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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
Health Care Transition

Introduction

This toolkit summarizes content from the Health Care Transition Evidence Accelerator and the MCHbest database. The peer-reviewed literature supporting this work can be found in the Established Evidence database. Use the resources below as you develop effective evidence-based/informed programs and measures.

From the MCH Block Grant Guidance. The transition of youth to adulthood, including the movement from a child to an adult model of healthcare, has become a priority issue nationwide as evidenced by the 2011 clinical report and algorithm developed jointly by the AAP, American Academy of Family Physicians and American College of Physicians to improve healthcare transitions for all youth and families. Poor health has the potential to impact negatively the youth and young adults’ academic and vocational outcomes. Over 90 percent of children with special health care needs now live to adulthood but are less likely than their non-disabled peers to complete high school, attend college or to be employed. Health and health care are cited as two of the major barriers to making successful transitions.

Goal. To increase the percent of adolescents with and without special health care needs who have received services to prepare for the transitions to adult health care.

Note. Access other related measures in this Population Domain through the Toolkits page.

Detail Sheet: Start with the MCH Block Grant Guidance

DEFINITION

Numerator:

Number of adolescents with and without special health care needs, ages 12 through 17, who are reported by a parent to have received services to prepare for the transition to adult health care (time alone with a health care provider, active work to gain skills to manage health/health care or understand changes in health care at age 18, discussed shift to adult providers if needed)

Denominator:

Number of adolescents, ages 12 through 17

Units: 100

Text: Percent

HEALTHY PEOPLE 2030 OBJECTIVE

Related to Adolescent Health (AH) Objective R01: Increase the proportion of adolescents (aged 12 to 17 years) with and without special health care needs who receive services to support their transition to adult health care. (Research) ;Related to AH Objective 02: Increase the proportion of adolescents who speak privately with a physician or other health care provider during a preventive medical visit. (Baseline: 38.4% in 2016-17, Target: 43.3%)

DATA SOURCES

National Survey of Children's Health (NSCH)

MCH POPULATION DOMAIN

Children with Special Health Care Needs or All Adolescents (CSHCN and non-CSHCN)

MEASURE DOMAIN

Clinical Health Systems

1. Accelerate with Evidence—Start with the Science

The first step to accelerate effective, evidence-based/informed programs is ensuring that the strategies we implement are meaningful and have high potential to affect desired change. Read more about using evidence-based/informed programs and then use this section to find strategies that you can adopt or adapt for your needs.

Evidence-based/Informed Strategies: MCHbest Database

The following strategies have emerged from studies in the scientific literature as being effective in advancing the measure. Use the links below to read more about each strategy or access the MCHbest database to find additional strategies.

Chart of Evidence-Linked Strategies and Tools

Evidence-Informed

Evidence-Based

Mixed Evidence

Emerging Evidence

Expert Opinion

Moderate Evidence

Scientifically Rigorous

 

 

Field-Based Strategies: Find promising programs from AMCHP’s Innovation Hub

Emerging:

Promising:

Best:

 

2. Think Upstream with Planning Tools—Lead with the Need

The second step in developing effective, evidence-based/informed programs challenges us to plan upstream to ensure that our work addresses issues early and is measurable in “turning the curve” on big issues that face MCH populations. Read more about moving from root causes to responsive programs and then use this section to align your work with the data and needs of your populations.

Move from Need to Strategy

Use Root-Cause Analysis (RCA) and Results-Based Accountability (RBA) tools to build upon the science to determine how to address needs.

Planning Tools: Use these tools to move from data to action

3. Work Together with Implementation Tools—Move from Planning to Practice

The third step in developing effective, evidence-based/informed programs calls us to work together to ensure that programs are implementable and moveable within the realities of Title V programs and lead to improved health outcomes for all people. Read more about implementation tools designed for MCH population change and then use this section to develop responsive strategies to bring about change that is responsive to the needs of your populations.

Additional MCH Evidence Center Resources: Access supplemental materials from the literature

Implementation Resources: Use these field-generated resources to affect change

Practice. The following tools can be used to translate evidence to action to advance this NPM:

  • Transition to Adult Health Care (PACER’s National Parent Center on Transition and Employment). This resource offers guidance and videos on HCT.
  • Condition-Specific Tools (American College of Physicians Pediatric to Adult Care Transitions Initiative). This resource offers condition specific information for the transition process.

Partnership. The following organizations focus efforts on supporting healthcare transition:

The following resources reinforce the need to improve the process of pediatric-to-adult HCT and highlight promising practices:

Additional Resources:

References

Introductory References: From the MCH Block Grant Guidance

1 White PH, Cooley WC; Transitions Clinical Report Authoring Group; American Academy of Pediatrics; American Academy of Family Physicians; American College of Physicians. Supporting the Health Care Transition From Adolescence to Adulthood in the Medical Home. Pediatrics. 2018;142(5):e20182587. Pediatrics. 2019;143(2):e20183610. doi:10.1542/peds.2018-3610.

2 American Academy of Pediatrics; American Academy of Family Physicians; American College of Physicians- American Society of Internal Medicine. A consensus statement on health care transitions for young adults with special health care needs. Pediatrics. 2002;110(6 Pt 2):1304-1306.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.