(P107) Development of a Transition Program for Adolescents with Type 1 Diabetes - A Feasibility Study

Key Takeaways of Your Research: Emerging adulthood presents special challenges for adolescents with type 1 diabetes (T1D), who must balance consistent medical follow-up and ongoing intensive self-care with the competing social, educational, occupational, and financial demands typical of this developmental stage. Emerging adults with T1D struggle with glycemic control that is further exacerbated by an often-times disorganized transfer of care between pediatric and adult endocrinology practices. A formal healthcare transition process can help prevent gaps in care, improve independent disease management skills and markers of disease control, decrease disease burden, and reduce acute and chronic diabetes complications.

Background/Purpose: There is increased focus within the pediatric community to formally prepare young adults with T1D for independent disease management as they transition to adult care. Organizing this transition process helps to decrease risk, enhance self-management, and optimize well-being. The purpose of this project was to adapt “Got Transition’s” Six Core Elements of Health Care Transition into a program for 16-18 year olds with T1D. Research Hypothesis and/or Research Questions and Specific

Aims: This project had two aims. Aim 1: Adapt the federal “Got Transition” framework to the specific needs of the pediatric endocrinology clinic via integration with the ADA's 14 recommendations for transitional care and Aim 2: Examine the feasibility of the Preparing Emerging Adults with Knowledge and Skills (PEAKS) program design. Methods/Methodology: The PEAKS program was developed using “Got Transition’s” Six Core Elements of Health Care Transition and the more diabetes-specific transition guidelines recommended by the ADA. Program visits included age-appropriate education, skill development, and support. A framework was built into the electronic health record to support the program. Feasibility of the program design was then evaluated using semi-structured interviews with stakeholders.

Results: The PEAKS program design required a series of iterative changes to help meet the requirements, limitations, and stakeholder preferences for transitional care in this setting. The final program design incorporated all six of “Got Transition’s” Six Core Elements of Health Care Transition and was trialed with patients over a four-month time period. Stakeholder interviews performed at two time-points during program implementation found the finished product to be both acceptable and practical. The program’s transition-focused education, documentation, and formal transfer of care processes did increase appointment times, resulting in stakeholders reporting increased time-burden. Conclusions (Impact on Diabetes Care and Education): Utilizing the PEAKS program framework to formalize and organize the transition process for emerging adults with T1D appears to be an acceptable and practical way to begin to bridge the identified gap between current practice and best-practice. The PEAKS program exemplified the science behind organized transitional care processes and helped stakeholders actualize team-based approaches, interdisciplinary communication, and patient-centered care. Source of Funding for this Research: This project was designed and implemented as part of the primary interventionist's Doctor of Nursing Practice (DNP) program requirements. The author acted in a volunteer capacity, and thus, no external funding was required or provided. "Got Transition" is a federally funded national resource center on health care transition (HCT). Its aim is to improve transition from pediatric to adult health care through the use of evidence-driven strategies for health care professionals, youth, young adults, and their families and is a no-cost resource that can be found online at gottransition.org.