflections, and documents were reviewed by two academic researchers and one AYA patient partner to identify the varying levels of involvement among AYA patient partners in the trial. The engagement strategies implemented to maximize the translational impact of the multimodal intervention and inform patient-centered care across various stages of the RCT were also examined.</div></div><div><h3>Results</h3><div>The processes, outputs and impacts of AYAs’ contributions in priority setting and planning, intervention design and refinement, study execution, dissemination, and post-trial intervention implementation and dissemination were identified. AYA patient partner motivations for involvement in the RCT and key learnings from this partnership were uncovered.</div></div><div><h3>Conclusion</h3><div>AYA patient partners’ contributions to the RCT were impactful, from study conceptualization to dissemination. Their involvement ensured the intervention's relevance, usability, and youth-friendliness, informed data analysis, and enhanced knowledge translation through co-creation. Future work in this field could involve evaluating the impact of patient engagement on AYA patient partners, research teams, and research outcomes in RCTs.</div></div>","PeriodicalId":100602,"journal":{"name":"Health Care Transitions","volume":"3 ","pages":"Article 100111"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adaptation and validation of the STARx for Ugandan adolescents","authors":"Melissa A. Saftner PhD, CNM, FACNM ,&nbsp;Tom D. Ngabirano MSN ,&nbsp;Scovia Nalugo Mbalinda PhD ,&nbsp;Barbara McMorris PhD ,&nbsp;Phionah Tukamushabe MS ,&nbsp;Sara Hildreth MPH ,&nbsp;Annie-Laurie McRee DrPh, FSAHM ,&nbsp;Peter Kirabira MD","doi":"10.1016/j.hctj.2025.100121","DOIUrl":"10.1016/j.hctj.2025.100121","url":null,"abstract":"<div><h3>Purpose</h3><div>Transitioning from pediatric to adult care is a significant challenge in Uganda, where over 170,000 young people living with HIV (YPLHIV) require continuous HIV care. Assessment of adolescents’ readiness to transition is a keystone of developmentally appropriate care. This study aimed to adapt and validate the Self-Management and Transition to Adulthood with Rx = Treatment (STARx) measurement tool for Ugandan YPLHIV.</div></div><div><h3>Methods</h3><div>The STARx tool was adapted for the Ugandan context through cognitive interviews with 10 YPLHIV (ages 15–20), leading to revisions in the tool's structure and language. The adapted STARx-Uganda tool was then validated with 154 YPLHIV. Data were collected using electronic tablets and analyzed through exploratory factor analysis and reliability testing.</div><div>The validation process included assessing the tool’s psychometric properties, including internal consistency, factor structure, and concurrent validity.</div></div><div><h3>Results</h3><div>The STARx-Uganda tool was found to have satisfactory internal consistency (Cronbach’s alpha = 0.73). Factor analysis revealed a five-factor model: Provider Communication, Disease Knowledge, Self-Management, Medication Management and Engagement during Appointments. The tool demonstrated concurrent validity, with higher readiness scores associated with better healthcare utilization, including fewer missed appointments and better adherence to antiretroviral therapy. Notably, the Self-Management subscale was consistently correlated with both healthcare utilization outcomes.</div></div><div><h3>Discussion</h3><div>The findings support the STARx-Uganda as a reliable and valid tool for assessing transition readiness among YPLHIV in Uganda. The tool’s modifications, including a simplified Likert-type scale and the inclusion of local healthcare terms, improved clarity and relevance. The STARx-Uganda can guide healthcare providers in improving the continuity of HIV care. Future research should evaluate the tool’s impact on long-term health outcomes and expand its application in diverse settings.</div></div>","PeriodicalId":100602,"journal":{"name":"Health Care Transitions","volume":"3 ","pages":"Article 100121"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145120841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}