Introduction to the Special Section: Health Care Transitions of Adolescents and Young Adults with Pediatric Chronic Conditions

Abstract

Over 90% of children with pediatric chronic conditions will survive to adulthood. As a result, an increasing number of adolescents and young adults (A/YA) with a chronic health condition will undergo a health care transition (HCT); the purposeful, planned movement from child-centered to adult-oriented health care systems including primary and subspecialty care (Blum et al., 1993). The purpose of transition is to effectively engage the A/YA in the adult health care system so that they receive developmentally and medically appropriate care to facilitate optimal health outcomes and quality of life (Rosen, Blum, Britto, Sawyer, & Siegel, 2003). The term transfer, often confused with transition, refers to the actual act of moving to a new health care setting, provider, or both (Betz & Redcay, 2003; Betz & Telfair, 2007). The transition to adult-based medical care typically occurs during a vulnerable developmental period and is accompanied by multiple barriers (e.g., difficulty establishing medical care with an adult care provider, difficulties negotiating the unfamiliar adult health care system, lack of communication between pediatric and adult providers, and differences between pediatric and adult approaches to care). Therefore, the HCT presents a number of challenges that patients, families, providers, and the larger health care system is ill equipped to handle. In response, numerous consensus statements have called for multi-disciplinary action to address this critical issue (American Academy of Pediatrics, 2002; Blum et al., 1993; DHHS, 2000). However, theoretical frameworks to guide research and practice in HCT remain underdeveloped and empirical data regarding HCT is extremely limited. This special section of the Journal of Pediatric Psychology is presented in response to the changing composition and needs of the pediatric populations that the journal serves. Traditionally, this interdisciplinary journal has disseminated science that applies psychological principles to optimize long-term medical and psychological outcomes in children, adolescents and their families. As pediatric populations age, research focusing on the needs of A/YA with special health care needs is increasingly relevant to patients, families, clinicians, researchers, policy makers, and other consumers of the journal. Therefore, it is incumbent for the Journal of Pediatric Psychology to address the needs of A/YA with special health care needs. The intent of this special section is to highlight the need for and to encourage future research in HCT and to formally identify HCT as an area of importance for the Journal of Pediatric Psychology.