Moynihan M*, Saewyc E, Whitehouse S, Paone M, McPherson G. (2015). Assessing readiness for transition from paediatric to adult health care: Revision and psychometric evaluation of the “Am I ON TRAC for Adult Care”. Journal of Advanced Nursing. 71(6): 1324-1355.

Aim

To refine and psychometrically test the Am I ON TRAC for Adult Care questionnaire.

Background

Inadequate transition to adult care for adolescents with special healthcare needs has been associated with greater risk of treatment non-adherence, lack of medical follow-up, increased morbidity and mortality. Presently, there are no well-validated measures assessing adolescents’ readiness to transition from paediatric to adult medical care.

Design

Descriptive cross-sectional study.

Methods

The Am I ON TRAC for Adult Care questionnaire was refined to improve the instrument’s methodological soundness. A literature review informed the revisions. A convenience sample of 200 adolescents, 12-19 years, was recruited from four outpatient clinics at a paediatric hospital in Western Canada between April–June 2012. Construct validity was evaluated by Exploratory Factory Analysis; concurrent validity was assessed using the Psychosocial Maturity Index. Internal consistency was evaluated by computing Cronbach’s alpha estimates.

Results

Factor analysis of the knowledge items identified a 14-item unidimensional scale. Knowledge and behaviour sub-scale scores increased with age, with a stronger relationship between knowledge and age. Psychosocial maturity correlated with both sub-scale scores, but had a stronger association with behaviour. Psychosocial maturity and age had a weak but significant correlation suggesting age is a loose proxy for maturity. Only 27% of 17-year olds, but 62% 18-year olds, scored above the behaviour cut-off for transition readiness.

Conclusion

The revised Am I ON TRAC for Adult Care questionnaire is a psychometrically sound measure that has potential to be used as a readiness assessment tool in both clinical practice and research.

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