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Introduction: We examined the influence of special healthcare needs, onset of the COVID-19 pandemic, and their interaction on receiving transition services to prepare for future adult care among US adolescents, and whether social determinants of health moderated the relationship of these factors with receiving transition services., Methods: We analyzed the National Survey of Children's Health (2019, 2020-2021) using adjusted multivariable logistic regression models. We assessed a repeated cross-sectional, nationally representative sample of adolescents aged 12-17 years old. Sampling weights were used to generalize samples to the populations of interest. The main outcome was receipt of transition services to prepare for future adult healthcare. Measures included pre vs. post COVID-19 onset, special healthcare needs, and social determinants of health (health insurance, food sufficiency, neighborhood safety, household language, race/ethnicity, and household poverty level). Sex and two-parent households were included as covariates., Results: A total of 45,935 adolescents were included, with N =12,230 in the pre COVID-19 group and N =33,705 in the post COVID-19 group. We found statistically significant higher odds of receiving transition services among adolescents with special healthcare needs ( 95 CI = 1.23, 1.58), females ( 95 CI = 1.09, 1.39), and during pre COVID-19 ( 95 CI = 1.14, 1.45). Private insurance ( 95 CI = 1.03, 1.37), English as primary household language ( 95 CI = 1.19, 2.27), and race/ethnicity were significant predictors of receipt of transition services. Neighborhood safety significantly moderated ( 95 CI = 1.70, 6.60) the relationship between special healthcare needs and receipt of transition services., Discussion: This population-based study identified significant disparities in receipt of transition services provided to US adolescents via the differential impact of social determinants of health, special healthcare needs, and COVID-19 onset on receipt of services., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Girdwood, Silva, Maslow and Docherty.)

Background: Enhancing family readiness for the healthcare transition (HCT) to adult-focused care can help adolescents and young adults (AYA) thrive in adulthood. We aimed to explore modifiable and non-modifiable individual, family, and healthcare factors associated with HCT readiness of AYA among families of AYA with cystic fibrosis (CF) during COVID-19., Methods: A multi-site, cross-sectional design was used and an online survey was deployed among families and their AYA from three US pediatric CF centers. The STAR x Transition Readiness Questionnaire assessed caregiver- and AYA-perceived HCT readiness of AYA., Results: Caregivers ( N  = 71) and their AYA with CF ( N  = 33, aged 12-21 years) perceived moderately high HCT readiness of AYA. Caregiver resilience was a significant ( p  = 0.006), family-level factor correlated with caregiver-perceived HCT readiness., Conclusions: Families perceived similar levels of AYA readiness for adult-focused care. Caregiver resilience is an important, modifiable family-level factor for targeted interdisciplinary interventions aimed at enhancing HCT processes during COVID-19., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Tyra Girdwood reports financial support was provided by the Robert Wood Johnson Foundation Future of Nursing Scholars Program. Jennifer Goralski reports research funding and speaker honoraria from the Cystic Fibrosis Foundation.

Purpose: Medical advances have increased the life expectancy of adolescents and young adults (AYA) with cystic fibrosis (CF) and importance of high-quality health care transitions (HCT) from pediatric-to-adult focused health care. The purpose of this study was to describe perceptions of HCT readiness among caregivers and AYA with CF during the COVID-19 pandemic., Design and Methods: Using a qualitative descriptive design, caregivers and AYA aged 12-21 years old were recruited from three large CF care centers across the eastern U.S. Data were collected using an online questionnaire with open ended and closed ended questions. Survey topics were: perceptions of HCT readiness, actions to prepare for HCT, and the impact of COVID-19. Results were interpreted using an adapted framework of the Health Care Transition Research Consortium Model and qualitative content analysis., Results: The sample included 73 caregivers (62 mothers) and 34 AYA (24 female, mean age 15.5 years). Three attributes of HCT readiness were identified from caregiver and AYA perceptions: (1) strong concerns that AYA lacked readiness to manage self-care needs in the future, (2) gaps in resources hindered ongoing efforts to enhance transition readiness, and (3) COVID changes created new barriers and facilitators to health care transition readiness., Conclusions: Caregivers and AYA felt they lacked readiness for HCT, they worried about worsening outcomes in adult-focused care, and they were challenged by the onset of the COVID-19 pandemic., Practical Implications: These findings provide a solid description of perceived transition readiness during a pandemic that may enhance transitional care design., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Tyra Girdwood reports financial support was provided by the Robert Wood Johnson Foundation Future of Nursing Scholars Program. The sponsor had no role in the design, methods, subject recruitment, data collections, analysis, or preparation of this paper., (© 2023 The Authors.)