Ready for adult care? An Italian adaptation and pilot validation of a youth transition readiness tool in a hospital-based transition from pediatric to adult care program
Year: 2026
Type: article
Abstract: Background The increasing prevalence of children with chronic conditions has led to a growing population of adolescents and young adults (AYAs) requiring transition from pediatric to adult care. Despite evidence supporting structured transition pathways, validated tools to assess transition readiness within multidisciplinary, hospital-based transition programs in the Italian setting are lacking. Objective To culturally adapt and preliminarily validate the sample Transition Readiness Assessment for Youth (TRA) into Italian, creating an Italian version (TRA ITA ) for use among AYAs with chronic and rare diseases beginning transition to adult care in a tertiary care university hospital. Methods This cross-sectional pilot study was conducted at the Azienda Ospedale-Università di Padova within the newly implemented hospital-based, multidisciplinary structured transition program. The TRA was translated into Italian using forward-backward translation methods and culturally adapted by a multidisciplinary expert panel. The questionnaire was administered to AYAs from 5 pediatric units (hematology-oncology, gastroenterology, pulmonology, diabetology and nephrology) adhering to the transition program. Psychometric properties were evaluated following COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) guidelines, including internal consistency: Cronbach’s alfa(α), McDonald’s omega(ω), split-half reliability(ρ), exploratory factor analysis (EFA), and construct validity through hypothesis testing. Results The adapted version was administered to 66 AYAs (mean age 19.7 years, range 15–30) with rare and chronic conditions (sickle cell disease, diabetes, gastroenterological, pulmonary and renal diseases).The TRA ITA demonstrated very good internal consistency (Cronbach’s α = 0.864; McDonald’s ω = 0.864) and stable split-half reliability (Spearman-Brown coefficient ρ = 0.893). Preliminary Explanatory Factor Analysis(EFA) suggested a multidimensional structure with a four-factor solution explaining 43.2% of variance. Item analysis revealed basic disease knowledge items showing higher competence than complex self-management skills. Age was significantly associated with transition readiness (beta (β)=−0.539, p = 0.008), with older adolescents demonstrating greater readiness. No significant differences were found across diseases or clinical units suggesting the feasibility of shared, cross-disease educational pathways within a unified transition program. Conclusions The TRA ITA demonstrates promising psychometric properties for assessing transition readiness in Italian AYAs with diverse chronic conditions. This pilot study supports its use as a screening tool in hospital-based multidisciplinary transition programs to identify individual strengths and guide personalized transition planning. Further validation in larger and more diverse cohorts is warranted.
Authors: Elisabetta Mezzalira, Sarah Donello, Eleonora Tomaello, Marina Giacon, Luca Bosa, Maria Rizzo, Francesca Zennaro, Giulia Rubin, Carlo Moretti, Giorgia Ghirardo, Elizabeth Maran, Stefania Zanconato, Valentina Agnese Ferraro, Maria Sangermano, Mauro Parozzi, Francesca Scalzotto, Rossella Perilli, Silvia Eugenia Bennici, Michele Tessarin, Giorgio Perilongo, Raffaella Colombatti
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,790
OpenAlex ID: W7225775385
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