Utilizing Medical Students As Patient Mentors: An Intervention to Improve Transition Readiness in Young Adults with Sickle Cell Disease

Background:Advances in medical care have resulted in nearly 95% of all children with sickle cell disease (SCD) living to adulthood. Standardized transition programming does not currently exist, resulting in high rates of mortality and morbidity among young adults (YA) during the transition period. Mentoring and social support have been used to impact health behavior change. Medical student mentors can serve as mentors offering specialized support for YA. This study examined the feasibility and preliminary efficacy of a medical student mentor intervention to improve transition outcomes for YAs with SCD. Methods:24 YA with sickle cell disease and 9 medical student mentors enrolled in the intervention. Feasibility and acceptability of the intervention was assessed through enrollment rates, reasons for refusal, retention rates, engagement with the intervention, satisfaction, and reasons for drop-out. The preliminary efficacy of the intervention among patient participants was assessed using dependent t-tests to evaluate changes in transition readiness, health related quality of life, self-efficacy, SCD knowledge medication adherence, and health literacy. Among medical student mentor participants, changes in attitudes towards chronic illness and SCD knowledge were explored. Results:Patient participants demonstrated adequate enrollment (63.2%), retention (75.0%), and adherence to the intervention (88.3%) and rated the intervention components highly. Patient participants demonstrated significant improvements in transition readiness (p= .001), self-efficacy (p= .002), medication adherence (p= .02), and health literacy (p= .05). Medical students also demonstrated significant improvements in SCD knowledge (p= .01). Discussion:A medical student mentor intervention to facilitate transition from pediatric to adult care for young adults with SCD is both feasible and acceptable to patients and medical students. Preliminary evidence suggests such an intervention may provide dual benefit for both patients and students. A randomized controlled trial is needed to evaluate efficacy. Disclosures No relevant conflicts of interest to declare.

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Feasibility of Medical Student Mentors to Improve Transition in Sickle Cell Disease

Journal of Pediatric Psychology ◽

10.1093/jpepsy/jsab031 ◽

2021 ◽

Author(s):

Adrienne S Viola ◽

Richard Drachtman ◽

Amanda Kaveney ◽

Ashwin Sridharan ◽

Beth Savage ◽

...

Keyword(s):

Medical Student ◽

Medication Adherence ◽

Health Literacy ◽

Sickle Cell Disease ◽

Sickle Cell ◽

Self Efficacy ◽

Cell Disease ◽

Adult Care ◽

Transition Readiness ◽

Student Mentor

Abstract Objective Advances in medical care have resulted in nearly 95% of all children with sickle cell disease (SCD) living to adulthood. There is a lack of effective transition programming, contributing to high rates of mortality and morbidity among adolescents and young adults (AYAs) during the transition from pediatric to adult healthcare. This nonrandomized study evaluated the feasibility, acceptability, and preliminary outcomes of a novel medical student mentor intervention to improve transition outcomes. Methods Eligible participants were ages 18–25 years, either preparing for transition or had transferred to adult care within the past year. Twenty-four AYA with SCD (Mage = 20.3, SD = 2.6) enrolled in the program and were matched with a medical student mentor. Feasibility and acceptability of the intervention was assessed through enrollment rates, reasons for refusal, retention rates, engagement with the intervention, satisfaction, and reasons for drop-out. Dependent t-tests were used to evaluate the preliminary effects of the intervention on patient transition readiness, health-related quality of life, self-efficacy, SCD knowledge, medication adherence, and health literacy. Results Participants (N = 24) demonstrated adequate retention (75.0%), adherence to the intervention (M = 5.3 of 6 sessions), and satisfaction with the intervention. Participants demonstrated significant improvements in transition readiness (p = .001), self-efficacy (p = .002), medication adherence (p = .02), and health literacy (p = .05). Conclusions A medical student mentor intervention to facilitate transition from pediatric to adult care for AYA with SCD is both feasible and acceptable to patients and medical students. Preliminary results suggest benefits for patients, warranting a larger efficacy study.

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Measuring Transition Readiness in Adolescents and Young Adults with Sickle Cell Disease Using the Transition Readiness Assessment Questionnaire

10.22541/au.162138591.15170944/v1 ◽

2021 ◽

Author(s):

Anjali Oberoi ◽

Alyssa Patterson ◽

Amy Sobota

Keyword(s):

Young Adults ◽

Sickle Cell Disease ◽

Sickle Cell ◽

Medical Center ◽

Self Report ◽

Adolescents And Young Adults ◽

Cell Disease ◽

Readiness Assessment ◽

Transition Readiness ◽

Assessment Questionnaire

Background/Objectives: Adolescents and young adults (AYA) with sickle cell disease (SCD) face challenges related to the disease and its treatment. The Transition Readiness Assessment Questionnaire (TRAQ) is a self-report tool for assessing transition readiness for youth with special health care needs (YSHCN), including SCD. This study uses the TRAQ to understand transition readiness in patients with SCD treated at the Boston Medical Center, evaluates associations between TRAQ scores and transition outcomes (e.g., EDr, EDu), and compares TRAQ scores in this population with other YSHCN. Methods: We reviewed electronic medical records of AYA with SCD who completed the TRAQ in the pediatric hematology clinic between January 1, 2019, and March 1, 2020, and categorized healthcare encounters to calculate EDu and EDr. We used t-tests and ANOVA models to analyze mean TRAQ scores, sex, age, genotype, EDu, and EDr. Results: The sample was 45 AYA patients with SCD between 13 and 22 years old. The mean TRAQ score for the overall patient sample was 3.67. Mean TRAQ scores did not significantly vary by sex or genotype but did significantly increase with age. TRAQ scores were lower in the SCD population than in other YSHCN. TRAQ scores did not correlate to EDu or EDr. Conclusions: AYA patients with SCD have lower transition readiness than other populations of YSHCN. The age of 18 may not be the most reliable attribute of readiness, though older patients do have higher readiness. The relationship between TRAQ scores, EDr, and EDu is not clear and requires further evaluation.

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Implementation of an educational intervention to optimize self‐management and transition readiness in young adults with sickle cell disease

Pediatric Blood & Cancer ◽

10.1002/pbc.27722 ◽

2019 ◽

Vol 66 (7) ◽

pp. e27722 ◽

Cited By ~ 4

Author(s):

Cecelia L. Calhoun ◽

Regina A. Abel ◽

Hai Ahn Pham ◽

Shomari Thompson ◽

Allison A. King

Keyword(s):

Young Adults ◽

Sickle Cell Disease ◽

Sickle Cell ◽

Educational Intervention ◽

Self Management ◽

Cell Disease ◽

Transition Readiness

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Measuring Transition Readiness: A Correlational Study of Perceptions of Parent and Adolescents and Young Adults with Sickle Cell Disease

Journal of Pediatric Nursing ◽

10.1016/j.pedn.2015.06.008 ◽

2015 ◽

Vol 30 (5) ◽

pp. 788-796 ◽

Cited By ~ 14

Author(s):

Barbara Speller-Brown ◽

Katherine Patterson Kelly ◽

Brigit VanGraafeiland ◽

Suzanne Feetham ◽

Anne Sill ◽

...

Keyword(s):

Young Adults ◽

Sickle Cell Disease ◽

Sickle Cell ◽

Adolescents And Young Adults ◽

Correlational Study ◽

Cell Disease ◽

Transition Readiness

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Self-reported Transition Readiness Among Young Adults With Sickle Cell Disease

Journal of Pediatric Hematology/Oncology ◽

10.1097/mph.0000000000000110 ◽

2014 ◽

Vol 36 (5) ◽

pp. 389-394 ◽

Cited By ~ 22

Author(s):

Amy Sobota ◽

Adeola Akinlonu ◽

Maria Champigny ◽

Megan Eldridge ◽

Lillian McMahon ◽

...

Keyword(s):

Young Adults ◽

Sickle Cell Disease ◽

Sickle Cell ◽

Cell Disease ◽

Transition Readiness

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Measuring transition readiness in adolescents and young adults with sickle cell disease using the transition readiness assessment questionnaire

Pediatric Blood & Cancer ◽

10.1002/pbc.29417 ◽

2021 ◽

Author(s):

Anjali R. Oberoi ◽

Alyssa Patterson ◽

Amy Sobota

Keyword(s):

Young Adults ◽

Sickle Cell Disease ◽

Sickle Cell ◽

Adolescents And Young Adults ◽

Cell Disease ◽

Readiness Assessment ◽

Transition Readiness ◽

Assessment Questionnaire

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Improving Transition Readiness in Young Adults With Sickle Cell Disease

The Journal for Nurse Practitioners ◽

10.1016/j.nurpra.2020.07.026 ◽

2020 ◽

Vol 16 (10) ◽

pp. e165-e167

Author(s):

Andrea D. Johnson ◽

Eula Pines ◽

Sherry Seibenhener ◽

Shunda Wilburn

Keyword(s):

Young Adults ◽

Sickle Cell Disease ◽

Sickle Cell ◽

Cell Disease ◽

Transition Readiness

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Development of a sickle cell disease readiness for transition assessment

International Journal of Adolescent Medicine and Health ◽

10.1515/ijamh-2015-0010 ◽

2016 ◽

Vol 28 (2) ◽

pp. 193-201 ◽

Cited By ~ 6

Author(s):

Marsha Treadwell ◽

Shirley Johnson ◽

India Sisler ◽

Matthew Bitsko ◽

Ginny Gildengorin ◽

...

Keyword(s):

Young Adults ◽

Sickle Cell Disease ◽

Sickle Cell ◽

Intervention Program ◽

Assessment Tool ◽

Face Validity ◽

Future Research ◽

Cell Disease ◽

Adult Care ◽

Transition Readiness

Abstract Background: Instrumentation with established reliability and validity is not yet routinely utilized to assess readiness for transition from pediatric to adult care for youth and young adults with chronic conditions, including sickle cell disease (SCD). Objective: The aim of this study was to develop a SCD specific readiness for transition assessment tool. Subjects: Fifty-seven youths with SCD, ages 15–21 years, completed the initial version of the Transition Intervention Program – Readiness for Transition (TIP-RFT) assessment; 113 youths/young adults with SCD, ages 14–26 years, at two distinct sites of care completed a refined version of the TIP-RFT. Methods: The TIP-RFT was constructed based on a literature review, provider and patient consensus and assessed domains including knowledge and skills in medical self-care, social support, health benefits and independent living and educational/vocational skills. We used principal components factor analysis to evaluate TIP-RFT responses and assessed differences in TIP-RFT scores in relation to age, gender, sickle cell diagnosis and site of care. Results: The original TIP-RFT, which had demonstrated face validity, was reduced from 56 to 22 items. The revised instrument consisting of four subscales demonstrated good internal consistency reliability and construct validity. Conclusion: Our results support that the TIP-RFT is a valid and reliable tool for the assessment of transition readiness for youths with SCD. The TIP-RFT assessment can guide interventions to improve transition readiness and can provide a foundation for future research on other variables that might be associated with transition readiness.

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