title: Patient-perceived facilitators in the transition of care for young adult survivors of childhood cancer.
abstract: BACKGROUND
  A new challenge has emerged in optimizing the transition of pediatric survivorship care to similarly focused programs that are age-appropriate for young adults. The purpose of this study is to identify components of a clinical survivorship program that facilitate the transition of care for young adult survivors of childhood cancer from a pediatric to adult care-setting.
  
  
  METHODS
  Prior to transition, a descriptive study of childhood cancer survivors was conducted using a cross-sectional study design. A questionnaire was used to identify which clinical components of a survivorship program would most influence their decision to transition care to an adult medical center.
  
  
  RESULTS
  Of 129 invited survivors, 103 participated (80%). Most survivors were age 16-19 years (40/103, 39%) or 20-24 years (37/103, 36%). When asked if the participant was willing to transition their survivorship care to an adult facility, 97 (95%) responded affirmatively. The clinical components most frequently rated "Very Important" in the decision to transition were the acceptance of insurance (80/103, 78%) followed by the presence of a provider knowledgeable in childhood cancer (68/103, 66%). The clinical components most frequently rated "Very Important" or "Important" were the availability of flexible scheduling (102/103, 99%) followed by the comprehensive nature of the care provided (101/103, 98%).
  
  
  CONCLUSIONS
  The decision to transition survivorship care to age-appropriate care-settings is complex and not well understood. Issues related to insurance, clinical team composition and scheduling appear to be most important for young adult survivors making this decision. Pediatr Blood Cancer 2013;601365-1368. © 2013 Wiley Periodicals, Inc.
authors: Center for Cancer and Blood Disorders, Children's National Medical Center, Washington, District of Columbia, USA. ktsadak@umn.edu
authors: Karim Thomas
authors: KT
authors: Sadak
authors: Amanda
authors: A
authors: Dinofia
authors: Gregory
authors: G
authors: Reaman
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D003430:Cross-Sectional Studies; D003657:Decision Making; D003695:Delivery of Health Care; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms; D012932:Social Facilitation; D011795:Surveys and Questionnaires; D017741:Survivors; D055815:Young Adult