Developing Anticipatory Guidance to Facilitate Optimal Care Transition Outcomes for Adolescents with Type 1 Diabetes

Background: Emerging adults with type 1 diabetes (T1D) are at increased risk for poor health outcomes as they transition from pediatric to adult care providers. This is in part due to the complexities of young adult life as individuals with T1D enter the work force, leave home, or start college while learning to manage the disease on their own. Purpose: To identify the barriers adolescents face during their emerging adult years with T1D and to develop anticipatory guidance material for adolescents with T1D to support optimal transition of care into adulthood. Methods: Adults, ages 24-35, who lived with T1D during their adolescent years were recruited from the diabetes online community to complete a survey regarding their experience with care transition. Categorical data were analyzed using descriptive statistics. A thematic analysis, guided by the Framework for Emerging Adults with T1D was used to explore the free-text data. Results: In total, 25 adults (84% female) with mean age of 28 years (SD=3.17) participated. Themes that arose from the analysis of care transition experiences included: (1) importance of support from key players, (2) challenges of navigating the healthcare system, (3) mental health needs of teens with T1D, (4) managing day-to-day life with T1D, and (5) early independence to ease transition. Conclusion: Three anticipatory guidance tools in an age-based framework of developmental milestones were created to address the identified themes. Further study is needed to determine if the anticipatory guidance tools will be effective at improving health outcomes.