The transfer from pediatric to adult care for adolescents and young adults (AYA) with T1D is a challenging process during which AYAs are vulnerable to worsening metabolic outcomes, missed clinic visits, and increased ED and hospital admissions. This study investigated which modifiable individual and family-specific transition readiness variables may lead to improved transfer of care outcomes. Two-hundred fifty-four individuals with T1D ages 16 to 25 years (Mage=20.9+2.7) completed an online survey. Multiple regression in SPSS assessed relations between (a) individual (diabetes-specific resilience, diabetes distress, self-care behaviors, problem solving) and (b) family (diabetes-related conflict, communication, miscarried helping, support) transition readiness variables and transfer of care outcomes. Variables were entered simultaneously, above and beyond covariates, and significant predictors were indicated by p < .05. With respect to individual factors, greater problem solving was associated with seeing an adult (versus pediatric) provider, less hospital admissions, less severe low blood sugars, and more clinic visits one-year post-transfer. Resilience was associated with increased readiness to transfer. Self-care behaviors were associated with fewer severe low blood sugars. Diabetes distress was associated with lower likelihood of seeing an adult provider and more ED and clinic visits. With respect to family factors, higher conflict was associated with a higher rate of ED visits, fewer clinic visits, and fewer episodes of severe low blood sugars post-transfer. Miscarried helping was associated with a greater likelihood of seeing an adult provider. Modifiable individual and family-specific transition readiness variables are uniquely associated with key transfer of care outcomes. Interventions that reduce family conflict and diabetes distress, and improve diabetes resilience and problem solving, are likely to improve these outcomes.

Disclosure

J.Shapiro: None. J.Weissberg-benchell: None.

Funding

Dixon Family Foundation

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