Development and Evaluation Of a Training Program for Adolescents With Special Healthcare Needs

Purpose: Every year, 750,000 children with special healthcare needs are transitioned from pediatrics to adult care. Most adolescents/young adults (AYAs) (ages 14 to 21 years) lack the needed preparation for transition from pediatric providers to an adult-based model of care. Barriers for healthcare providers to transitioning AYAs include lack of knowledge, confidence, and experience to provide needed transition assessment and planning. Designs/Methods: To promote appropriate transition for AYAs with special healthcare needs, including spina bifida and cerebral palsy, an Adolescent Young Adult Healthcare Transition (AYAHT) program was developed to educate providers in an outpatient rehabilitation department of major metropolitan inner city pediatric teaching and research hospital. Pediatric rehabilitation physicians and advanced practice nurses developed the AYAHT program in four phases over eight weeks. The program featured age-specific healthcare transition interventions in an anticipatory guidance format. A 25-item pre/posttest AYAHT Knowledge, Confidence, and Experience questionnaire was used to evaluate changes in providers' knowledge, confidence, and experience regarding elements of the transition program both before and after training about its usage. Results: Survey questions on the AYAHT Knowledge, Confidence, and Experience questionnaire--assessing knowledge, confidence, and experience--demonstrated a significant increase between pre- and post-survey scores in most areas. Conclusion: Education is a first step in promoting guideline implementation to ensure successful transition for AYAs and caregivers.
The 2009-2010 National Survey of Children with Special Health Care Needs (NS-CSHCN) revealed that almost 4 million of the 25 million adolescents in the United States have a physical, mental, [...]