title: Adolescent transition clinic in inflammatory bowel disease: quantitative assessment of self-efficacy skills.
abstract: OBJECTIVE
  There is no model for the process of transition of adolescents with inflammatory bowel diseases (IBD) to the adult care protocol. We recently established a transition clinic where 17-year-old to 18-year-old IBD patients are seen by a multidisciplinary team including pediatric and adult gastroenterologists with expertise in IBD treatments, an IBD nurse, and a psychologist. We quantitatively describe this model and its benefits, and correlate demographic and transition parameters to self-efficacy in IBD adolescent patients before and after transition.
  
  
  METHODS
  All adolescent IBD patients enrolled in our transition clinic between January 2013 and December 2015 were included. They completed a self-efficacy questionnaire ('IBD-yourself') before and after the transition. The scores were correlated to demographic, disease, and transition parameters.
  
  
  RESULTS
  Thirty of the 36 enrolled patients (mean age: 19±1.8 years, range: 17-27) had Crohn's disease. Twenty-seven patients completed the transition protocol, which included an average of 3-4 meetings (range: 2-8) over 6.9±3.5 months. Self-efficacy scores in all domains of the questionnaire were significantly higher after completion of the transition. The weighted average score of the questionnaire's domains was 1.85±0.3 before and 1.41±0.21 after transition (P<0.0001). Age, sex, disease duration, duration of transition, and the number of meetings in the clinic correlated with the questionnaire's scores in the domains of coping with IBD, knowledge of the transition process, and medication use.
  
  
  CONCLUSIONS
  A well-planned adolescent IBD transition clinic contributes significantly toward improved self-efficacy in IBD. We recommend its implementation in IBD centers to enable a personalized transition program tailored to the needs of adolescents with IBD in specific domains.
authors.affiliation: aPediatric Gastroenterology Unit, 'Dana-Dwek' Children's Hospital bIBD Center of the Department of Gastroenterology and Liver Diseases cHealth and Medical Psychological Service dTel Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Anat
authors.initials: A
authors.lastname: Yerushalmy-Feler
authors.forename: Yulia
authors.initials: Y
authors.lastname: Ron
authors.forename: Efrat
authors.initials: E
authors.lastname: Barnea
authors.forename: Ayala
authors.initials: A
authors.lastname: Nachum
authors.forename: Shay
authors.initials: S
authors.lastname: Matalon
authors.forename: Margalit
authors.initials: M
authors.lastname: Dali-Levy
authors.forename: Iris
authors.initials: I
authors.lastname: Dotan
authors.forename: Shlomi
authors.initials: S
authors.lastname: Cohen
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D003424:Crohn Disease / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D019033:Delivery of Health Care, Integrated; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D055118:Medication Adherence; D010348:Patient Care Team; D010360:Patient Transfer; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D055815:Young Adult