Transition Readiness Research Articles

A68 PERCEPTIONS OF ADOLESCENTS AND YOUNG ADULTS WITH INFLAMMATORY BOWEL DISEASE REGARDING A BIOPSYCHOSOCIAL TRANSITION INTERVENTION: A QUALITATIVE STUDY

Abstract Background The transition from the pediatric to adult care healthcare system for adolescents and young adults (AYAs) with inflammatory bowel disease (IBD) is complex. This group requires support to prepare for and adapt to adult care due to the manifestation of the disease, expectations for self-management, and simultaneous life transitions. To address this need, a multi-site randomized controlled trial (RCT) is being conducted to evaluate the impact of a multimodal transition intervention on functional, clinical, and psychosocial outcomes for AYAs with IBD. An embedded qualitative study explored participants’ perspectives of the intervention's acceptability and appropriateness to support the translation of findings into practice. Aims Using in-depth individual qualitative interviews with a purposive sample of AYAs in both the intervention and control arms of the RCT, this qualitative study aimed to understand AYAs’ experiences preparing for and undergoing service transitions, developing self-management skills, and engaging with the intervention. Methods Semi-structured interviews were held via videoconference with 21 AYAs aged 16-18 years participating in the RCT (intervention arm n=11; control arm n=10) in Toronto, Canada. Purposive sampling was used to recruit AYAs with diverse demographic and clinical characteristics at different stages of the healthcare transition. Interviews were audio-recorded, transcribed verbatim, and analyzed using an inductive approach to reflexive thematic analysis. Results The analysis yielded four overarching themes related to 1) individual, familial, and system-level factors promoting transition readiness, 2) areas of strength and areas for growth regarding self-management skill development, 3) perceptions of the multimodal transition intervention, including barriers and facilitators to engagement, and 4) recommendations for future transition care, including refinement of the intervention. Findings to date indicate the criticality of considering AYAs’ support systems, learning styles, and communication preferences when designing and implementing transition interventions. The qualitative data analysis is ongoing, and the full results will be presented. Conclusions The perspectives of AYAs with IBD can inform the development and refinement of clinical interventions, ensuring they are tailored to recipients’ unique needs and preferences and promote engagement and skill development during pediatric-adult transitions. Funding Agencies CCCThe Leona M. and Harry B. Helmsley Charitable Trust

156. Maturing into Adulthood: Transition Readiness Over Time in Primary Care

156. Maturing into Adulthood: Transition Readiness Over Time in Primary Care

P198 Systematic review to highlight practices and programmes for transition for adolescents with Inflammatory bowel disease

Abstract Background Adolescents with inflammatory bowel disease (IBD) will eventually transition from the family-centric paediatric healthcare team to the adult service. This process happens at an appropriate age or level of development and depends on a number of factors such as transition readiness, disease specific factors, and local policies and practice. This transition period is challenging for patients, families and healthcare providers. The use of structured transition programmes is increasingly incorporated into standards of care, yet the optimal format is not yet fully delineated, and practices vary considerably. The aim of this study was to carry out a systematic review of structured transition programmes and their components to assess impact on disease-specific and transition-related outcomes. Methods A literature review was carried out in four main databases (PubMed, CINAHL, CENTRAL, EMBASE) and relevant publications from the year range 1970-2023 reviewed. Inclusion criteria: reporting on adolescent IBD patients and investigating structured transition programmes/interventions. Exclusion criteria: not reporting outcomes relating to transition readiness/skills or disease related outcomes. Two investigators reviewed the articles, extracted data, and two assessed bias. Results There were 3432 articles identified from initial searches, and 38 included in the final review. Twenty-six studies reported the use of structured transition programmes, and 12 investigated discrete interventions. The key outcomes studies included knowledge, self-efficacy, adherence, clinic attendance and transition readiness. These outcomes consistently improved with the use of structured transition programmes. Those adolescents with IBD transitioning with no structured programme experienced a 3.5-fold increase in IBD related surgical rates, and 2-fold increase in hospital admission rates. Structured transition programmes were shown to significantly improve transition readiness assessment scores. Transitional care programmes consistently improved the following outcomes; relapse/admission rates, corticosteroid use, quality of life, and surgery. The bias assessment showed between-study heterogeneity, low quality of evidence, and high risk of bias. Conclusion Transition outcomes for adolescents with IBD were consistently improved with the use of structured transition programmes. This literature review highlights the considerable variation in delivery of transition care, and the need for optimization of strategies. There is no current standardized model for adolescent IBD patients in Australasia, and this review will guide development of regional IBD transitional care consensus statements.

P350 Development of consensus statements for transitional care for adolescents with Inflammatory bowel disease throughout Australia and New Zealand

Abstract Background The incidence of paediatric inflammatory bowel disease (IBD) is rising, and as such there is an increasing need to support adolescents with IBD as they from transition from paediatric to adult care. The use of a structured process for transition is well supported in the literature, however, variation in the delivery of transitional care for adolescents with IBD has been identified across Australis and New Zealand. The aim of this study was to develop consensus statements, based on evidence and expert opinion, to guide transitional care services in IBD. Methods The consensus statements were developed using a modified UCLA-RAND methodology. An IBD expert steering committee was formed, and then a systematic literature review conducted to grade the available evidence and inform initial development of consensus statements. A multi-disciplinary group was formed comprising 16 participants [clinicians, nurses, surgeons, psychologists], that voted anonymously on the level of appropriateness and necessity for each consensus statement, as well as provided general feedback for each. Scoring was facilitated using Likert scales [1=lowest, 9=highest] with a median ≥7 required for inclusion. Results Fourteen consensus statements were devised by the Steering committee (Table 1). Key recommendations including the use of a structured transition programme and transition coordinator. Statements recommended assessment of mental health and transition readiness, and outlined discussion points regarding lifestyle, environment and psychosocial factors to be held with adolescents. The importance of allied health input, the age for transition, recommendations for clinical communication and handover were highlighted, as well as considerations for individual patients. In the first voting round by the multi-disciplinary group each statement reached a median score of ≥ 8 for appropriateness, and ≥7 for necessity. An online meeting with both groups was held to discuss voting results and refine statements. Table 1. Final consensus statements to guide transition of children with inflammatory bowel disease in Australasia. Conclusion There is an identified need for guidance in paediatric to adult transitional care for adolescents with IBD. Consensus statements were developed by a multi-disciplinary group, supported by published evidence, to provide this guidance. The planned publication of the consensus process and statements will facilitate standardize delivery of IBD transitional care within Australasia.

Transitions Pop-ups: Co-designing client-centred support for disabled youth transitioning to adult life.

When transitioning to adulthood, youth with disabilities and their families face many service gaps. Successful inter-agency collaborations can promote family-centred, inclusive transition support amenable to personal choice and health conditions. This paper reports the 3-year co-design process of an innovative transition service that links a pediatric hospital and adult service agencies and addresses key areas of transition preparedness with joint accountability. A team of pediatric rehabilitation professionals, adult service providers, young adults with disabilities and their families, and researchers engaged in a co-design process over three years. Following a design thinking (DT) framework, the team went through an iterative process of Empathize. Define, Ideation, Prototyping, and Testing phases. The trial-and-error process allowed for deeper reflection and an opportunity to pivot the design. The co-design yielded Transitions Pop-ups, a nimble service model that can "pop up" at critical times and places to meet clients' urgent and emergent transition-related needs. Two pilot sessions were conducted at the testing phase with adult service agencies. The final model included five key elements: (1) community partnership; (2) targeted information sharing; (3) peer mentoring; (4) action (on-the-spot completion of a key transition task/activity such as submitting an adult funding application); and (5) warm handover. The co-design process highlighted the importance of open communication and iterative prototype testing as a means for trialing new ideas and clarifying the intent of the project. The DT framework optimally facilitated the co-development of a contextually relevant and sustainable service model for pediatric rehabilitation clients and families.

Protocol for evaluation of the feasibility and preliminary efficacy of a targeted transition readiness workshop intervention for pediatric brain tumor survivors

BackgroundPediatric brain tumor survivors (PBTS) are at risk of physical, cognitive, and psychosocial challenges related to their diagnosis and treatment. Routine follow-up care as adults is therefore essential to their long-term health and quality of life. In order to successfully navigate to adult healthcare, it is recommended that youth develop transition readiness skills. Existing transition readiness interventions often focus on disease management. However, PBTS are also at risk of social competence and cognitive functioning challenges. In this paper, we describe the protocol of this pilot study and the methodology that will be used for the evaluation of the feasibility, acceptability, and preliminary efficacy testing of the first targeted transition intervention workshops specifically designed to meet the needs of PBTS and their caregivers.MethodsThis study will use a mixed method to evaluate three 1 ½-h workshops targeted for dyads (N = 40) of PBTS (14 years or older) and their parents. Dyads will be recruited via a community pediatric cancer organization and the long-term follow-up clinic of a large pediatric hospital. Participants will complete an online survey which includes the Transition Readiness Assessment Questionnaire (TRAQ) before and after the workshops.Each workshop will cover a specific topic related to PBTS transition readiness: disease management, social competence, and cognitive functioning. Workshops will follow the same structure: topic presentation, discussion by a post-transfer survivor or parent, teaching two strategies, and workshop evaluation. Workshops will be co-led by healthcare specialists and patient partners.Feasibility and acceptability will be assessed via recruitment, attendance, retention, and Likert scales, and they will be analyzed by describing and comparing rates. Satisfaction will be measured using satisfaction surveys and audio-recorded focus groups. Qualitative data will be described through thematic content analysis. In order to test the preliminary efficacy of this study, we will compare transition readiness skills pre- and post-workshops using paired samples T test and ANCOVA to examine the impact of workshop on TRAQ skills.DiscussionResults of the study will inform refinement and future broader implementation of targeted transition readiness workshops for the specific needs of pediatric brain tumor survivors.

Perspectives of Adolescents and Young Adults With Sickle Cell Disease and Clinicians on Improving Transition Readiness With a Video Game Intervention.

We aimed to learn the experiences of clinicians and adolescents and young adults with sickle cell disease (AYA-SCD) with managing their disease at home and making medical decisions as they transition from pediatric to adult care, and their perceptions of a video game intervention to positively impact these skills. We conducted individual, semistructured interviews with patients (AYA-SCD ages 15 to 26 years) and clinicians who provide care to AYA-SCD at an urban, quaternary-care hospital. Interviews elicited patients' and clinicians' experiences with AYA-SCD, barriers and facilitators to successful home management, and their perspectives on shared decision-making and a video game intervention. To identify themes, we conducted an inductive analysis until data saturation was reached. Participants (16 patients and 21 clinicians) identified 4 main themes: (1) self-efficacy as a critical skill for a successful transition from pediatric to adult care, (2) the importance of patient engagement in making medical decisions, (3) multilevel determinants of optimal self-efficacy and patient engagement, and (4) support for a video game intervention which, by targeting potential determinants of AYA-SCD achieving optimal self-efficacy and engagement in decision-making, may improve these important skills.

Occupational Therapy’s Role within the Middle and High School Settings in the United States

ABSTRACT There is a need for occupational therapy (OT) in the middle and high school settings, yet the role practitioners (OTPs) play in these settings is not clearly defined. School-based OT is in alignment with the Occupational Therapy Practice Framework (OTPF) which recognizes health is supported and maintained when clients are able to engage in their home, school, workplace, and community (American Occupational Therapy Association, 2020). OTPs serving students in the middle and high school settings ensure successful engagement while at school by addressing not only the occupations specific to education but also by addressing the factors that disrupt or empower these occupations American Occupational Therapy Association (2020). Evidence suggests OTPs are struggling to provide relevant service due to limited clarity of their role . A scoping review was conducted to describe the role of American-based OT in the middle and high school settings, identify barriers that affect practitioners, and provide practitioners with information about the role of the OT. Researchers utilized Preferred Reporting Items for Systematic Reviews and Meta Analyses-Scoping Review extension guidelines. Inclusion criteria included were articles published in English, peer-reviewed journals, within the past twenty years and within the scope of OT practice. A total of 1,107 records were identified of which 24 articles were included. Three themes emerged: 1. specific interventions used in middle and high school settings such as transition readiness, social participation, fine motor/handwriting, assistive technology, literacy participation, and life skills; 2. barriers to service delivery; 3. and the need for advocacy. More research is needed to develop conclusive evidence relating to the current practices of occupational therapy in the middle and high school settings.

An Updated Equitable Model of Readiness for Transition to Adult Care

Despite elevated health risks during young adulthood, many adolescents and young adults with serious health care needs face barriers during the transfer to an adult specialty practitioner, and health disparities may occur during the transition. To validate the content of an updated Social-Ecological Model of Adolescent and Young Adult Readiness for Transition to Promote Health Equity (SMART-E) in a group of adolescents and young adults with sickle cell disease (SCD) and their supports. Health equity framework components were reviewed. Systems of power (eg, institutional and practitioner bias) and environments or networks (eg, peer or school support) were added as SMART-E preexisting factors, and health literacy was included within readiness factors. Adolescents and young adults aged 16 to 29 years with SCD, caregivers, and practitioners participated in this convergent, mixed-methods study within Children's Hospital of Philadelphia between January and August 2022. Content validity was assessed through nominations of top 3 most important transition barriers prior to interviews and focus groups, ratings on importance of SMART-E factors (0-4 scale; ratings >2 support validity) after interviews and focus groups, nominations of 3 most important factors for transition and for health equity, and qualitative content analysis of interview transcripts. The study enrolled 10 pediatric adolescents and young adults (mean [SD] age, 18.6 [2.9] years; 4 female and 6 male), 10 transferred adolescents and young adults (mean [SD] age, 22.9 [2.1] years; 8 female and 2 male), 9 caregivers (mean [SD] age, 49.8 [8.7] years; 5 female and 4 male), and 9 practitioners (mean [SD] age, 45.6 [10.5] years; 8 female and 1 male). Quantitative ratings supported the content validity of SMART-E and met established criteria for validity. Systems of power was the most endorsed transition barrier (14 of 38 participants) reported prior to interviews and focus groups. After the interview, participants endorsed all SMART-E factors as important for transition, with new factors systems of power and environments and networks rated at a mean (SD) 2.8 (1.23) and 3.1 (0.90), respectively, on a 0 to 4 scale of importance. The most important factors for transition and equity varied by participant group, with all factors being endorsed, supporting the comprehensiveness of SMART-E. Qualitative data corroborated quantitative findings, further supporting validity, and minor modifications were made to definitions. SMART-E obtained initial content validation with inclusion of health equity factors for adolescents and young adults with SCD, caregivers, and practitioners. The model should be evaluated in other populations of adolescents and young adults with chronic disease.

Online Educational Resources for Youth Living With Type 1 Diabetes Transitioning to Adult Care: An Environmental Scan of Canadian Content

ObjectivesThere are many educational resources for adolescents and young adults living with type 1 diabetes; however, it is unknown whether they address the breadth of topics related to transition to adult care. Our aim in this study was to collect educational resources relevant to Canadian youth and assess their quality and comprehensiveness in addressing the knowledge necessary for youth to prepare for interdependent management of their diabetes. MethodsWe conducted an environmental scan, a systematic assessment and analysis, of online education resources in English and French relevant to Canadian youth living with type 1 diabetes. Resources were screened using an open education resource evaluation grid and relevant resources were mapped to the Readiness for Emerging Adults with Diabetes Diagnosed in Youth, a validated diabetes transition readiness assessment tool. ResultsFrom 44 different sources, 1,245 resources were identified and, of these, 760 were retained for analysis. The majority were webpages (50.1%) and downloadable PDFs (42.4%), and 12.1% were interactive. Most resources covered Diabetes Knowledge (46.0%), Health Behaviour (23.8%), Insulin and Insulin Pump Management (11.8% and 8.6%, respectively), and Health-care System Navigation (9.7%). Topic areas with the fewest resources were disability accommodations (n=5), sexual health/function (n=4), and locating trustworthy diabetes resources (n=3). ConclusionsThere are many resources available for those living with type 1 diabetes preparing to transition to adult care, with the majority pertaining to diabetes knowledge and the least for navigation of the health system. Few resources were available on the topics of substance use, sexual health, and reproductive health. An interactive presentation of these resources, as well as a central repository to house these resources, would improve access for youth and diabetes care providers during transition preparation.

Time to grow up: readiness associated with improved clinical outcomes in pediatric inflammatory bowel disease patients undergoing transition.

The transition from pediatric to adult healthcare in individuals with inflammatory bowel disease (IBD) poses significant challenges mainly due to the high burden of IBD during adolescence, a critical period of psychosocial development. So far, there are few longitudinal data linking transition readiness to long-term disease outcomes. We aimed to assess patients' readiness to transition and its impact on clinical outcomes, quality of life, and adherence to therapy. An observational, prospective study was conducted in a tertiary adult and pediatric center, including adolescents aged ⩾17 years with a diagnosis of IBD, who underwent a 'structured transition' program including two joint adult-pediatric visits. Transition readiness skills were assessed with the Transition Readiness Assessment Questionnaire (TRAQ). All patients completed the TRAQ at the time of recruitment, which occurred during the initial joint adult-pediatric visit, to determine those deemed ready for transition versus those not ready. The Morisky Medication Adherence Scale and the 36-Item Short Form Health Survey Questionnaire (SF-36) were also completed at baseline and after 12 months. Clinical outcomes were collected at the 12-month follow-up. In all, 80 patients were enrolled who had transitioned through a structured transition clinic and completed 12 months of follow-up. In total, 54 patients were ready for the transition, with a mean TRAQ = 3.2 ± 0.5. The number of clinical relapses and hospitalizations at 12 months was lower in ready compared to not-ready patients (p = 0.004 and p = 0.04, respectively). SF-36 did not differ between ready and not-ready patients and pre- and post-transition clinics (p > 0.05). Based on the receiver operating characteristic curve, a TRAQ cutoff ⩾3.16 could predict medication adherence with a sensibility of 77%, a specificity of 82%, and an AUC of 0.81 (0.71-0.91; p < 0.001). Patients ready for transition had better outcomes at 12 months compared to those who were not ready. Therefore, readiness assessment tools should be integrated into transition management to ensure that interventions are targeted, patient-centered, and responsive to individuals' changing needs.

Healthcare transition readiness of families of youth with cystic fibrosis during COVID-19: A correlational multicenter analysis

BackgroundEnhancing family readiness for the healthcare transition (HCT) to adult-focused care can help adolescents and young adults (AYA) thrive in adulthood. We aimed to explore modifiable and non-modifiable individual, family, and healthcare factors associated with HCT readiness of AYA among families of AYA with cystic fibrosis (CF) during COVID-19. MethodsA multi-site, cross-sectional design was used and an online survey was deployed among families and their AYA from three US pediatric CF centers. The STARx Transition Readiness Questionnaire assessed caregiver- and AYA-perceived HCT readiness of AYA. ResultsCaregivers (N = 71) and their AYA with CF (N = 33, aged 12–21 years) perceived moderately high HCT readiness of AYA. Caregiver resilience was a significant (p = 0.006), family-level factor correlated with caregiver-perceived HCT readiness. ConclusionsFamilies perceived similar levels of AYA readiness for adult-focused care. Caregiver resilience is an important, modifiable family-level factor for targeted interdisciplinary interventions aimed at enhancing HCT processes during COVID-19.

Understanding readiness for transition from Global Alliance for Vaccines and Immunization support for immunization at the subnational level in Kenya: the case of 15 counties

Understanding readiness for transition from Global Alliance for Vaccines and Immunization support for immunization at the subnational level in Kenya: the case of 15 counties

A Systematic Review of Early Childhood Education and Primary School Readiness for Transition Through Play-Based Pedagogies

This systematic review is based on studies that explored school readiness and transition through play-based pedagogies in Early Childhood and Primary Education. Relevant literature involved global literature whose search was conducted by independent researchers following the keyword string, which included among others, stakeholders’ roles in school readiness, transition, and play-based pedagogies. The literature search was done from May to August 2022 following the Preferred Reporting Item for Systematic Review and Meta-Analysis Protocols (PRISMA). Twenty peer-reviewed studies were identified, appraised, and included in the review. Findings from international literature showed that teachers’ implementation of play-based pedagogy revealed a significant and positive relationship to all domains of children’s holistic development. Learner assessment for school readiness and transitioning from pre-primary to primary through play-based pedagogies included academic, social, and personal learning during periods of play. The types of play-based assessments for school readiness identified included: (1) withdrawal assessment, (2) observational assessment, (3) embedded assessment, (4) teacher questioning/interview, (5) Photographs/videos and (6) documentation walls. While literature showed a positive connection between parental involvement and a child’s readiness for school including successful transition from preprimary to primary school, there was limited evidence pointing specifically to the influence of parental involvement in play-based pedagogies for school transitioning.

Translation to Portuguese and cross-cultural adaptation of the epilepsy transition readiness checklist for use in Brazil

ObjectivesPlanning for the child and adolescent to have a safe handling in the epilepsy transition process is essential. In this work, the authors translated the “Readiness Checklists” and applied them to a group of patients and their respective caregivers in the transition process to assess the possibility of using them as a monitoring and instructional instrument. MethodsThe “Readiness Checklists” were applied to thirty adolescents with epilepsy and their caregivers. The original English version of this instrument underwent a process of translation and cultural adaptation by a translator with knowledge of English and epilepsy. Subsequently, it was carried out the back-translation and the Portuguese version was compared to the original, analyzing discrepancies, thus obtaining the final version for the Brazilian population. ResultsParticipants were able to answer the questions. In four questions there was an association between the teenagers' educational level and the response pattern to the questionnaires. The authors found a strong positive correlation between the responses of adolescents and caregivers (RhoSpearman = 0.837; p < 0.001). The application of the questionnaire by the health team was feasible for all interviewed patients and their respective caregivers. ConclusionThe translation and application of the “Readiness Checklists” is feasible in Portuguese. Patients with lower educational levels felt less prepared for the transition than patients with higher educational levels, independently of age. Adolescents and caregivers showed similar perceptions regarding patients' abilities. The lists can be very useful tools to assess and plan the follow-up of the population of patients with epilepsy in the process of transition.

Na putu ka održivosti u GCC zemljama - spremnost za energetsku tranziciju

Whilst stakeholders and policymakers in industry and academia increasingly use circular and sustainable, the terms are not clearly understood. Furthermore, the need for a switch from a current economic model (linear) to a circular one has been recognized globally by the major decision-makers. The shift from one mechanism to another experiences challenges in grasping the Circular Economy (CE) and Sustainability (S) principles: defining them, understanding the similarities and differences, and successfully applying them using the Triple Bottom Line (TBL) approach. Employing a systematic literature review, the paper aims to clarify the ambiguities and add to clarity by exploring the concepts and the relationship of CE and S by applying the TBL framework - social, environmental and economic variables. The gaps regarding relations to people and profit contribution are identified in the literature, and future research priorities and new frameworks are recommended. Finally, the objective is to ascertain whether a strategic approach to sustainability and measures are in place in the Gulf Cooperation Council (GCC), such as increased investment in renewable energy infrastructure that could positively affect energy transition readiness, evidenced by energy efficiency indicators (reduced carbon emissions). Hence, three GCC countries were selected, their goals, and challenges were explored, and further research was recommended.

The Analysis of Organizational Changes using Structural Equation Modelling with Mediating Readiness to Change in Higher Education

This research study demonstrates that the readiness to change moderates the association between supervisor support and commitment to organizational change. The variable "readiness to change" fulfills this moderating function. The State University in West Sumatra, a prestigious institution of higher education in Indonesia, boasts a faculty comprising 260 committed teaching personnel. The formulation of the questionnaire was grounded upon a predetermined set of criteria. The data analysis process involved utilizing Structural Equation Modelling (SEM) and SmartPLS 3.0 software. The results obtained from using structural equation modeling (SEM) were consistent with recognized metrics such as Cronbach alpha, composite reliability, mean-variance extracted, and evaluation criteria for both measurement and structural models. Furthermore, it also showcased the soundness and reliability of the measurement instruments. The study suggests that the mediating factor of preparation for change plays a role in the association between the provision of high-quality support and the level of commitment towards organizational change. This study contributes to the field of management and organizational leadership by providing insights on how to develop robust change strategies through enhancing employees' readiness for transition. This study makes a valuable contribution to the field of change management by emphasizing the role of readiness to change as a mediating factor in the relationship between supervisor support and organizational change commitment. This research additionally aids organizations in developing grooming and training programs aimed at equipping employees with the necessary skills and knowledge to adapt to change.

The Analysis of Organizational Changes using Structural Equation Modelling with Mediating Readiness to Change in Higher Education

This research study demonstrates that the readiness to change moderates the association between supervisor support and commitment to organizational change. The variable "readiness to change" fulfills this moderating function. The State University in West Sumatra, a prestigious institution of higher education in Indonesia, boasts a faculty comprising 260 committed teaching personnel. The formulation of the questionnaire was grounded upon a predetermined set of criteria. The data analysis process involved utilizing Structural Equation Modelling (SEM) and SmartPLS 3.0 software. The results obtained from using structural equation modeling (SEM) were consistent with recognized metrics such as Cronbach alpha, composite reliability, mean-variance extracted, and evaluation criteria for both measurement and structural models. Furthermore, it also showcased the soundness and reliability of the measurement instruments. The study suggests that the mediating factor of preparation for change plays a role in the association between the provision of high-quality support and the level of commitment towards organizational change. This study contributes to the field of management and organizational leadership by providing insights on how to develop robust change strategies through enhancing employees' readiness for transition. This study makes a valuable contribution to the field of change management by emphasizing the role of readiness to change as a mediating factor in the relationship between supervisor support and organizational change commitment. This research additionally aids organizations in developing grooming and training programs aimed at equipping employees with the necessary skills and knowledge to adapt to change.

The Analysis of Organizational Changes using Structural Equation Modelling with Mediating Readiness to Change in Higher Education

This research study demonstrates that the readiness to change moderates the association between supervisor support and commitment to organizational change. The variable "readiness to change" fulfills this moderating function. The State University in West Sumatra, a prestigious institution of higher education in Indonesia, boasts a faculty comprising 260 committed teaching personnel. The formulation of the questionnaire was grounded upon a predetermined set of criteria. The data analysis process involved utilizing Structural Equation Modelling (SEM) and SmartPLS 3.0 software. The results obtained from using structural equation modeling (SEM) were consistent with recognized metrics such as Cronbach alpha, composite reliability, mean-variance extracted, and evaluation criteria for both measurement and structural models. Furthermore, it also showcased the soundness and reliability of the measurement instruments. The study suggests that the mediating factor of preparation for change plays a role in the association between the provision of high-quality support and the level of commitment towards organizational change. This study contributes to the field of management and organizational leadership by providing insights on how to develop robust change strategies through enhancing employees' readiness for transition. This study makes a valuable contribution to the field of change management by emphasizing the role of readiness to change as a mediating factor in the relationship between supervisor support and organizational change commitment. This research additionally aids organizations in developing grooming and training programs aimed at equipping employees with the necessary skills and knowledge to adapt to change.

Clinical, Sociodemographic, and Psychological Factors Associated with Transition Readiness in Patients with Epilepsy.

The transition to adult care for patients with epilepsy is a complicated clinical issue associated with adverse outcomes, including non-adherence to treatment, dropout of medical care, and worse prognosis. Moreover, youngsters with epilepsy are notably prone to emotional, psychological, and social difficulties during the transition to adulthood. Transition needs depend on the type of epilepsy and the epileptic syndrome, as well as on the presence of co-morbidities. Having a structured transition program in place is essential to reduce poor health consequences. A key strategy to optimize outcomes involves the use of transition readiness and associated factors assessment to implement the recognition of vulnerability and protective aspects, knowledge, and skills of these patients and their parents. Therefore, this study aims to provide a comprehensive framework of clinical and psychosocial aspects associated with the transition from pediatric to adult medical care of patients with epilepsy. Measures examining different aspects of transition readiness and associated clinical, socio-demographic, psychological, and emotional factors were administered to 13 patients with epilepsy (Mage = 22.92, SD = 6.56) with (n = 6) or without (n = 7) rare diseases, and a respective parent (Mage = 56.63, SD = 7.36). patients showed fewer problems in tracking health issues, appointment keeping, and pharmacological adherence as well as low mood symptoms and moderate resiliency. Moreover, they referred to a low quality of sleep. Notably, parents of patients with rare diseases reported a lower quality of sleep as compared to the other group of parents. Increasing awareness around transition readiness is essential to promote self-management skills of patients with epilepsy and their parents. Anticipating the period of transition could be beneficial, especially to prevent problematic sleep patterns and promote independence in health care management. Parents of patients with epilepsy and rare diseases should be monitored for their mental status which can affect patients' well-being.