Validation of the Transition Readiness Assessment Questionnaire (TRAQ) 5.0 for Use Among Youth in Mental Health Services

Overview

Journal Child Care Health Dev

Specialty Pediatrics

Date 2022 Jul 15

PMID 35838020

Authors

Kristin Cleverley

Julia Davies

Brooke Allemang

Sarah Brennenstuhl

Affiliations

Soon will be listed here.

Abstract

Background: Among youth with psychiatric disorders, the transition from child to adult mental health services is a period of vulnerability to discontinuous care and service disengagement. Regular assessment of transition readiness has been identified as a core component of transition planning, contributing to successful care transitions. The Transition Readiness Assessment Questionnaire (TRAQ) 5.0 is a 20-item questionnaire that measures transition readiness in youth preparing to transition to adult care. Although the TRAQ has been validated and used across many health settings, it has not been validated in youth with primarily mental health concerns. The objective of this study was to validate the TRAQ for use among youth accessing mental health services.

Methods: This study used the Longitudinal Youth in Transition Study baseline cohort, which consists of 237 clinically referred youth (aged 16-18 years) receiving outpatient mental health treatment. Psychometric evaluation of the TRAQ 5.0 included confirmatory factor analysis (CFA), assessment of internal consistency, testing convergent validity using the Dimensions of Emerging Adulthood (IDEAS) and Difficulty in Emotional Regulation (DERS) scales, criterion validity using a question on whether the participant had talked about transition with their clinician and known-group testing based on age.

Results: The CFA indicated adequate fit of the five-factor TRAQ structure. The overall scale (=.86) and three of the subscales demonstrated adequate internal consistency. As hypothesized, overall TRAQ scores were higher for youth who had discussed transition and those aged 18. Small correlations were found between the overall TRAQ score and measures of developmental maturity (IDEAS) and emotional awareness (DERS); however, certain subscales did not demonstrate correlation with these constructs.

Conclusions: The TRAQ 5.0 appears to be valid tool to assess the transition readiness of youth in outpatient mental health services. Additional work needs determine whether findings are similar among specific mental health conditions, including substance use disorders and psychotic disorders.

Citing Articles

Transition from pediatric to adult health services: A survey of challenges, needs, and preferences of youths and parents.

Racine E, Ouimet F, Gutierrez Rojas R, Clermont M, Fournier A Health Care Transit. 2025; 3:100095.

PMID: 39927091 PMC: 11802371. DOI: 10.1016/j.hctj.2025.100095.

Assessing mental health transition readiness in youth with medical conditions.

Gray W, Partain L, Benekos E, Konishi C, Alpern A, Weiss M Health Care Transit. 2024; 2:100077.

PMID: 39712616 PMC: 11657549. DOI: 10.1016/j.hctj.2024.100077.

Transition Readiness Among Youth Accessing Mental Health Services With Physical Health Co-Morbidities.

Davies J, Brennenstuhl S, Allemang B, Salman S, Sainsbury K, Cleverley K Child Care Health Dev. 2024; 50(6):e70009.

PMID: 39565058 PMC: 11577999. DOI: 10.1111/cch.70009.

Transitioning from pediatric to adult-oriented healthcare in rheumatology: the pediatric side of the coin.

Batu E, Balik Z, Sener S, Aliyev E, Bayindir Y, Cam V Rheumatology (Oxford). 2024; 64(3):1003-1009.

PMID: 38710478 PMC: 11879301. DOI: 10.1093/rheumatology/keae254.

Validation of the Transition Readiness Assessment Questionnaire (TRAQ) 5.0 for use among youth in mental health services.

Cleverley K, Davies J, Allemang B, Brennenstuhl S Child Care Health Dev. 2022; 49(2):248-257.

PMID: 35838020 PMC: 10087053. DOI: 10.1111/cch.13035.

References

Schwartz L, Tuchman L, Hobbie W, Ginsberg J . A social-ecological model of readiness for transition to adult-oriented care for adolescents and young adults with chronic health conditions. Child Care Health Dev. 2011; 37(6):883-95. DOI: 10.1111/j.1365-2214.2011.01282.x. View

Zhang L, Ho J, Kennedy S . A systematic review of the psychometric properties of transition readiness assessment tools in adolescents with chronic disease. BMC Pediatr. 2014; 14:4. PMC: 3898257. DOI: 10.1186/1471-2431-14-4. View

Cleverley K, Rowland E, Bennett K, Jeffs L, Gore D . Identifying core components and indicators of successful transitions from child to adult mental health services: a scoping review. Eur Child Adolesc Psychiatry. 2018; 29(2):107-121. PMC: 7024692. DOI: 10.1007/s00787-018-1213-1. View

Sato Y, Ochiai R, Ishizaki Y, Nishida T, Miura K, Taki A . Validation of the Japanese Transition Readiness Assessment Questionnaire. Pediatr Int. 2019; 62(2):221-228. DOI: 10.1111/ped.14086. View

Gaydos S, Chowdhury S, Judd R, McHugh K . A transition clinic intervention to improve follow-up rates in adolescents and young adults with congenital heart disease. Cardiol Young. 2020; 30(5):633-640. PMC: 7778829. DOI: 10.1017/S1047951120000682. View

Chapados P, Aramideh J, Lamore K, Dumont E, Lugasi T, Clermont M . Getting ready for transition to adult care: Tool validation and multi-informant strategy using the Transition Readiness Assessment Questionnaire in pediatrics. Child Care Health Dev. 2021; 47(5):645-653. DOI: 10.1111/cch.12872. View

Goodman I, Henderson J, Peterson-Badali M, Goldstein A . The relationship between psychosocial features of emerging adulthood and substance use change motivation in youth. J Subst Abuse Treat. 2015; 52:58-66. DOI: 10.1016/j.jsat.2014.12.004. View

Beal S, Riddle I, Kichler J, Duncan A, Houchen A, Casnellie L . The Associations of Chronic Condition Type and Individual Characteristics With Transition Readiness. Acad Pediatr. 2016; 16(7):660-7. DOI: 10.1016/j.acap.2016.06.007. View

Chan J, Soni J, Sahni D, Mantis S, Boucher-Berry C . Measuring the Transition Readiness of Adolescents With Type 1 Diabetes Using the Transition Readiness Assessment Questionnaire. Clin Diabetes. 2019; 37(4):347-352. PMC: 6794230. DOI: 10.2337/cd18-0027. View

10.

Singh S, Paul M, Ford T, Kramer T, Weaver T, McLaren S . Process, outcome and experience of transition from child to adult mental healthcare: multiperspective study. Br J Psychiatry. 2010; 197(4):305-12. DOI: 10.1192/bjp.bp.109.075135. View

11.

McPherson M, Thaniel L, Minniti C . Transition of patients with sickle cell disease from pediatric to adult care: Assessing patient readiness. Pediatr Blood Cancer. 2009; 52(7):838-41. DOI: 10.1002/pbc.21974. View

12.

Pottick K, Bilder S, Vander Stoep A, Warner L, Alvarez M . US patterns of mental health service utilization for transition-age youth and young adults. J Behav Health Serv Res. 2007; 35(4):373-89. DOI: 10.1007/s11414-007-9080-4. View

13.

Lapp V, Chase S . How Do Youth with Cystic Fibrosis Perceive Their Readiness to Transition to Adult Healthcare Compared to Their Caregivers' Views?. J Pediatr Nurs. 2018; 43:104-110. DOI: 10.1016/j.pedn.2018.09.012. View

14.

Heffernan O, Herzog T, Schiralli J, Hawke L, Chaim G, Henderson J . Implementation of a youth-adult partnership model in youth mental health systems research: Challenges and successes. Health Expect. 2017; 20(6):1183-1188. PMC: 5689223. DOI: 10.1111/hex.12554. View

15.

Cohen J . A power primer. Psychol Bull. 2009; 112(1):155-9. DOI: 10.1037//0033-2909.112.1.155. View

16.

Wood D, Sawicki G, Miller M, Smotherman C, Lukens-Bull K, Livingood W . The Transition Readiness Assessment Questionnaire (TRAQ): its factor structure, reliability, and validity. Acad Pediatr. 2014; 14(4):415-22. DOI: 10.1016/j.acap.2014.03.008. View

17.

de Girolamo G, Dagani J, Purcell R, Cocchi A, McGorry P . Age of onset of mental disorders and use of mental health services: needs, opportunities and obstacles. Epidemiol Psychiatr Sci. 2012; 21(1):47-57. DOI: 10.1017/s2045796011000746. View

18.

van Staa A, Jedeloo S, van Meeteren J, Latour J . Crossing the transition chasm: experiences and recommendations for improving transitional care of young adults, parents and providers. Child Care Health Dev. 2011; 37(6):821-32. DOI: 10.1111/j.1365-2214.2011.01261.x. View

19.

Sawicki G, Lukens-Bull K, Yin X, Demars N, Huang I, Livingood W . Measuring the transition readiness of youth with special healthcare needs: validation of the TRAQ--Transition Readiness Assessment Questionnaire. J Pediatr Psychol. 2009; 36(2):160-71. PMC: 3415980. DOI: 10.1093/jpepsy/jsp128. View

20.

Sjowall D, Thorell L . Neuropsychological deficits in relation to ADHD symptoms, quality of life, and daily life functioning in young adulthood. Appl Neuropsychol Adult. 2019; 29(1):32-40. DOI: 10.1080/23279095.2019.1704287. View