Development and Validation of the Adolescent Assessment of Preparation for Transition: A Novel Patient Experience Measure.
PURPOSE
Significant gaps exist in health care transition (HCT) preparation that can impact care and outcomes in young adults with chronic illness. No quality measure exists to directly assess adolescent experiences of HCT preparation. Our objective was to develop an adolescent-reported measure of the quality of HCT preparation received from pediatric health care providers.


METHODS
The Adolescent Assessment of Preparation for Transition (ADAPT) is a 26-item mailed survey designed for completion by 16- and 17-year-old adolescents with a chronic health condition. Adolescents from three samples (two large Medicaid insurance plans [n = 3,000 each] and one large tertiary care pediatric hospital [n = 623]) were mailed the survey. An iterative developmental process included focus groups and cognitive interviews, and validity was assessed using confirmatory factor analysis and ordinal reliability coefficients.


RESULTS
Reliability and validity was evaluated for the following three prespecified composite measures: (1) counseling on transition self-management; (2) counseling on prescription medication; and (3) transfer planning. Across the three samples, all but one measure had good internal consistency (ordinal reliability coefficient ≥ .7). Confirmatory factor analysis using tetrachoric correlation coefficients was stable across samples and supported the construct validity of the first two composite measures.


CONCLUSIONS
ADAPT is a reliable, validated instrument measuring the quality of HCT preparation experiences reported by adolescents with chronic disease. ADAPT will enable clinical programs and health care delivery systems to assess the quality of HCT preparation and provide targets for improvement in adolescent counseling related to transition.
['Sawicki|Gregory S|GS|', 'Garvey|Katharine C|KC|', 'Toomey|Sara L|SL|', 'Williams|Kathryn A|KA|', 'Chen|Yuefan|Y|', 'Hargraves|J Lee|JL|', 'Leblanc|Jessica|J|', 'Schuster|Mark A|MA|', 'Finkelstein|Jonathan A|JA|']
D000293:Adolescent D016497:Adolescent Health Services D002908:Chronic Disease D037001:Directive Counseling D019538:Health Care Surveys D006801:Humans D055118:Medication Adherence D011787:Quality of Health Care D012648:Self Care D057566:Self Report D060305:Transition to Adult Care
Patient experience Health care transition Quality measurement Survey development