A social-ecological model of readiness for transition to adult-oriented care for adolescents and young adults with chronic health conditions

Background  Policy and research related to transition to adult care for adolescents and young adults (AYAs) has focused primarily on patient age, disease skills and knowledge. Objective  In an effort to broaden conceptualization of transition and move beyond isolated patient variables, a new social‐...

Full description

Saved in:
Bibliographic Details
Published in:Child : care, health & development health & development, 2011-11, Vol.37 (6), p.883-895
Main Authors: Schwartz, L. A., Tuchman, L. K., Hobbie, W. L., Ginsberg, J. P.
Format: Article
Language:English
Subjects:
Adaptation, Psychological
Adolescent
adolescent and young adults
Adolescents
Adult
Age Factors
cancer survivors
Chronic Disease
chronic health condition
Chronic illnesses
Concept Formation
Conceptualization
Data Collection
Disease Management
Evidence based research
Female
Health care policy
Health Knowledge, Attitudes, Practice
Health Policy
Health Status Indicators
Humans
Interpersonal Relations
Male
Medical research
Models, Psychological
Neoplasms - psychology
paediatric
Parents
Patients
Pediatrics - methods
Readiness
Social Environment
Stress, Psychological
Surveys and Questionnaires
Survivors
transition readiness
Transition to Adult Care
Transitions
Young Adult
Young adults
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background  Policy and research related to transition to adult care for adolescents and young adults (AYAs) has focused primarily on patient age, disease skills and knowledge. Objective  In an effort to broaden conceptualization of transition and move beyond isolated patient variables, a new social‐ecological model of AYA readiness for transition (SMART) was developed. Methods  SMART development was informed by related theories, literature, expert opinion and pilot data collection using a questionnaire developed to assess provider report of SMART components with 100 consecutive patients in a childhood cancer survivorship clinic. Results  The literature, expert opinion and pilot data collection support the relevance of SMART components and a social‐ecological conceptualization of transition. Provider report revealed that many components, representing more than age, disease knowledge and skills, related to provider plans for transferring patients. Conclusions  SMART consists of inter‐related constructs of patients, parents and providers with emphasis on variables amenable to intervention. Results support SMART's broadened conceptualization of transition readiness and need for assessment of multiple stakeholders' perspectives of patient transition readiness. A companion measure of SMART, which will be able to be completed by patients, parents and providers, will be developed to target areas of intervention to facilitate optimal transition readiness. Similar research programmes to establish evidence‐based transition measures and interventions are needed.
ISSN:0305-1862
1365-2214
DOI:10.1111/j.1365-2214.2011.01282.x