title: Development and Validation of the Adolescent Assessment of Preparation for Transition: A Novel Patient Experience Measure.
abstract: OBJECTIVE
  Significant gaps exist in health care transition (HCT) preparation that can impact care and outcomes in young adults with chronic illness. No quality measure exists to directly assess adolescent experiences of HCT preparation. Our objective was to develop an adolescent-reported measure of the quality of HCT preparation received from pediatric health care providers.
  
  
  METHODS
  The Adolescent Assessment of Preparation for Transition (ADAPT) is a 26-item mailed survey designed for completion by 16- and 17-year-old adolescents with a chronic health condition. Adolescents from three samples (two large Medicaid insurance plans [n = 3,000 each] and one large tertiary care pediatric hospital [n = 623]) were mailed the survey. An iterative developmental process included focus groups and cognitive interviews, and validity was assessed using confirmatory factor analysis and ordinal reliability coefficients.
  
  
  RESULTS
  Reliability and validity was evaluated for the following three prespecified composite measures: (1) counseling on transition self-management; (2) counseling on prescription medication; and (3) transfer planning. Across the three samples, all but one measure had good internal consistency (ordinal reliability coefficient ≥ .7). Confirmatory factor analysis using tetrachoric correlation coefficients was stable across samples and supported the construct validity of the first two composite measures.
  
  
  CONCLUSIONS
  ADAPT is a reliable, validated instrument measuring the quality of HCT preparation experiences reported by adolescents with chronic disease. ADAPT will enable clinical programs and health care delivery systems to assess the quality of HCT preparation and provide targets for improvement in adolescent counseling related to transition.
authors: Division of General Pediatrics, Boston Children's Hospital, Boston, Massachusetts; Division of Respiratory Diseases, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts. Electronic address: gregory.sawicki@childrens.harvard.edu.
authors: Gregory S
authors: GS
authors: Sawicki
authors: Division of General Pediatrics, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Division of Endocrinology, Boston Children's Hospital, Boston, Massachusetts.
authors: Katharine C
authors: KC
authors: Garvey
authors: Division of General Pediatrics, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.
authors: Sara L
authors: SL
authors: Toomey
authors: Clinical Research Center, Boston Children's Hospital, Boston, Massachusetts.
authors: Kathryn A
authors: KA
authors: Williams
authors: Division of General Pediatrics, Boston Children's Hospital, Boston, Massachusetts.
authors: Yuefan
authors: Y
authors: Chen
authors: Center for Survey Research, University of Massachusetts, Boston, Massachusetts.
authors: J Lee
authors: JL
authors: Hargraves
authors: Center for Survey Research, University of Massachusetts, Boston, Massachusetts.
authors: Jessica
authors: J
authors: Leblanc
authors: Division of General Pediatrics, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.
authors: Mark A
authors: MA
authors: Schuster
authors: Division of General Pediatrics, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.
authors: Jonathan A
authors: JA
authors: Finkelstein
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services / Q000592:standards; D002908:Chronic Disease; D037001:Directive Counseling / Q000592:standards; D019538:Health Care Surveys / Q000379:methods*; D006801:Humans; D055118:Medication Adherence; D011787:Quality of Health Care; D012648:Self Care / Q000379:methods; D057566:Self Report; D060305:Transition to Adult Care
keywords: Health care transition; Patient experience; Quality measurement; Survey development