A mixed methods exploratory study assessing youth knowledge, self-efficacy and mental health outcomes in transition to adult healthcare

Abstract

Background

Transition from adolescence to adulthood is a change in status yielding self-sufficiency, independence, and participation in adult roles. There are numerous efforts to define transition elements and encourage formalized processes readying youth for adulthood, yet significant challenges remain.

Methods

We recruited individuals who were age 12 years or older and not transitioned or 18 years and older who transitioned within 24 months to complete questionnaires and participate in a focus group.

Results

25 participants (Mean age 17.9 years) completed questionnaires and 76 % participated in focus groups. Youth 18 years and older had mean scores in the reason for concern range on 7 of 9 NIH Toolbox scales de. Transition readiness was lower in adults across all five categories. Key themes include misunderstanding the concept of transition and self-determination in transition.

Conclusions

Few youth understood what “transition” entails. Most considered it a single issue, such as aging out of insurance or leaving their pediatric specialist. Youth self-efficacy and life outlook declines in the late teens and early adulthood, exacerbating perceived inability to self-manage and gain independence. Most concerning is the emotional well-being and self-esteem of our adults who scored in the reason for concern range in 7 of 9 scales whereas adolescent peers did not. A directed attempt to create self-efficacy for youth in transition through training in health management, understanding the meaning of transition and promoting a positive perception prior to transition is needed.