Transition readiness measures for adolescents with chronic illness: A scoping review of new measures

Background

The transition from pediatric to adult care settings for adolescents and young adults living with chronic conditions can be challenging and has been associated with declines in health and access to care. Well-validated measures of patients’ transition readiness are critical, both for use in the clinical setting and to rigorously evaluate transition support programs for the purposes of research and health care quality improvement.

Objectives

This review aimed to build off existing reviews and 1) identify and describe all newly developed and validated measures for the assessment of transition readiness for youth with chronic illness from the period of 2018–2022, and 2) evaluate their measurement properties and identify gaps in measurement testing.

Methods

Electronic searches were conducted in MEDLINE, EMBASE, CINAHL and PsychINFO to identify articles developing and validating transition readiness in individuals aged 12–26 years with a chronic illness between 2018 and 2022. Two reviewers independently selected articles for review and assessed quality of measurement properties.

Results

22 studies met inclusion criteria reporting on 21 different tools. 9 studies reported on the development and evaluation of a new tool, and 13 reported on the adaptation, modification, and/or translation of an existing tool. Most adapted tools were translations and adaptations of the Transition Readiness Assessment Questionnaire (TRAQ) (n = 7). While some of these studies demonstrated sufficient internal consistency and structural validity, few met the COSMIN criteria for reliability and hypothesis testing and none met the criteria for cross-cultural validity. Criterion validity and measurement error were not assessed in any studies.

Conclusion

Many new transition readiness measures continue to be developed in recent years, yet few have undergone rigorous psychometric evaluation. The TRAQ was the existing measure most often used as a model for developing new or modified tools. There remains a clear need for further validation of existing measures of patients’ readiness to transition as opposed to continuing to develop new measures.