An app-based Transition Toolkit targeting youth with chronic health conditions: A randomized trial as a foundation to improve healthcare transition and outcomes
Jan Willem Gorter
905-525-9140 ext. 27855
905.525.9140 ext. 22979
McMaster University Hamilton Health Sciences
HAH-17-007 When transition to adult healthcare is poorly supported, patients’ and families’ adverse experiences of care are higher, as is risk for poor health outcomes, costly hospitalizations, inequity of healthcare services and “other” costs (e.g. missed school/work). Despite world-leading transition expertise at McMaster Children’s Hospital/Hamilton Health Sciences, a broadly-applicable and successfully implemented transition intervention is lacking. We assessed the feasibility and potential effect of an app-based transition toolkit (named MyTransition) for improving health of youth, healthcare transition experience & achievement of health and life goals. Our team learned many valuable lessons from this study, including but not limited to the following: Buy-in from youth around the importance of transition preparation/goal setting. ApplyIT and other transition studies point to goal setting as a vital ingredient for making transition planning relevant, meaningful and tailored to an individual youth to improve Transition to Adulthood.
HAH-17-007 More children with chronic conditions are surviving into adulthood. We know that transition to adult care is an unavoidable and challenging period for patients and their families, and comes with adverse outcomes in experience of care, population health and costs. Parents of children with chronic conditions report a greater need for support around the time of healthcare transition. Adolescents are expected to take on more responsibility for their own health as they age, yet many providers report neither having the tools nor appropriate resources to foster smooth transitions for patients and their families. We hypothesized that the MyTransition app-based transition toolkit designed to support youth moving from pediatric to adult healthcare can improve their experiences and lead to better health. The MyTransition app includes tools to describe one’s health condition, raise important health needs in new situations and measure skills related to managing health.The purpose of this study was to explore whether the use of the TRANSITION-Q (a validated transition readiness tool, non-disease specific measure of self- management in healthcare for adolescents with chronic health conditions) in clinical practice at McMaster Children’s Hospital improves healthcare self-management and healthcare experience for youth with chronic conditions aged 14-18 years. This panel discussion will outline the results of our pilot Randomized Controlled Trial (RCT) to implement the Transition-Q into clinical practice amongst 14-18 year olds at McMaster Children’s Hospital and discuss the challenges in implementation. The primary feasibility outcome examined whether a 90% retention could be attained. Our team was successful in achieving this outcome with 36 out of 39 participants completing all 3 time points (92% retention). It was evident, however, that recruitment was the largest barrier to a successful future RCT with only 39/100 participants agreeing to participate. Qualitative data indicated that: goal setting was an important part in successful transition to adult healthcare, education is needed to support youth in planning for transition, and app use would be enhanced if physicians were knowledgable and promoted the apps use amongst youth. The panel will be composed of a physician, youth and parent. Armed with the results of this study and previous, we are currently exploring strategies to implement the TRANSITION-Q combined with individualized goal setting broadly at McMaster Children’s Hospital. Transition readiness can ultimately optimize healthcare transition outcomes across conditions and systems.