title: Self-Management and Transition Readiness Assessment: Development, Reliability, and Factor Structure of the STARx Questionnaire.
abstract: BACKGROUND
  The Self-Management and Transition to Adulthood with Rx=Treatment (STARx) Questionnaire was developed to collect information on self-management and health care transition (HCT) skills, via self-report, in a broad population of adolescents and young adults (AYAs) with chronic conditions.
  
  
  METHODS
  Over several iterations, the STARx questionnaire was created with AYA, family, and health provider input. The development and pilot testing of the STARx Questionnaire took place with the assistance of 1219 AYAs with different chronic health conditions, in multiple institutions and settings over three phases: item development, pilot testing, reliability and factor structuring.
  
  
  RESULTS
  The three development phases resulted in a final version of the STARx Questionnaire. The exploratory factor analysis of the third version of the 18-item STARx identified six factors that accounted for about 65% of the variance: Medication management, Provider communication, Engagement during appointments, Disease knowledge, Adult health responsibilities, and Resource utilization. Reliability estimates revealed good internal consistency and temporal stability, with the alpha coefficient for the overall scale being .80. The STARx was developmentally sensitive, with older patients scoring significantly higher on nearly every factor than younger patients.
  
  
  CONCLUSIONS
  The STARx Questionnaire is a reliable, self-report tool with adequate internal consistency, temporal stability, and a strong, multidimensional factor structure. It provides another assessment strategy to measure self-management and transition skills in AYAs with chronic conditions.
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: M
authors.initials: M
authors.lastname: Ferris
authors.affiliation: The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC.
authors.forename: S
authors.initials: S
authors.lastname: Cohen
authors.affiliation: Wake Forest University, Winston-Salem, NC; Victory Junction Camp, Randleman, NC.
authors.forename: C
authors.initials: C
authors.lastname: Haberman
authors.affiliation: The University of North Carolina at Chapel Hill School of Public Health, Chapel Hill, NC.
authors.forename: K
authors.initials: K
authors.lastname: Javalkar
authors.affiliation: Levine Children's Hospital at Carolinas Medical Center, Charlotte, NC.
authors.forename: S
authors.initials: S
authors.lastname: Massengill
authors.affiliation: Nationwide Children's Hospital, Columbus, OH; The Ohio State University, Columbus, OH.
authors.forename: J D
authors.initials: JD
authors.lastname: Mahan
authors.affiliation: Nationwide Children's Hospital, Columbus, OH; The Ohio State University, Columbus, OH.
authors.forename: S
authors.initials: S
authors.lastname: Kim
authors.affiliation: The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC.
authors.forename: K
authors.initials: K
authors.lastname: Bickford
authors.affiliation: Escuela de Medicina, Universidad Panamericana.
authors.forename: G
authors.initials: G
authors.lastname: Cantu
authors.affiliation: Hospital Infantil de México Federico Gómez.
authors.forename: M
authors.initials: M
authors.lastname: Medeiros
authors.affiliation: Hospital Infantil de México Federico Gómez.
authors.forename: A
authors.initials: A
authors.lastname: Phillips
authors.affiliation: The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC.
authors.forename: M T
authors.initials: MT
authors.lastname: Ferris
authors.affiliation: The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC.
authors.forename: S R
authors.initials: SR
authors.lastname: Hooper
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D002908:Chronic Disease / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D010865:Pilot Projects; D015397:Program Evaluation; D015203:Reproducibility of Results; D012648:Self Care / Q000379:methods*; D011795:Surveys and Questionnaires; D060305:Transition to Adult Care / Q000458:organization & administration*; D000069341:Transitional Care / Q000458:organization & administration; D055815:Young Adult
keywords: Adolescents; Chronic conditions; Measure; Self-management; Transition; Young adults