Abstract

In an effort to refine a model of clinical care identifying effective communication with health care providers (HCPs) as a key skill for successful transition to adult medical care, this study explored the perspectives of emerging adults with type 1 diabetes (T1D) about factors that impact the quality and content of communication with their HCPs. Twenty emerging adults with T1D were interviewed about health communication experiences with their pediatric HCP and readiness for transition to adult diabetes care. Interviews were recorded and transcribed; three raters coded transcripts using conventional content analysis for broad themes. Five themes emerged from the data capturing factors that influence emerging adult-HCP communication: HCP interaction style, HCP consistency, HCP support for autonomy, parental involvement in medical care, and emerging adult comfort with disclosure. Most emerging adults had not discussed transition to adult diabetes care with their HCP; some expressed confidence in their ability to transition while others expressed anxiety about the transition process. Findings support the conceptual model of communication and inform clinical implications for working with emerging adults with T1D. Continuity of care should be prioritized with transition-age patients. Additionally, HCPs should initiate conversations about engagement in risky behaviors and transition to adult medical care and ensure emerging adults have time without parents to discuss these sensitive topics. Psychologists can enhance the transition process by facilitating effective patient-HCP communication and coaching both patients and HCPs to ask questions about risky behaviors and transition to adult medical care.

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