Outcomes of a Structured Ambulatory Care Health Care Transition Approach in a Large Children's Hospital.

Purpose: Without a structured health-care transition (HCT) process, youths with chronic conditions face increased morbidity, care gaps, and dissatisfaction. This article documents the process and outcomes of implementing a standardized approach in a large children's hospital.

Methods: Children's Mercy Kansas City adopted Got Transition's Six Core Elements of Health Care Transition and established a system-wide implementation plan, between 2015 and 2019, involving leadership buy-in, consumer engagement, infrastructure improvements, and quality improvement efforts.

Practice Survey: Depression Screening in Pediatric Inflammatory Bowel Disease.

Background: Little is known about depression screening practices in pediatric inflammatory bowel disease (IBD) care. This study summarizes depression screening within IBD centers in the ImproveCareNow Collaborative Network.

Methods: Pediatric IBD providers across 79 IBD centers completed an online survey on current practices surrounding depression screening.

ACG Clinical Report and Recommendations on Transition of Care in Children and Adolescents With Hereditary Polyposis Syndromes.

Transition of care (TOC) in adolescents and young adults (AYAs) with chronic gastrointestinal disorders has received increased attention, especially in those with inflammatory bowel disease. AYAs with hereditary polyposis syndromes are a heterogeneous group of patients with overlapping and complex medical needs. These patients are particularly vulnerable because of the risk of loss of continuity of care and subsequent poor disease outcomes.

Integrated Multidisciplinary Treatment for Pediatric Inflammatory Bowel Disease.

Inflammatory Bowel Disease (IBD) is a chronic and relapsing inflammatory disorder of the gastrointestinal tract [...

Perceived effect of pediatric inflammatory bowel diseases on academics, college planning, and college adjustment.

To examine the relationship between perceived effect of inflammatory bowel diseases (IBD) on high school academics and college planning on college adjustment. Participants (N = 97) were college students with IBD. Participants completed an online survey including the Student Adaptation to College Questionnaire and study-developed questions assessing the perceived impact of their diagnosis on their high school academics and college planning.

Using a Mixed-method Approach to Develop a Transition Program for Young Adults With Inflammatory Bowel Disease.

Background: Although transition guidelines have been specified in pediatric inflammatory bowel disease (IBD), few IBD centers implement these into standard care. We describe a mixed qualitative and quantitative process of developing a needs-based transition program for adolescents and young adults with IBD.

Methods: We enrolled 29 adolescents with IBD, 8 young adults with IBD in adult care, 14 pediatric gastroenterologists, and 58 adult gastroenterologists to provide input into barriers to successful transition, essential patient competencies, and key targets of clinical intervention.

Depression Screening in Pediatric Inflammatory Bowel Disease Clinics: Recommendations and a Toolkit for Implementation.

Objective: Rates of youth depression are increasing, and approximately 75% of adolescents with depression go unrecognized. Research in pediatric IBD documents increased depression risk, with rates up to 25%, as well as worse adherence and treatment outcomes associated with depressive symptoms. Evidence-based psychological interventions improve the physical and emotional health of these patients, highlighting the importance of detection and treatment.

Health-Related Quality of Life Predicts Psychology Referral in Youth with Inflammatory Bowel Disease.

Purpose: The current study sought to explore psychosocial data gathered from routine screening within an interdisciplinary IBD program, with two-fold aims: 1) to examine parent-child agreement across health-related quality of life domains and 2) to evaluate the differential predictive value of child and parent ratings of health-related quality of life domains on referrals for psychological services.

Design And Methods: A convenience sample of 92 youth (ages 8-18) and their parents completed the Pediatric Quality of Life Inventory.

Results: Children and parents showed moderate to good agreement across health-related quality of life domains.

Substance Use in Adolescents and Young Adults With Inflammatory Bowel Diseases: An Exploratory Cluster Analysis.

Objectives: Adolescents and young adults (AYAs) with chronic illnesses use substances at similar, if not greater, rates compared to healthy peers. The present study aimed to examine rates and patterns of tobacco use, marijuana use, and binge drinking in AYAs with inflammatory bowel diseases. We expected that substance use would be associated with poorer physical health, psychosocial functioning, and disease management.

Practice survey: adherence monitoring and intervention in pediatric gastroenterology and hepatology.

Purpose: Despite significant medication nonadherence rates among youth with pediatric gastroenterology and hepatology disorders, little is known about current adherence practices in pediatric gastroenterology care. This study summarizes current practices surrounding adherence monitoring and intervention in pediatric gastrointestinal (GI) and hepatologic care in the USA.

Participants And Methods: One hundred and fifty-four pediatric GI providers completed an online survey designed to examine current practices surrounding adherence monitoring and intervention, specific strategies used to monitor and treat poor adherence, and the barriers currently experienced in relation to adherence monitoring and intervention.

Patient and Caregiver Perspectives on Transition and Transfer.

Little is known about the needs of adolescents with inflammatory bowel disease (IBD) with regard to transition, and how well those needs align with guidelines put forth by the American Academy of Pediatrics (AAP). This study examines perspectives on transition among young IBD patients and their caregivers. Surveys were mailed to 370 adolescent IBD patients, aged 12 years and older, and their caregivers.

Current Transition Practices in Pediatric IBD: Findings from a National Survey of Pediatric Providers.

Background: Although practice guidelines have been published for transition to adult care among general chronic illness populations and specific to pediatric inflammatory bowel disease (IBD), little is known about current transition practices in IBD care. This study presents data characterizing current transition practices as reported by a national sample of pediatric providers in the United States.

Methods: One hundred forty-one pediatric providers completed an online survey designed to assess current transition practices, barriers and challenges to developing and maintaining transition programming, and desired resources to improve transition services.

Preparing Patients for Transfer of Care: Practices of Primary Care Pediatricians.

Comprehensive transition planning by pediatric providers is essential for successful transition into adulthood and transfer to adult medical health care settings. Yet, little is known about the level and type of transition planning and preparation provided by pediatric primary care providers. This study examined the range of transition services provided in primary care pediatric centers.

No guts, no glory: models of integrated care within a GI subspecialty practice.

The focus in pediatric medicine has shifted from a concentration on mortality and morbidity to a more comprehensive view encompassing the physical, social, and psychological aspects of health. What follows is a description of four integrated, collaborative care clinics within the GI subspecialty at Children's Mercy Kansas City that specifically address this trend in pediatric healthcare. With these descriptions, we hope to inform broader acceptance and utilization of similar models across other pediatric populations.

Implementing motivational interviewing in a pediatric hospital.

Motivational Interviewing is a collaborative style of communication designed to strengthen a person's own motivation and commitment to change. We report on our ongoing efforts to implement motivational interviewing to address health behavior change among several patient populations in our pediatric hospital, including sexual risk reduction among adolescents, increased self-care for patients with spina bifida, increased adherence for adolescents with Type 1 diabetes, and facilitation with transition from pediatric to adult care among gastroenterology patients.

Self-management in pediatric inflammatory bowel disease: A clinical report of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.

This clinical report aims to review key self-management and adherence issues in pediatric inflammatory bowel disease (IBD) and to provide recommendations for health care providers regarding evidence-based assessment and treatment approaches to promote optimal self-management. Self-management difficulties in the form of nonadherence to treatment regimens are common in pediatric IBD and are influenced by various disease-related, individual, family, and health professional relationship factors. To promote adaptive self-management, health care providers are encouraged to adopt a long-term preventive orientation, which includes routine screening of barriers to self-management and nonadherence in the context of routine clinic appointments.