Transition Guide Dissemination to Foster Patient–Care Team Conversations: A Childhood Arthritis Rheumatology Research Alliance Transition Learning Collaborative Pilot Implementation Study
Objective Uptake of evidence‐informed health care transition processes among pediatric rheumatologists is low despite poor outcomes of transition from pediatric to adult care. We piloted a learning collaborative model to implement transition guides. We dually assessed implementation outcomes and cha...
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| Format: | Article |
| Language: | English |
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Wiley
2025-01-01
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| Series: | ACR Open Rheumatology |
| Online Access: | https://doi.org/10.1002/acr2.11753 |
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| author | Joyce C. Chang Gabrielle Alonzi Cora Sears Nicole Bitencourt Alex Hernandez Rosemary Peterson Risa Alperin Rebecca S. Overbury Mariel dela Paz Lindsay N. Waqar‐Cowles Patience H. White Kristine Carandang Erica F. Lawson for the CARRA Transition Workgroup |
| author_facet | Joyce C. Chang Gabrielle Alonzi Cora Sears Nicole Bitencourt Alex Hernandez Rosemary Peterson Risa Alperin Rebecca S. Overbury Mariel dela Paz Lindsay N. Waqar‐Cowles Patience H. White Kristine Carandang Erica F. Lawson for the CARRA Transition Workgroup |
| author_sort | Joyce C. Chang |
| collection | DOAJ |
| description | Objective Uptake of evidence‐informed health care transition processes among pediatric rheumatologists is low despite poor outcomes of transition from pediatric to adult care. We piloted a learning collaborative model to implement transition guides. We dually assessed implementation outcomes and changes in reported patient–care team discussions about transition. Methods This was a type II hybrid effectiveness‐implementation pilot study of transition guide dissemination to patients at least 14 years old with rheumatic conditions across nine pediatric rheumatology centers in the Childhood Arthritis Rheumatology Research Alliance Transition Learning Collaborative. We evaluated implementation outcomes (feasibility, adaptations, and fidelity) and the proportion of patients surveyed that reported having discussions with their care team regarding transfer planning. Results Six sites were retained through the COVID‐19 pandemic (below 70% target). Five out of six sites contributed outcome data (met 80% target) but with substantial heterogeneity in how transition guides were shared (eg, in‐person, electronic messages, and posted flyers), and data were collected. The pooled proportion of respondents having discussed transfer planning with their care team was 39% preimplementation (n = 239; 95% confidence interval [CI] 32%–46%) and 55% postimplementation (n = 864; 95% CI 36%–73%). After implementation, there were significant increases in the likelihood of respondents recalling receiving a transition guide (odds ratio [OR] 2.58, 95% CI 1.35–4.92) and discussing transfer planning (OR 2.14, 95% CI 1.30–3.52), adjusted for age and site of care. Conclusion Transition guide dissemination is a simple intervention associated with increased awareness among young people with rheumatic conditions and discussions with their care team about transition preparation. The learning collaborative model facilitated identification of several dissemination strategies adaptable to site‐specific resources. |
| format | Article |
| id | doaj-art-5ea9dca6bffb40a49de5330aef69608a |
| institution | Kabale University |
| issn | 2578-5745 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | ACR Open Rheumatology |
| spelling | doaj-art-5ea9dca6bffb40a49de5330aef69608a2025-02-04T06:21:23ZengWileyACR Open Rheumatology2578-57452025-01-0171n/an/a10.1002/acr2.11753Transition Guide Dissemination to Foster Patient–Care Team Conversations: A Childhood Arthritis Rheumatology Research Alliance Transition Learning Collaborative Pilot Implementation StudyJoyce C. Chang0Gabrielle Alonzi1Cora Sears2Nicole Bitencourt3Alex Hernandez4Rosemary Peterson5Risa Alperin6Rebecca S. Overbury7Mariel dela Paz8Lindsay N. Waqar‐Cowles9Patience H. White10Kristine Carandang11Erica F. Lawson12for the CARRA Transition WorkgroupBoston Children's Hospital, Boston, Massachusetts and Children's Hospital of Philadelphia Philadelphia PennsylvaniaBoston Children's Hospital Boston MassachusettsChildren's Hospital of Philadelphia Philadelphia PennsylvaniaLoma Linda University Medical Center Loma Linda CaliforniaScottish Rite for Children Dallas TexasChildren's Hospital of Philadelphia, Philadelphia, Pennsylvania and Dell Children's Medical Center Austin TexasNew York University Langone Health New York New YorkUniversity of Utah Salt Lake City UtahUniversity of California San Francisco San Francisco CaliforniaChildren's Hospital of Philadelphia Philadelphia PennsylvaniaGot Transition/The National Alliance to Advance Adolescent Health and The George Washington University Washington District of ColumbiaYoung Patients’ Autoimmune Research & Empowerment Alliance San Diego CaliforniaUniversity of California San Francisco San Francisco CaliforniaObjective Uptake of evidence‐informed health care transition processes among pediatric rheumatologists is low despite poor outcomes of transition from pediatric to adult care. We piloted a learning collaborative model to implement transition guides. We dually assessed implementation outcomes and changes in reported patient–care team discussions about transition. Methods This was a type II hybrid effectiveness‐implementation pilot study of transition guide dissemination to patients at least 14 years old with rheumatic conditions across nine pediatric rheumatology centers in the Childhood Arthritis Rheumatology Research Alliance Transition Learning Collaborative. We evaluated implementation outcomes (feasibility, adaptations, and fidelity) and the proportion of patients surveyed that reported having discussions with their care team regarding transfer planning. Results Six sites were retained through the COVID‐19 pandemic (below 70% target). Five out of six sites contributed outcome data (met 80% target) but with substantial heterogeneity in how transition guides were shared (eg, in‐person, electronic messages, and posted flyers), and data were collected. The pooled proportion of respondents having discussed transfer planning with their care team was 39% preimplementation (n = 239; 95% confidence interval [CI] 32%–46%) and 55% postimplementation (n = 864; 95% CI 36%–73%). After implementation, there were significant increases in the likelihood of respondents recalling receiving a transition guide (odds ratio [OR] 2.58, 95% CI 1.35–4.92) and discussing transfer planning (OR 2.14, 95% CI 1.30–3.52), adjusted for age and site of care. Conclusion Transition guide dissemination is a simple intervention associated with increased awareness among young people with rheumatic conditions and discussions with their care team about transition preparation. The learning collaborative model facilitated identification of several dissemination strategies adaptable to site‐specific resources.https://doi.org/10.1002/acr2.11753 |
| spellingShingle | Joyce C. Chang Gabrielle Alonzi Cora Sears Nicole Bitencourt Alex Hernandez Rosemary Peterson Risa Alperin Rebecca S. Overbury Mariel dela Paz Lindsay N. Waqar‐Cowles Patience H. White Kristine Carandang Erica F. Lawson for the CARRA Transition Workgroup Transition Guide Dissemination to Foster Patient–Care Team Conversations: A Childhood Arthritis Rheumatology Research Alliance Transition Learning Collaborative Pilot Implementation Study ACR Open Rheumatology |
| title | Transition Guide Dissemination to Foster Patient–Care Team Conversations: A Childhood Arthritis Rheumatology Research Alliance Transition Learning Collaborative Pilot Implementation Study |
| title_full | Transition Guide Dissemination to Foster Patient–Care Team Conversations: A Childhood Arthritis Rheumatology Research Alliance Transition Learning Collaborative Pilot Implementation Study |
| title_fullStr | Transition Guide Dissemination to Foster Patient–Care Team Conversations: A Childhood Arthritis Rheumatology Research Alliance Transition Learning Collaborative Pilot Implementation Study |
| title_full_unstemmed | Transition Guide Dissemination to Foster Patient–Care Team Conversations: A Childhood Arthritis Rheumatology Research Alliance Transition Learning Collaborative Pilot Implementation Study |
| title_short | Transition Guide Dissemination to Foster Patient–Care Team Conversations: A Childhood Arthritis Rheumatology Research Alliance Transition Learning Collaborative Pilot Implementation Study |
| title_sort | transition guide dissemination to foster patient care team conversations a childhood arthritis rheumatology research alliance transition learning collaborative pilot implementation study |
| url | https://doi.org/10.1002/acr2.11753 |
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