Stakeholder validation of a model of readiness for transition to adult care

Lisa A. Schwartz; Lauren D. Brumley; Lisa K. Tuchman; Lamia P. Barakat; Wendy L. Hobbie; Jill P. Ginsberg; Lauren C. Daniel; Anne E. Kazak; Katherine Bevans; Janet A. Deatrick

doi:10.1001/jamapediatrics.2013.2223

Stakeholder validation of a model of readiness for transition to adult care

Lisa A. Schwartz, Lauren D. Brumley, Lisa K. Tuchman, Lamia P. Barakat, Wendy L. Hobbie, Jill P. Ginsberg, Lauren C. Daniel, Anne E. Kazak, Katherine Bevans, Janet A. Deatrick

Research output: Contribution to journal › Article › peer-review

110 Scopus citations

Abstract

Importance: That too few youth with special health care needs make the transition to adult-oriented health care successfully may be due, in part, to lack of readiness to transfer care. There is a lack of theoretical models to guide development and implementation of evidence-based guidelines, assessments, and interventions to improve transition readiness. OBJECTIVE: To further validate the Social-ecological Model of Adolescent and Young Adult Readiness to Transition (SMART) via feedback from stakeholders (patients, parents, and providers) from a medically diverse population in need of life-long follow-up care, survivors of childhood cancer. DESIGN: Mixed-methods participatory research design. SETTING: A large Mid-Atlantic children's hospital. PARTICIPANTS: Adolescent and young adult survivors of childhood cancer (n = 14), parents (n = 18), and pediatric providers (n = 10). MAIN EXPOSURES: Patients and parents participated in focus groups; providers participated in individual semi-structured interviews. MAIN OUTCOMES AND MEASURES: Validity of SMARTwas assessed 3ways: (1) ratings on importance of SMART components for transition readiness using a 5-point scale (0-4; ratings >2 support validity), (2) nominations of 3 "most important" components, and (3) directed content analysis of focus group/interview transcripts. RESULTS: Qualitative data supported the validity of SMART, with minor modifications to definitions of components. Quantitative ratings met criteria for validity; stakeholders endorsed all components of SMART as important for transition. No additional SMART variables were suggested by stakeholders and the "most important" components varied by stakeholders, thus supporting the comprehensiveness of SMART and need to involve multiple perspectives. CONCLUSIONS AND RELEVANCE: SMART represents a comprehensive and empirically validated framework for transition research and program planning, supported by survivors of childhood cancer, parents, and pediatric providers. Future research should validate SMART among other populations with special health care needs.

Original language	English (US)
Pages (from-to)	939-946
Number of pages	8
Journal	JAMA Pediatrics
Volume	167
Issue number	10
DOIs	https://doi.org/10.1001/jamapediatrics.2013.2223
State	Published - Oct 2013
Externally published	Yes

All Science Journal Classification (ASJC) codes

Pediatrics, Perinatology, and Child Health

Access to Document

10.1001/jamapediatrics.2013.2223

Cite this

@article{d39507d58a654ba4a6f4fb323c2bf380,

title = "Stakeholder validation of a model of readiness for transition to adult care",

abstract = "Importance: That too few youth with special health care needs make the transition to adult-oriented health care successfully may be due, in part, to lack of readiness to transfer care. There is a lack of theoretical models to guide development and implementation of evidence-based guidelines, assessments, and interventions to improve transition readiness. OBJECTIVE: To further validate the Social-ecological Model of Adolescent and Young Adult Readiness to Transition (SMART) via feedback from stakeholders (patients, parents, and providers) from a medically diverse population in need of life-long follow-up care, survivors of childhood cancer. DESIGN: Mixed-methods participatory research design. SETTING: A large Mid-Atlantic children's hospital. PARTICIPANTS: Adolescent and young adult survivors of childhood cancer (n = 14), parents (n = 18), and pediatric providers (n = 10). MAIN EXPOSURES: Patients and parents participated in focus groups; providers participated in individual semi-structured interviews. MAIN OUTCOMES AND MEASURES: Validity of SMARTwas assessed 3ways: (1) ratings on importance of SMART components for transition readiness using a 5-point scale (0-4; ratings >2 support validity), (2) nominations of 3 {"}most important{"} components, and (3) directed content analysis of focus group/interview transcripts. RESULTS: Qualitative data supported the validity of SMART, with minor modifications to definitions of components. Quantitative ratings met criteria for validity; stakeholders endorsed all components of SMART as important for transition. No additional SMART variables were suggested by stakeholders and the {"}most important{"} components varied by stakeholders, thus supporting the comprehensiveness of SMART and need to involve multiple perspectives. CONCLUSIONS AND RELEVANCE: SMART represents a comprehensive and empirically validated framework for transition research and program planning, supported by survivors of childhood cancer, parents, and pediatric providers. Future research should validate SMART among other populations with special health care needs.",

author = "Schwartz, {Lisa A.} and Brumley, {Lauren D.} and Tuchman, {Lisa K.} and Barakat, {Lamia P.} and Hobbie, {Wendy L.} and Ginsberg, {Jill P.} and Daniel, {Lauren C.} and Kazak, {Anne E.} and Katherine Bevans and Deatrick, {Janet A.}",

year = "2013",

month = oct,

doi = "10.1001/jamapediatrics.2013.2223",

language = "English (US)",

volume = "167",

pages = "939--946",

journal = "JAMA Pediatrics",

issn = "2168-6203",

publisher = "American Medical Association",

number = "10",

}

TY - JOUR

T1 - Stakeholder validation of a model of readiness for transition to adult care

AU - Schwartz, Lisa A.

AU - Brumley, Lauren D.

AU - Tuchman, Lisa K.

AU - Barakat, Lamia P.

AU - Hobbie, Wendy L.

AU - Ginsberg, Jill P.

AU - Daniel, Lauren C.

AU - Kazak, Anne E.

AU - Bevans, Katherine

AU - Deatrick, Janet A.

PY - 2013/10

Y1 - 2013/10

N2 - Importance: That too few youth with special health care needs make the transition to adult-oriented health care successfully may be due, in part, to lack of readiness to transfer care. There is a lack of theoretical models to guide development and implementation of evidence-based guidelines, assessments, and interventions to improve transition readiness. OBJECTIVE: To further validate the Social-ecological Model of Adolescent and Young Adult Readiness to Transition (SMART) via feedback from stakeholders (patients, parents, and providers) from a medically diverse population in need of life-long follow-up care, survivors of childhood cancer. DESIGN: Mixed-methods participatory research design. SETTING: A large Mid-Atlantic children's hospital. PARTICIPANTS: Adolescent and young adult survivors of childhood cancer (n = 14), parents (n = 18), and pediatric providers (n = 10). MAIN EXPOSURES: Patients and parents participated in focus groups; providers participated in individual semi-structured interviews. MAIN OUTCOMES AND MEASURES: Validity of SMARTwas assessed 3ways: (1) ratings on importance of SMART components for transition readiness using a 5-point scale (0-4; ratings >2 support validity), (2) nominations of 3 "most important" components, and (3) directed content analysis of focus group/interview transcripts. RESULTS: Qualitative data supported the validity of SMART, with minor modifications to definitions of components. Quantitative ratings met criteria for validity; stakeholders endorsed all components of SMART as important for transition. No additional SMART variables were suggested by stakeholders and the "most important" components varied by stakeholders, thus supporting the comprehensiveness of SMART and need to involve multiple perspectives. CONCLUSIONS AND RELEVANCE: SMART represents a comprehensive and empirically validated framework for transition research and program planning, supported by survivors of childhood cancer, parents, and pediatric providers. Future research should validate SMART among other populations with special health care needs.

AB - Importance: That too few youth with special health care needs make the transition to adult-oriented health care successfully may be due, in part, to lack of readiness to transfer care. There is a lack of theoretical models to guide development and implementation of evidence-based guidelines, assessments, and interventions to improve transition readiness. OBJECTIVE: To further validate the Social-ecological Model of Adolescent and Young Adult Readiness to Transition (SMART) via feedback from stakeholders (patients, parents, and providers) from a medically diverse population in need of life-long follow-up care, survivors of childhood cancer. DESIGN: Mixed-methods participatory research design. SETTING: A large Mid-Atlantic children's hospital. PARTICIPANTS: Adolescent and young adult survivors of childhood cancer (n = 14), parents (n = 18), and pediatric providers (n = 10). MAIN EXPOSURES: Patients and parents participated in focus groups; providers participated in individual semi-structured interviews. MAIN OUTCOMES AND MEASURES: Validity of SMARTwas assessed 3ways: (1) ratings on importance of SMART components for transition readiness using a 5-point scale (0-4; ratings >2 support validity), (2) nominations of 3 "most important" components, and (3) directed content analysis of focus group/interview transcripts. RESULTS: Qualitative data supported the validity of SMART, with minor modifications to definitions of components. Quantitative ratings met criteria for validity; stakeholders endorsed all components of SMART as important for transition. No additional SMART variables were suggested by stakeholders and the "most important" components varied by stakeholders, thus supporting the comprehensiveness of SMART and need to involve multiple perspectives. CONCLUSIONS AND RELEVANCE: SMART represents a comprehensive and empirically validated framework for transition research and program planning, supported by survivors of childhood cancer, parents, and pediatric providers. Future research should validate SMART among other populations with special health care needs.

UR - http://www.scopus.com/inward/record.url?scp=84885206285&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84885206285&partnerID=8YFLogxK

U2 - 10.1001/jamapediatrics.2013.2223

DO - 10.1001/jamapediatrics.2013.2223

M3 - Article

C2 - 23959392

AN - SCOPUS:84885206285

SN - 2168-6203

VL - 167

SP - 939

EP - 946

JO - JAMA Pediatrics

JF - JAMA Pediatrics

IS - 10

ER -

Stakeholder validation of a model of readiness for transition to adult care

Abstract

All Science Journal Classification (ASJC) codes

Access to Document

Other files and links

Fingerprint

Cite this