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Strengthening the evidence base for maternal and child health programs

New: MCH Best strategies database for sample ESMs

Evidence Tools
MCH Best. NPM 12: Health Care Transition

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Strategy. Training/Educating Youth (Including Communications and Social Media)

Approach. Provide training for adolescents with and without special health care needs who are ready for transition to adult care.

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Overview. Studies have found mixed results in training youth in measures of understanding and improving general health behaviors and intention to improve well-being or quality of life as a result of the training. However, there seems to be some improvements in readiness for transition as a result of these interventions. More evidence is needed to conclusively show effectiveness.1 In addition to training, "continued efforts are encouraged to actively engage youth, young adults, and families, especially those from racial and ethnic minority populations, in all aspects of health care transition planning, implementation, and evaluation."2 

Evidence. Emerging Evidence. There is emerging, recent evidence on the effectiveness of youth training/education on transition. This strategy has been tested more than once and results trend positive overall. However, more research is needed for conclusive results. Access the peer-reviewed evidence through Outcome Evidence for Structured Pediatric to Adult Health Care Transition Interventions: A Systematic Review and Outcomes of pediatric to adult health care transition interventions: An updated systematic review (Got Transition/Center for Health Care Transition Improvement). (Read more about understanding evidence ratings).

Target Audience. Adolescents with and without special health care needs.

Outcome. Adolescents with and without special health care needs who received information necessary to facilitate transition to adult health care. Title V programs can use Got Transition' ® tools from the Six Core Elements packages to determine a baseline measure and regularly assess their progress in achieving implementation of evidence-informed health care transition processes. See the AMCHP/Got Transition NPM 12 Implementation Toolkit: Measurement and Assessment Strategic Approaches for tools to download. For detailed outcomes related to each study supporting this strategy, click on the peer-reviewed evidence link above and read the "Intervention Results" for each study.

Examples from the Field. There are currently 12 ESMs across all states/jurisdictions that use this strategy directly or intervention components that align with this strategy. Access descriptions of these ESMs through the MCH Digital Library. You can use these ESMs to see how other Title V agencies are addressing the NPM. Current agency-based examples drawn from the NPM 12 Implementation Toolkit: Youth and Family Education and Leadership Development Strategic Approaches include:

Current agency-based examples drawn from the NPM 12 Implementation Toolkit: Communications and Social Media Strategic Approaches include:

Sample ESMs. Using the approach “Provide training (e.g., in-person trainings or a web-based curriculum) for adolescents with and without special health care needs who are ready for transition to adult care,” here are sample ESMs you can use as a model for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies):

Quadrant 1:
Measuring Quantity of Effort
("What/how much did we do?")

  • Number of adolescent who completed the web-based curriculum.
  • Number of adolescent trained.

Quadrant 2:
Measuring Quality of Effort
("How well did we do it?")

  • Percentage of visitors who completed the web-based curriculum and indicated through a feedback form that the information was useful.
  • Percentage of adolescents trained who reported satisfaction in the process from transitioning from pediatric to adult care.

Quadrant 3:
Measuring Quantity of Effect
("Is anyone better off?")

  • Number of adolescents with website training who report increased knowledge, skills, or transition to adult health care.
  • Number of adolescents trained who reported successful health care transition.

Quadrant 4:
Measuring Quality of Effect
("How are they better off?")

  • Percentage of adolescents who accessed website who report increased knowledge, skills, or transition to adult health care.
  • Percentage of adolescents trained who reported successful health care transition.

Note. ESMs become stronger as they move from measuring quantity to measuring quality (moving from Quadrants 1 and 3, respectively, to Quadrants 2 and 4) and from measuring effort to measuring effect (moving from Quadrants 1 and 2, respectively, to Quadrants 3 and 4).

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.


Reference:

1 Campbell F, Biggs K, Aldiss SK, O’Neill PM, Clowes M, McDonaghJ, While A, Gibson F. Transition of care for adolescents from paediatric services to adult health services. Cochrane Database of Systematic Reviews 2016, Issue 4. Art. No.: CD009794. DOI:10.1002/14651858.CD009794.pub2.

2 Association of MCH Programs and Got Transition. NPM 12: Transition Implementation Toolkit. Youth and Family Education and Leadership Development.

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.