title: Let's Empower and Prepare (LEAP): Evaluation of a Structured Transition Program for Young Adults With Type 1 Diabetes.
abstract: OBJECTIVE
  To evaluate the efficacy of a structured transition program compared with usual care in improving routine follow-up, clinical, and psychosocial outcomes among young adults with type 1 diabetes.
  
  
  METHODS
  Eighty-one young adults in their last year of pediatric care were recruited from three clinics. Intervention group (IG) participants (n = 51) received a structured transition program incorporating tailored diabetes education, case management, group education classes, and access to a newly developed young adult diabetes clinic and transition website. Control group (CG) participants (n = 30) received usual care. The primary outcome was the number of routine clinic visits. Secondary outcomes included glycemic control, hypoglycemia, health care use, and psychosocial well-being. Assessments were conducted at baseline, and 6 and 12 months.
  
  
  RESULTS
  Limitations in CG follow-up prevented direct comparisons of adult care visits; however, at the 12-month follow-up among IG participants discharged from pediatric care (n = 32), 78% had one or more adult visits. Among IG participants, the total number of clinic visits did not differ between those who transitioned and those who remained in pediatric care (3.0 ± 1.24 vs. 3.11 ± 0.94, P = 0.74). IG compared with CG participants had improved glycemic control (-0.40 ± 1.16% vs. 0.42 ± 1.51% [4.4 ± 12.7 mmol/mol vs. 4.6 ± 16.5 mmol/mol], P = 0.01), incidence of severe hypoglycemia (0.0% vs. 16%, P = 0.02), and global well-being (P = 0.02) at 12 months.
  
  
  CONCLUSIONS
  A structured transition program was successful in facilitating transition to adult care without a decrease in clinical follow-up. Compared with usual care, the transition program facilitated improvements in glycemic control, hypoglycemia, and psychosocial well-being.
authors.affiliation: Department of Pediatrics, University of Southern California, Los Angeles, CA psequeir@usc.edu.
authors.forename: Paola A
authors.initials: PA
authors.lastname: Sequeira
authors.affiliation: Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Pyatak
authors.affiliation: Department of Pediatrics, University of Southern California, Los Angeles, CA.
authors.forename: Marc J
authors.initials: MJ
authors.lastname: Weigensberg
authors.affiliation: Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA.
authors.forename: Cheryl P
authors.initials: CP
authors.lastname: Vigen
authors.affiliation: Children's Hospital Los Angeles, Los Angeles, CA.
authors.forename: Jamie R
authors.initials: JR
authors.lastname: Wood
authors.affiliation: Keck School of Medicine of University of Southern California, Los Angeles, CA.
authors.forename: Valerie
authors.initials: V
authors.lastname: Ruelas
authors.affiliation: Keck School of Medicine of University of Southern California, Los Angeles, CA.
authors.forename: Lucy
authors.initials: L
authors.lastname: Montoya
authors.affiliation: Children's Hospital Los Angeles, Los Angeles, CA.
authors.forename: Marisa
authors.initials: M
authors.lastname: Cohen
authors.affiliation: Children's Hospital of Orange County, Orange, CA.
authors.forename: Heather
authors.initials: H
authors.lastname: Speer
authors.affiliation: Children's Hospital of Orange County, Orange, CA.
authors.forename: Susan
authors.initials: S
authors.lastname: Clark
authors.affiliation: Keck School of Medicine of University of Southern California, Los Angeles, CA.
authors.forename: Anne L
authors.initials: AL
authors.lastname: Peters
mesh_terms: D000553:Ambulatory Care; D001786:Blood Glucose / Q000032:analysis; D019090:Case Management; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D015397:Program Evaluation; D011446:Prospective Studies; D060305:Transition to Adult Care; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D001786:Blood Glucose