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Abstract
Objective: To develop a measure of transition readiness and use the measure to identify factors associated with perceived readiness for transition from pediatric to adult medical care among patients participating in a multidisciplinary adolescent kidney transplant transition clinic. Methods: The adolescent and parent completed Readiness for Transition Questionnaire (RTQ- teen; RTQ-parent) was created for use in this study to assess overall transition readiness, adolescent healthcare behavior, and familial involvement in healthcare. Participants consisted of 48 adolescent kidney transplant recipients ages 15 to 21. Thirty-two (66.7%) of the adolescents caregivers also participated in the study. Adolescents completed the RTQ-teen and self-report measures of adherence and barriers to adherence. Parents completed the RTQ-parent. Results: Although highly and positively correlated with one another, there were significant differences between parent and teen report of transition readiness and adolescent responsibility with teens reporting significantly higher scores. In one set of regression models, increased adolescent responsibility and decreased parental involvement predicted significantly greater reported transition readiness. In an additional set of regression models, increased adolescent adherence factors (e.g., fewer barriers to medication taking, increased medication knowledge, calling in refills) also predicted significantly greater transition readiness. Conclusions: The preliminary psychometrics of the RTQ appear to be robust. The components of the RTQ showed strong internal consistency and the construct validity of the components of the RTQ was supported by the significant relationships with other variables assessed in this investigation. As a whole, these data demonstrate that transition readiness involves more than an adolescents age. Instead, transition readiness involves adolescents taking responsibility for their own healthcare tasks with less ongoing assistance from their parents and caregivers. Further, these data underscore the need for assessing both parent and adolescent report of transition readiness and healthcare responsibility. Additional research should begin to evaluate transitional programming to identify which clinical components are related to improvements in transition readiness, adolescent responsibility, and medical outcomes. INDEX WORDS: Pediatric transition, Transition readiness, Adolescent transplant, Kidney transplant