Lisa A. Schwartz and Lisa K. Tuchman are co-first authors.
A social-ecological model of readiness for transition to adult-oriented care for adolescents and young adults with chronic health conditions
Article first published online: 18 OCT 2011
© 2011 Blackwell Publishing Ltd
Child: Care, Health and Development
Special Issue: Transition to Adulthood
Volume 37, Issue 6, pages 883–895, November 2011
How to Cite
Schwartz, L. A., Tuchman, L. K., Hobbie, W. L. and Ginsberg, J. P. (2011), A social-ecological model of readiness for transition to adult-oriented care for adolescents and young adults with chronic health conditions. Child: Care, Health and Development, 37: 883–895. doi: 10.1111/j.1365-2214.2011.01282.x
- Issue published online: 18 OCT 2011
- Article first published online: 18 OCT 2011
- Accepted for publication 19 May 2011
- adolescent and young adults;
- cancer survivors;
- chronic health condition;
- transition readiness;
- transition to adult care
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.