title: Self-Management and Transition Readiness Assessment: Concurrent, Predictive and Discriminant Validation of the STARx Questionnaire.
abstract: BACKGROUND
  The STARx Questionnaire was designed with patient and provider input, to measure self-management and transition skills in adolescents and young adults (AYA) with chronic health conditions. With proven reliability and an empirically-based factor structure, the self-report STARx Questionnaire requires further validation to demonstrate its clinical and research utility. In this study we examine the concurrent, predictive, and discriminant validity of the STARx Questionnaire.
  
  
  METHODS
  To examine concurrent validity, the STARx Questionnaire was compared to two other published transition readiness tools. Predictive validity was examined using linear regressions between the STARx Total Score and literacy, medication adherence, quality of life, and health services use. Discriminant validity was examined by comparing the performance of three chronic illness conditions on the STARx Total Score and associated subscales.
  
  
  RESULTS
  The STARx Questionnaire and its subscales positively correlated with the scores for both transition readiness tools reflecting strong concurrent validity. The STARx Questionnaire also correlated positively with the literacy, self-efficacy, and adherence measures indicating strong predictive validity; however, it did not correlate with either quality of life or health care utilization. The performance of AYA across three different clinical conditions was not significant, indicating the clinical utility of this HCT tool for a variety of chronic health conditions.
  
  
  CONCLUSIONS
  The strong validity of the STARx Questionnaire, in tandem with its strong reliability, indicated adequate psychometric properties for this generic self-report measure. These strong psychometric properties should contribute to the STARx being a viable measure of health care transition for both research and clinical purposes.
authors.affiliation: The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Cohen
authors.affiliation: The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC.
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Hooper
authors.affiliation: The University of North Carolina at Chapel Hill School of Public Health, 135 Dauer Dr, Chapel Hill, NC.
authors.forename: Karina
authors.initials: K
authors.lastname: Javalkar
authors.affiliation: Wake Forest University, 1834 Wake Forest Rd, Winston-Salem, NC; Victory Junction Camp, 4500 Adam's Way, Randleman, NC.
authors.forename: Cara
authors.initials: C
authors.lastname: Haberman
authors.affiliation: The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC.
authors.forename: Nicole
authors.initials: N
authors.lastname: Fenton
authors.affiliation: The Brody School of Medicine at East Carolina University, 600 Moye Blvd, Greenville, NC.
authors.forename: Hsiao
authors.initials: H
authors.lastname: Lai
authors.affiliation: Nationwide Children's Hospital, 700 Children's Dr, Columbus, OH; The Ohio State University, Columbus, OH.
authors.forename: John D
authors.initials: JD
authors.lastname: Mahan
authors.affiliation: Levine Children's Hospital at Carolinas Medical Center, 1000 Blythe Blvd, Charlotte, NC.
authors.forename: Susan
authors.initials: S
authors.lastname: Massengill
authors.affiliation: The University of North Carolina at Chapel Hill School of Nursing, Carrington Hall, CB#7460, Chapel Hill, NC.
authors.forename: Maureen
authors.initials: M
authors.lastname: Kelly
authors.affiliation: Escuela de Medicina, Universidad Panamericana, Puerto Vallarta, Mexico.
authors.forename: Guillermo
authors.initials: G
authors.lastname: Cantú
authors.affiliation: Hospital Infantil de México Federico Gómez, Calle Dr. Márquez 162, Cuahtemoc, Doctores, Ciudad de México, D.F., Mexico.
authors.forename: Mara
authors.initials: M
authors.lastname: Medeiros
authors.affiliation: The University of North Carolina at Chapel Hill, Chapel Hill, NC.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Phillips
authors.affiliation: Boston Children's Hospital, 300 Longwood Ave, Boston, MA.
authors.forename: Gregory
authors.initials: G
authors.lastname: Sawicki
authors.affiliation: East Tennessee State University James H. Quillen College of Medicine, 178 Maple Avenue, Mountain Home, TN.
authors.forename: David
authors.initials: D
authors.lastname: Wood
authors.affiliation: The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC.
authors.forename: Meredith
authors.initials: M
authors.lastname: Johnson
authors.affiliation: The University of North Carolina at Chapel Hill, Chapel Hill, NC.
authors.forename: Mary H
authors.initials: MH
authors.lastname: Benton
authors.affiliation: The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC. Electronic address: maria_ferris@med.unc.edu.
authors.forename: Maria
authors.initials: M
authors.lastname: Ferris
mesh_terms: D000293:Adolescent; D002908:Chronic Disease / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D015397:Program Evaluation; D011788:Quality of Life; D015203:Reproducibility of Results; D012648:Self Care / Q000379:methods*; D011795:Surveys and Questionnaires; D060305:Transition to Adult Care / Q000458:organization & administration*; D055815:Young Adult
keywords: Chronic conditions; STAR(x) validity; Self-management; Self-report transition measure; Transition