The Associations of Chronic Condition Type and Individual Characteristics With Transition Readiness

OBJECTIVE: Identifying differences in transition readiness according to chronic condition is essential for understanding whether special emphasis within specific populations is warranted. Youth with chronic conditions (type 1 diabetes, Turner syndrome, spina bifida, autism spectrum disorder [ASD]) representing various types of impairments were compared with youth without chronic conditions. It was hypothesized that differences would be observed according to condition type, with youth with cognitive/behavioral conditions showing less readiness than youth with other conditions and youth without chronic conditions showing the highest levels of transition readiness. METHODS: Patients (N = 163) ages 12 to 22 were recruited via outpatient clinics at a large freestanding children's hospital. Demographic characteristics (age, sex, race, and maternal education), health literacy, perceptions about health care responsibility, importance and confidence about transfer to adult health care, and the Transition Readiness Assessment Questionnaire (TRAQ) were included. RESULTS: Significant differences in transition readiness were found according to condition type; youth with ASD had the lowest transition readiness scores. Patient and family characteristics and condition were predictors of TRAQ scores and self perceived readiness to take responsibility for health care and transfer to adult care. Item-level analysis indicated that medication, appointment-keeping, and activities of daily living accounted for differences in TRAQ scores according to condition. CONCLUSIONS: Disparities in transition readiness were detected across condition types, with potentially modifiable mechanisms identified to address gaps in readiness for youth transferring to adult health care systems. Developing interventions that assist providers in addressing these modifiable characteristics might improve transition to adult health care for adolescents with various chronic conditions.