Health Care Transitions最新文献

{"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}

{"title":"Experiences of barriers and facilitators in mental health care transitions: A qualitative exploration of perspectives from transitional-aged youth, family, and service providers (part 1)","authors":"Roula Markoulakis ,&nbsp;Hinaya Cader ,&nbsp;Karen Wong ,&nbsp;Sugy Kodeeswaran ,&nbsp;Tracey Addison ,&nbsp;Cathy Walsh ,&nbsp;Jocelyn Charles ,&nbsp;Amy Cheung ,&nbsp;Deepy Sur ,&nbsp;David Willis ,&nbsp;Anthony Levitt","doi":"10.1016/j.hctj.2024.100087","DOIUrl":"10.1016/j.hctj.2024.100087","url":null,"abstract":"<div><h3>Introduction</h3><div>Transitional-aged youth (TAY) are at a vulnerable stage of their development in which mental health and/or addiction (MHA) issues tend to manifest and/or increase in severity. TAY also tend to find themselves subject to multiple care transitions, often resulting in sub-optimal access to MHA services. The objective of this study was to explore the perspectives of TAY, family members, and system providers regarding the supports needed by TAY and their families during transitions through MHA care.</div></div><div><h3>Methods</h3><div>This is a descriptive qualitative study of TAY, family, and provider perspectives on their experiences with accessing/providing MHA care and transition supports for TAY. Focus groups and interviews were conducted with 14 TAY, 26 family members, and 23 service providers. Participants were asked about their experiences with regard to barriers and facilitators to transitions in care for TAY with MHA concerns. Data was analyzed utilizing a thematic analysis approach.</div></div><div><h3>Results</h3><div>Six themes emerged during data analysis: pathways to care, appropriate and comprehensive care, continuity of care, informed care, family involvement, and TAY involvement. These results provide a better understanding of the needs of TAY and their families in relation to accessing and transitioning through MHA system supports and improving MHA outcomes. They also include the views of service providers on the current state of access to and transitions through MHA care, specifically for the TAY population.</div></div><div><h3>Discussion</h3><div>This information reveals the supports needed by TAY and their families along with the challenges created due to a lack of guidance, transition preparation, collaboration, and continuity in the MHA system. MHA providers working with TAY and families can utilize these findings to promote effective TAY and family engagement for positive transitions and care experiences.</div></div>","PeriodicalId":100602,"journal":{"name":"Health Care Transitions","volume":"3 ","pages":"Article 100087"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142721094","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":"Clinical trials and young adults with inflammatory bowel disease","authors":"Sneha Dave ,&nbsp;Sydney Reed ,&nbsp;Mara Shapiro ,&nbsp;Yeabsira Taye ,&nbsp;Isabela Hernandez ,&nbsp;Navin Kariyawasam ,&nbsp;Ildiko Mehes ,&nbsp;Manasi Agrawal ,&nbsp;Miguel Regueiro ,&nbsp;Adam Faye ,&nbsp;Jeremy Adler","doi":"10.1016/j.hctj.2025.100100","DOIUrl":"10.1016/j.hctj.2025.100100","url":null,"abstract":"<div><div>Young adults (approximately 18–35 years) with inflammatory bowel disease (IBD) represent a distinct demographic with unique developmental and physiological characteristics, yet they are underrepresented in clinical trials. This commentary synthesizes insights from a roundtable discussion facilitated by the Crohn's and Colitis Young Adults Network (CCYAN) between young adult patients with IBD and medical professionals, including physicians, nurses, psychologists, and trainees/medical students. Themes include defining young adults as a distinct demographic in research, improving outcomes for young adults with IBD through age-specific data disaggregation, barriers for participation and post-trial responsibilities, as well as regulatory and legislative policy opportunities to enhance young adult representation in clinical trials.</div></div>","PeriodicalId":100602,"journal":{"name":"Health Care Transitions","volume":"3 ","pages":"Article 100100"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143738388","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":"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":"Community health workers supporting emerging adults with sickle cell disease","authors":"Sadie M. Butcher ,&nbsp;Caren Steinway ,&nbsp;Brahadesh Sivakumar ,&nbsp;Katherine Wu ,&nbsp;Toyosi Oluwole ,&nbsp;Desireé N. Williford ,&nbsp;Sophia Jan ,&nbsp;Symme W. Trachtenberg ,&nbsp;Kim Smith-Whitley ,&nbsp;Tanisha D. Belton","doi":"10.1016/j.hctj.2024.100091","DOIUrl":"10.1016/j.hctj.2024.100091","url":null,"abstract":"<div><h3>Background</h3><div>Community health workers (CHWs) are vital links between communities and health systems, with CHW models facilitating positive health and life outcomes. However, little is known about CHWs’ experiences serving in these roles or their potential to support the transition to adulthood for adolescents and young adults (AYA).</div></div><div><h3>Methods</h3><div>Semi-structured interviews were conducted with CHWs and their supervisors from five recruitment sites affiliated with Community Health Worker and Mobile Health for Emerging Adults Transitioning Sickle Cell Disease Care (COMETS) Trial. COMETS compared the effectiveness of a CHW intervention, mobile health application, or enhanced usual care on the health-related quality of life of AYA with SCD transitioning from pediatric to adult care. To understand CHW and CHW supervisor experiences during the COMETS trial, interviews were analyzed using an integrated inductive and deductive thematic analytic approach.</div></div><div><h3>Results</h3><div>Three key themes emerged as interviewees described the unique aspects of the CHW role: (1) the supports for transition to adulthood that CHWs provided to patients, (2) the experiences of establishing trusting relationships with patients, and (3) the impact of the role on CHWs themselves. All interviewees reported unique contributions made by CHWs in supporting patients’ transition readiness, and CHWs expressed that participating in COMETS impacted them personally and professionally.</div></div><div><h3>Conclusion</h3><div>This study highlights that the CHW role is unique both in how CHWs connect with AYA and how it impacts CHWs. Health systems should explore paths for sustainable funding and workforce development for CHWs and invest in infrastructure for CHW transition programs.</div></div>","PeriodicalId":100602,"journal":{"name":"Health Care Transitions","volume":"3 ","pages":"Article 100091"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143141407","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":"Diagnostic stability of attention deficit hyperactivity disorder during healthcare transition","authors":"Alberto Rodríguez-Quiroga ,&nbsp;Cristina Bonilla Sanz ,&nbsp;Miguel Ángel Álvarez-Mon ,&nbsp;Fernando Mora Mínguez ,&nbsp;Javier Quintero","doi":"10.1016/j.hctj.2024.100089","DOIUrl":"10.1016/j.hctj.2024.100089","url":null,"abstract":"<div><h3>Background and Aims</h3><div>The belief that ADHD remitted in adulthood and the absence of specific criteria for its diagnosis in adults have led to discrepancies in estimating its persistence, hindering proper treatment. The objective of this study was to evaluate the persistence of diagnosis and subtypes of ADHD in patients transitioning to adulthood in a specialized setting using DSM-5 criteria.</div></div><div><h3>Material and Methods</h3><div>Retrospective data were collected from 59 patients diagnosed with ADHD at the Hospital Universitario Infanta Leonor, Madrid, with symptom onset between 2 and 12 years of age. Subgroups were formed based on diagnosis and initial subtype stability, and descriptive and statistical analysis was performed using SPSS software.</div></div><div><h3>Results</h3><div>The persistence rate was 93.2 %. Persistence was significantly associated with the need for specific follow-up at present, but not with gender, current age, or treatment. High percentages of comorbidity were found in both the persistent and remission groups. The initial inattentive subtype showed greater stability, with a preservation rate of 95.83 %. The combined subtype decreased more over time, with a preservation rate of 71.4 %. The diagnostic consistency for each subtype was high, although overall diagnostic concordance decreased slightly with age.</div></div><div><h3>Conclusions</h3><div>ADHD stability using appropriate criteria is higher than previously described. Comprehensive follow-up is necessary regardless of the current diagnostic status, especially in the period of transition from adolescence to adulthood.</div></div>","PeriodicalId":100602,"journal":{"name":"Health Care Transitions","volume":"3 ","pages":"Article 100089"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143141984","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":"Bolstering connectedness through peer support: Randomized-controlled trial of a web-based peer support program for adolescents with inflammatory bowel disease","authors":"Meghan K. Ford ,&nbsp;Armanda Iuliano ,&nbsp;Thomas D. Walters ,&nbsp;Anthony R. Otley ,&nbsp;David R. Mack ,&nbsp;Kevan Jacobson ,&nbsp;Jason D. Rights ,&nbsp;Dean A. Tripp ,&nbsp;Jennifer N. Stinson ,&nbsp;Sara Ahola Kohut","doi":"10.1016/j.hctj.2024.100085","DOIUrl":"10.1016/j.hctj.2024.100085","url":null,"abstract":"<div><h3>Background</h3><div>Inflammatory bowel disease (IBD) is a chronic autoimmune disease often diagnosed during adolescence. IBD negatively impacts all aspects of health-related quality of life, resulting in physical, emotional, social, school, and work functioning challenges. Adolescents have identified the need for peer support in managing their disease and promoting positive health outcomes. However, studies have yet to explore the peer support needs of this population. The study aimed to capture whether a peer mentoring program (iPeer2Peer©) was successful at improving adolescent disease self-management. The study also aimed to understand the lived experiences of adolescents participating in iPeer2Peer©.</div></div><div><h3>Methods</h3><div>Adolescents with IBD were recruited from three tertiary hospitals in Canada. The study adopted a waitlist pilot randomized control trial (RCT) with participants randomly allocated to the intervention (iPeer2Peer© program) or control group. Participants completed questionnaire measures at baseline and post-program examining self-reported self-management, self-efficacy, emotional distress, social support, and health-related quality of life. A subset of intervention participants were randomly invited post-program to participate in a semi-structured interview to examine mentee program experiences</div></div><div><h3>Results</h3><div>The quantitative analyses showed no significant differences between the intervention and control group. Three themes were identified in the qualitative analysis: 1) forming a connection over shared experiences and beyond, 2) improving mentee program experience, and 3) program flexibility.</div></div><div><h3>Conclusion</h3><div>Despite the lack of significant quantitative outcomes, qualitative data suggests peer support for adolescents with IBD adds value to IBD care by developing a sense of belonging with peers who share lived experiences. This study demonstrates the complexity of mentee psychosocial needs and challenges in measuring outcomes in peer support research. Clinical implications and future research opportunities are discussed.</div></div>","PeriodicalId":100602,"journal":{"name":"Health Care Transitions","volume":"3 ","pages":"Article 100085"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142707037","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":"The effects of serving as a peer supporter on adolescents and young adults with chronic conditions: A scoping review","authors":"Alison Manning ,&nbsp;McLean D. Pollock ,&nbsp;Nikhita Gopisetty ,&nbsp;Brian Linder ,&nbsp;Remi Misiewicz ,&nbsp;Tyra Girdwood ,&nbsp;Mirai Matsuura ,&nbsp;Jodie Neukirch Elliot ,&nbsp;Gary Maslow ,&nbsp;Sharron Docherty","doi":"10.1016/j.hctj.2025.100103","DOIUrl":"10.1016/j.hctj.2025.100103","url":null,"abstract":"<div><h3>Introduction</h3><div>Peer support has been shown to improve self-management and quality of life for adolescents and young adults (AYA) living with childhood onset chronic conditions (COCC), but little is known about the impact on AYA supporters. This review evaluates the impact of being a peer supporter with a COCC on the supporters and places those results within a theoretical context.</div></div><div><h3>Methods</h3><div>Extraction and synthesis of study findings was conducted using a collaborative approach.</div></div><div><h3>Results</h3><div>16 articles were included. The majority of studies were qualitative and fair to good quality. Effects were categorized into 3 areas: condition-related factors, personal/professional growth, and connectedness. 4 articles described risks of serving as a peer supporter.</div></div><div><h3>Discussion</h3><div>AYA peer supporters with COCC benefited from their role. Serving as a peer supporter may enhance skills related to becoming a successful, healthy young adult. Risks may be mitigated with training and support. Psychological theories inform the results.</div></div><div><h3>Implications <strong>to practice</strong></h3><div>Providers should encourage youth to engage in peer support programs as peer supporters, which may lead to improved health and related outcomes.</div></div>","PeriodicalId":100602,"journal":{"name":"Health Care Transitions","volume":"3 ","pages":"Article 100103"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143912625","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":"Dynamic assessment of a transition process for patients with diabetes","authors":"Sarah Allan ,&nbsp;Jessica Schmitt,&nbsp;Christy Foster","doi":"10.1016/j.hctj.2025.100097","DOIUrl":"10.1016/j.hctj.2025.100097","url":null,"abstract":"<div><h3>Introduction</h3><div>Adolescence can be defined as the period during which all individuals move from childhood to adulthood, including in the healthcare system, creating a need for a healthcare transition process. Children’s of Alabama provides four transition education sessions during clinic visits for adolescents with type 1 diabetes (T1D). We aimed to assess baseline patient data and patient perspectives of our current transition education process to guide our efforts to improve this process.</div></div><div><h3>Methods</h3><div>We used a mixed methods design comprised of a quantitative analysis of baseline data in our adolescents with T1D and qualitative analysis of provide and patient perspectives. We queried the electronic medical record to obtain baseline characteristics of adolescent adolescents with T1D seen at our center from January 2022 to May 2022 and sought input via anonymous surveys of adult and pediatric endocrinology attendings, fellows, and nurse practitioners at our institution and of adolescents with T1D who had completed the final education session via an electronic secure database.</div></div><div><h3>Results</h3><div>Electronic Medical review of adolescents with T1D transitioning to adult care at our center revealed most of our adolescents with T1D had a gap in care of four months or greater between last pediatric visit and first adult visit. Pediatric provider surveys emphasized barriers for adolescents with T1D with appointment scheduling and challenges navigating the adult health care system. Adult surveys emphasized lack of communication with the adult health care team. Adolescents with T1D overall reported transition education prepared them well for adult care, but only 35.3 % had identified an adult provider after completing transition education.</div></div><div><h3>Conclusions</h3><div>Our findings outline additional areas for improvement in our transition process for adolescents with T1D. Based on feedback from the pediatric team, we are working to initiate transition education by age 16, standardize document discussions around transition, document date of planned transition, and document planned accepting adult provider. We are working to streamline record transfer based on feedback from adult providers. Based on patient feedback and our documented gaps in care, we are working to place referrals for adult care to minimize gaps in diabetes care.</div></div>","PeriodicalId":100602,"journal":{"name":"Health Care Transitions","volume":"3 ","pages":"Article 100097"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143577662","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":"A mixed methods exploratory study assessing youth knowledge, self-efficacy and mental health outcomes in transition to adult healthcare","authors":"Jennifer G. Andrews ,&nbsp;Rena Shifren ,&nbsp;Richard Wahl ,&nbsp;Wendy Parent-Johnson ,&nbsp;Scott Klewer","doi":"10.1016/j.hctj.2025.100096","DOIUrl":"10.1016/j.hctj.2025.100096","url":null,"abstract":"<div><h3>Background</h3><div>Transition from adolescence to adulthood is a change in status yielding self-sufficiency, independence, and participation in adult roles. There are numerous efforts to define transition elements and encourage formalized processes readying youth for adulthood, yet significant challenges remain.</div></div><div><h3>Methods</h3><div>We recruited individuals who were age 12 years or older and not transitioned or 18 years and older who transitioned within 24 months to complete questionnaires and participate in a focus group.</div></div><div><h3>Results</h3><div>25 participants (Mean age 17.9 years) completed questionnaires and 76 % participated in focus groups. Youth 18 years and older had mean scores in the reason for concern range on 7 of 9 NIH Toolbox scales de. Transition readiness was lower in adults across all five categories. Key themes include misunderstanding the concept of transition and self-determination in transition.</div></div><div><h3>Conclusions</h3><div>Few youth understood what “transition” entails. Most considered it a single issue, such as aging out of insurance or leaving their pediatric specialist. Youth self-efficacy and life outlook declines in the late teens and early adulthood, exacerbating perceived inability to self-manage and gain independence. Most concerning is the emotional well-being and self-esteem of our adults who scored in the reason for concern range in 7 of 9 scales whereas adolescent peers did not. A directed attempt to create self-efficacy for youth in transition through training in health management, understanding the meaning of transition and promoting a positive perception prior to transition is needed.</div></div>","PeriodicalId":100602,"journal":{"name":"Health Care Transitions","volume":"3 ","pages":"Article 100096"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143227652","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}