Provider-Patient Communication and Transition Readiness Among Adolescents with Type 1 Diabetes

Provider-Patient Communication and Transition Readiness Among Adolescents with Type 1 Diabetes Corrine N. Ahrabi-Nejad The majority of adolescents with type 1 diabetes do not maintain a glycemic control within the recommended range. Poor diabetes control can yield both short term and long term acute health complications, making it critical for adolescents to achieve diabetes control. During this same time in development, adolescents are preparing for the transition from pediatric to adult diabetes care. Adolescents often transition to adult care based on their age rather than their transition readiness, which may result in a lack of support from their pediatric provider, potentially exacerbating their already poor glycemic control. Transitioning from pediatric care to adult care among adolescents with type 1 diabetes (T1D) often occurs spontaneously and with little guidance from pediatric providers. This abruptness in uncoordinated transition leads to decreased illness adherence. Research in the field of transition has identified that adolescents receive little information regarding the transition process including how to find an adult care provider, differences in adult care, and how to discuss their diabetes independently without a parent present. Adolescents who report poor transition readiness experienced gaps in care of 6 months or greater post-transition. Transition readiness can mitigate the negative effects that this transitional period often has. One potential method of increasing an adolescents’ readiness to transition into adult care is through information disseminated by their pediatric provider. The current project assessed the relation between provider-patient communication and transition readiness in adolescents with type 1 diabetes. A total of 60 adolescents (ages 13 to 17) and their caregiver were recruited from West Virginia University Health Sciences Center. Participants were identified using the medical record database and eligible participants were approached and invited to participate at a regularly scheduled pediatric endocrinology clinic visit. Upon assent and consent, respectively, adolescents and their caregiver completed questionnaire measures using electronic tablets and all data were securely stored using REDCap software system. The aims of this study were to identify (1) whether adolescent better perceived provider-patient communication was associated significantly with greater transition readiness; and (2) if glycemic control acts as a moderator or mediator on this relation. Results from this study suggest that provider patient communication, as measured, is not a significant predictor of transition readiness, nor is glycemic control. Future studies should consider using alternative methods for measuring provider-patient communication, broadening sample characteristics for both providers and patients, and expanding investigation to include other factors that could potentially influence transition readiness. PROVIDER-PATIENT COMMUNICATION AND TRANSITION READINESS IN T1D iii Acknowledgements I would like to recognize and thank the many people who helped me throughout the entirety of this project. I would like to thank Dr. Christina Duncan, for her support in brainstorming research ideas, conducting data analysis, and creating this final report. I would also like to thank the members of my committee, Dr. Shari Steinman and Dr. Claire St. Peter, for both their time and thoughtful feedback on the development of this project. I would also like to thank the many undergraduate members of the Pediatric Lab for Adherence and Transition for their countless hours of time recruiting participants for this study. Finally, I would like to thank my family and friends for their unending support and encouragement. PROVIDER-PATIENT COMMUNICATION AND TRANSITION READINESS IN T1D iv Table of