MON-214 - Improving Transition Readiness in Adolescents/Emerging Adults with Type 1 Diabetes

Introduction:
For adolescents with type 1 diabetes (T1D), the transition from pediatric to adult care is a critical period for developing disease self-management skills to prevent poor glycemic control and related adverse outcomes. Transition readiness, one of the six core elements of health care transition (HCT), is typically assessed through structured evaluations. This study aims to evaluate transition readiness using two validated assessments, and use these to assess the effectiveness of a video-based educational intervention. We hypothesize that adolescents aged 17-21 years have suboptimal transition readiness and that a video-based educational intervention will lead to measurable improvement.

Methods:
Participants were recruited from a pediatric diabetes clinic at a single institution during outpatient visits, following eligibility screening. Inclusion criteria were age of 17-21 and diagnosis of T1D; exclusion criteria were non-English speakers and inability to complete surveys. At enrollment, participants completed two transition readiness assessments: the Transition Readiness Assessment Questionnaire (TRAQ), a validated tool recommended by the American Academy of Pediatrics, and On TRAck, a T1D-specific validated instrument. Demographics, HbA1c, and diabetes management metrics were extracted from the health record. Zip code-level socioeconomic variables were obtained from U. S. Census data. Descriptive statistics were calculated for all variables, with group comparisons performed using ANOVA and associations assessed using Pearson correlation.

Results:
A total of 86 participants were recruited (aged 18.3 ± 1.3 years). Mean A1C was 8.2 ± 1.9%. Mean TRAQ score was 3.6 ± 0.67 out of 5, and mean On TRAck was 187 ± 25.4 out of 240. TRAQ and On TRAck correlated with each other (r=0.42, p< 0.0001) and with participant age (TRAQ r= 0.29 and p=0.006, On TRAck r= 0.21, p=0.046.) Higher On TRAck scores correlated with lower HbA1C (r= -0.31, p=0.003). Higher poverty rates were negatively associated with overall TRAQ, sub-scores for appointment keeping/tracking health information, and On TRAck autonomy scores (p < 0.05).

Conclusion:
We demonstrate that adolescents/emerging adults aged 17-21 years need further support prior to transition to adult care, as mean TRAQ was 3.6 out of 5 with an established threshold of “ready” being 4 out of 5. Associations with age support initiating transition programs earlier, consistent with guidelines recommending assessment beginning at age 14. Significant association between optimal HbA1C and On TRAck suggests this tool identifies meaningful skills and behaviors that translate to optimal diabetes control. Socioeconomic disparities appear to represent barriers to transition readiness. Our ongoing research will evaluate how a video-based educational intervention improves transition readiness.

*Unless otherwise noted, all abstracts presented at ENDO must not be released to the press or the public until the date and time of presentation. For oral presentations, the abstracts are embargoed until the session begins. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO.*