PMID- 33932647
OWN - NLM
STAT- MEDLINE
DCOM- 20210720
LR  - 20210720
IS  - 1532-8449 (Electronic)
IS  - 0882-5963 (Linking)
VI  - 59
DP  - 2021 Jul-Aug
TI  - Adult Provider Perspectives on Transition and Transfer to Adult Care: A 
      Multi-Specialty, Multi-Institutional Exploration.
PG  - 173-180
LID - S0882-5963(21)00130-5 [pii]
LID - 10.1016/j.pedn.2021.04.017 [doi]
AB  - PURPOSE: To identify barriers that transcend multiple adult care specialties and 
      identify potential solutions. DESIGN AND METHODS: Twenty-one adult care providers 
      practicing in the specialty areas of internal medicine, family medicine, 
      gastroenterology, endocrinology, and neurology participated in one of six 
      semi-structured focus group interviews. Data were coded and analyzed according to 
      the Socio-ecological Model of Adolescent/Young Adult Readiness for Transition 
      (SMART). RESULTS: Three themes and one subtheme emerged from the data. These fell 
      within the beliefs/expectations, knowledge, access/insurance, and relationships 
      (subtheme) domains of the SMART model. Family beliefs/expectations regarding the 
      provider role, difficulty accessing reliable information, and limited access to 
      mental health and behavioral providers reportedly affect providers' ability to 
      provide optimal health care. CONCLUSIONS: Adult providers identified several 
      barriers affecting their ability to care for newly transferred patients. 
      Increased education of families and improved methods of communication between 
      providers were recommended. Barriers related to access and insurance are common 
      and require larger systems-level collaborations between health care systems and 
      payor sources. PRACTICAL IMPLICATIONS: Some recommendations (e.g., educating 
      families on the distinct roles of the PCP vs. specialist, highlighting new 
      treatment opportunities in adult care, conveying trust and endorsing the new 
      provider), represent concrete steps pediatric providers can immediately take to 
      improve transfer. Other steps will require forging bridges across the pediatric 
      and adult care world to expand patient access to medical, mental health, and 
      behavioral services.
CI  - Copyright (c) 2021 Elsevier Inc. All rights reserved.
FAU - Gray, Wendy
AU  - Gray W
AD  - Children's Health of Orange County, Orange, CA, United States of America. 
      Electronic address: wendy.gray@choc.org.
FAU - Dorriz, Parasto
AU  - Dorriz P
AD  - Children's Health of Orange County, Orange, CA, United States of America.
FAU - Kim, Hanae
AU  - Kim H
AD  - Children's Health of Orange County, Orange, CA, United States of America.
FAU - Partain, Lauren
AU  - Partain L
AD  - Children's Health of Orange County, Orange, CA, United States of America.
FAU - Benekos, Erin
AU  - Benekos E
AD  - Children's Health of Orange County, Orange, CA, United States of America.
FAU - Carpinelli, Anne
AU  - Carpinelli A
AD  - Children's Health of Orange County, Orange, CA, United States of America.
FAU - Zupanc, Mary
AU  - Zupanc M
AD  - Children's Health of Orange County, Orange, CA, United States of America.
FAU - Grant, Kenneth
AU  - Grant K
AD  - Children's Health of Orange County, Orange, CA, United States of America.
FAU - Weiss, Michael
AU  - Weiss M
AD  - Children's Health of Orange County, Orange, CA, United States of America.
LA  - eng
PT  - Journal Article
DEP - 20210428
PL  - United States
TA  - J Pediatr Nurs
JT  - Journal of pediatric nursing
JID - 8607529
SB  - IM
MH  - Adolescent
MH  - Child
MH  - Communication
MH  - Delivery of Health Care
MH  - Focus Groups
MH  - Humans
MH  - Qualitative Research
MH  - Specialization
MH  - *Transition to Adult Care
MH  - Young Adult
OTO - NOTNLM
OT  - Adolescent
OT  - Adult
OT  - Barriers
OT  - Pediatric
OT  - Transfer
OT  - Transition
OT  - Young adult
EDAT- 2021/05/02 06:00
MHDA- 2021/07/21 06:00
CRDT- 2021/05/01 20:13
PHST- 2020/12/15 00:00 [received]
PHST- 2021/04/20 00:00 [revised]
PHST- 2021/04/20 00:00 [accepted]
PHST- 2021/05/02 06:00 [pubmed]
PHST- 2021/07/21 06:00 [medline]
PHST- 2021/05/01 20:13 [entrez]
AID - S0882-5963(21)00130-5 [pii]
AID - 10.1016/j.pedn.2021.04.017 [doi]
PST - ppublish
SO  - J Pediatr Nurs. 2021 Jul-Aug;59:173-180. doi: 10.1016/j.pedn.2021.04.017. Epub 
      2021 Apr 28.