Transition to Adulthood Through Coaching and Empowerment in Rheumatology (TRACER): Results of a Feasibility Randomized‐Control Trial
Madison Lackie, Megan Clarke, Julie Herrington, Pamela Jarvis, Roberta Berard, Karen Beattie, Michelle BatthishObjective
Health care transitions are a time of high needs for youth with chronic rheumatic conditions. Our study aimed to evaluate the feasibility of a multicenter randomized‐controlled trial implementing a virtual transition coach intervention (TCI) for youth transitioning from pediatric to adult rheumatology care.
Methods
Youth aged 17 to 18 years with pediatric‐onset rheumatic diseases were recruited from McMaster Children's Hospital in Hamilton, and Children's Hospital, London Health Sciences Centre in London, Canada. Participants were randomized to receive a youth transition roadmap (YTR) (standard of care), or YTR plus TCI—eight virtual monthly coaching sessions covering topics from the YTR. Primary outcomes included feasibility criteria, whereas secondary outcomes focused on measures of readiness for transition (Transition‐Q), global functioning (PedsQL 4.0), and self‐efficacy (PROMIS self‐efficacy for managing chronic conditions) at baseline, 8 months, and 11 months. A satisfaction survey was provided to TCI participants upon study completion.
Results
Of 65 patients approached, 31 (48%) consented. Over 95% of TCI sessions were attended, 80% of patients completed 8‐month follow‐up questionnaires, and missing data were 13%. TCI participants demonstrated slightly larger mean changes across each time point for each instrument compared to controls. TCI participants overwhelmingly endorsed the intervention, with 78% satisfied with the intervention and 89% willing to recommend the intervention to a friend.
Conclusion
Transition coaching is a feasible intervention to support youth transitioning from pediatric to adult rheumatology care. Results from this trial will inform a multicenter trial, investigating the efficacy of a TCI on transition readiness and self‐efficacy for managing chronic conditions.