Evaluation of readiness to transfer to adult healthcare: What about the well adolescent?

Background: Understanding readiness to transfer from pediatric to adult healthcare is important For all youth; however, research and implementation guidelines in this area have emphasized youth seen in pediatric subspecialty settings. The purpose of this study was to develop an approach For evaluating transition readiness in a primary care setting, collect pilot data that examined the transition readiness of teens in that program, and implement assessments as part of clinical care. Method: Forty boys and girls aged 12-22 were recruited From an adolescent medicine outpatient program in a large children's hospital. The first 10 adolescents provided responses to questions and participated in cognitive interviewing. Questions changed minimally and responses from all 40 participants were combined. After the study visit, a researcher compared participant responses to electronic medical records and coded responses for accuracy. The survey consisted of 41 transition readiness items from previously published measures. Results: The research team was able to develop a tool to assess transition readiness within a clinical setting. When administered to participants from that program, participants demonstrated poor transition readiness. Modifications were made based on participant feedback and implementation in the clinical setting. Clinicians were successful with administering transition readiness assessments. Conclusions: It appears that even in youth who are generally well, transition readiness is low. Transition readiness assessments can be implemented in the primary care setting, and have been useful for guiding clinical care. Additional barriers and next steps will be discussed. (C) 2014 Elsevier Inc. All rights reserved.