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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. Transition.

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Strategy. Youth Preparedness (Planning for Transition + Training/Educating Youth)

Approach. Provide planning services, including training and educating youth with and without special health care needs, who are ready for transition to adult care

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Overview. Transition Youth Preparedness is crucial for a successful shift from pediatric to adult healthcare, aiming to foster self-sufficiency, independence, and active participation in adult roles.[1,2] Currently, many youth misinterpret "transition" as a single event, leading to declining self-efficacy and life outlook in late adolescence.[1 Challenges also include parental overprotection and adult systems hesitating to accept complex cases.[2,3] Title V programs can enhance preparedness through early and consistent discussions starting at age 14,[3] coupled with comprehensive education on health management and the holistic meaning of transition.[1] Promoting youth autonomy and self-determination by empowering decision-making, supported by healthcare providers who encourage active participation, is vital.[1,2] Structured transfer plans, formal care coordination across health and other systems, and peer support programs facilitate a smoother process and sustained engagement.[2,3,4] Additionally, leveraging technology and automated assessments can create sustainable practices for identifying and addressing knowledge gaps.[5,6]

Evidence. Moderate Evidence. Strategies with this rating are likely to work...

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source.

Potential Data Sources. Data to support this strategy can be accessed through:

  • Training and education program data
  • Youth knowledge and skills assessment data
  • Partnerships and engagement data

Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):

  • Access to/Receipt of Care. This strategy increases the ability for individuals to obtain healthcare services when needed, including preventive, diagnostic, and treatment services.
  • Health and Health Behaviors/Behavior Change. This strategy improves individuals' physical and mental health and their adoption of healthy behaviors (e.g., healthy eating, physical activity).
  • Timeliness of Care. This strategy promotes delivery of healthcare services in a timely manner to optimize benefits and prevent complications.

Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.

Intervention Type. Health Teaching (Education and Promotion) (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Individual/Family-Focused

Examples from the Field. Access descriptions of ESMs that use this strategy or aligned components.

Sample ESMs. Here are sample ESMs to use as models for your own measures using the RBA framework (see The Role of Title V in Adapting Strategies).

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

  • Number of pediatric practices and health systems that offer transition planning services, including training and education for youth with and without special health care needs (SHCN). (Measures the availability and usability of transition planning and education services)
  • Number of transition plans developed for youth with and without SHCN, including medical summaries, electronic medical information, and patient/family feedback on the transition process. (Measures the output and quality of transition planning services)

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

  • Percent of youth with and without SHCN who complete all recommended components of transition planning and education, based on their individual needs and goals. (Measures the completion rates and fidelity of transition planning and education services)
  • Percent of transition planning and education services that are delivered using youth-friendly, usable formats and materials. (Measures the youth-centeredness in transition planning and education approaches)

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

  • Number of partnerships and collaborations established among Title V programs, pediatric practices, adult health systems, schools, and community organizations to support the delivery of transition planning and education services. (Measures the level of multi-sector engagement and coordination in transition efforts)
  • Number of quality improvement projects and evaluation studies conducted to assess the effectiveness, implementation, and impact of transition planning and education interventions for youth with and without SHCN. (Measures the use of data and continuous improvement strategies to optimize transition service quality and outcomes)
  • Number of preventable emergency department visits, hospitalizations, and adverse health events avoided among youth with and without SHCN as a result of effective transition planning, education, and self-management support. (Measures the impact of transition planning and education on improving health outcomes and reducing unnecessary health care utilization)
  • Number of best practices, lessons learned, and successful transition planning and education models disseminated and replicated across states, health systems, and communities. (Measures the potential for spread, scale, and sustainability of transition planning and education initiatives)

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

  • Percent of transition planning and education services that are tailored to meet the unique needs and preferences of youth with and without SHCN from different backgrounds and communities. (Measures the responsiveness of transition planning and education approaches)
  • Percent of transition planning and education interventions that are co-designed and led by youth with and without SHCN and their families to ensure relevance, acceptability, and shared decision-making. (Measures the level of youth and family engagement and leadership in transition service design and delivery)
  • Percent of youth with and without SHCN who report increased resilience, self-determination, and quality of life as a result of the skills, knowledge, and support gained through transition planning and education services. (Measures the impact of transition planning and education on promoting positive youth development and well-being)
  • Percent of overall health care costs and utilization for youth with and without SHCN that are associated with preventive, proactive transition planning and education, as opposed to reactive, crisis-oriented care. (Measures the long-term financial and system-level impact of transition planning and education on population health outcomes and sustainability)

Note. When looking at your ESMs, SPMs, or other strategies:

  1. Move from measuring quantity to quality.
  2. Move from measuring effort to effect.
  3. Quadrant 1 strategies should be used sparingly, when no other data exists.
  4. The most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.

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

References

[1] Andrews, J. G., Shifren, R., Wahl, R., Parent-Johnson, W., & Klewer, S. (2025). A mixed methods exploratory study assessing youth knowledge, self-efficacy and mental health outcomes in transition to adult healthcare. Health Care Transitions, 3, 100096.
[2] Hong, H. S., & Im, Y. (2024). Factors associated with healthcare transition readiness for adolescents with chronic conditions: A cross-sectional study. Journal of Child Health Care.
[3] Cady, R. G., Bahr, T., Au-Yeung, C., Kinoglu, S., Lutz, M., & Jankowski, M. (2024). Health care transition experiences of young adults with medical complexity. Health Care Transitions, 2, 100070.
[4] Seko, Y., Oh, A., Thompson, L., Bowman, L. R., & Curran, C. J. (2024). Transitions Pop-ups: Co-designing client-centred support for disabled youth transitioning to adult life. Frontiers in Rehabilitation Sciences, 5.
[5] Argraves, M., Murray, E., Taxter, A., Wise, K., Jensen, P. T., Goldstein-Leever, A., Thomas, B., Scott, A., Gallup, J., Leone, A., Ardoin, S. P., & Sivaraman, V. (2024). Implementation of an automated transition readiness assessment in a pediatric rheumatology clinic. Frontiers in Pediatrics, 12.
[6] Beal, S. J., Nause, K., Lutz, N., & Greiner, M. V. (2020). The Impact of Health Care Education on Utilization Among Adolescents Preparing for Emancipation From Foster Care. Journal of Adolescent Health, 66(6), 740–746.

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.