Cross-Cultural Validation of the HIV Adolescent Readiness for Transition Scale (HARTS) in China

Overview

Journal AIDS Behav

Specialty Infectious Diseases

Date 2024 Dec 20

PMID 39702556

Authors

Wenxi Zhong

Dan Tan

Xi Zhang

Jing Cheng

Bianchuan Cao

Jian Tang

Mei Liu

Song Fan

WeiLi Hu

Yanhua Chen

Affiliations

Soon will be listed here.

Abstract

For adolescents infected with the Human Immunodeficiency Virus (HIV), transitioning from pediatric to adult healthcare requires thorough preparation to maintain care continuity and optimal health outcomes. In China, a dedicated scale for assessing their transition readiness is lacking. The HIV Adolescent Readiness for Transition Scale (HARTS) addresses this by evaluating transition readiness across vital domains, with its 15-item design predicting post-transition viral suppression-a key indicator of a successful transition. With no equivalent tool in China, the HARTS's cross-cultural adaptation holds significant potential for enhancing personalized transition strategies and health management. To validate the HIV Adolescent Readiness for Transition Scale (HARTS) among adolescents with HIV in China, the validation was conducted from October 2023 to February 2024, following a five-step process: translation and back-translation; content validity examination by 13 experts; pre-survey with 30 adolescents with HIV; test-retest reliability assessment with 40 adolescents with HIV over a 10-day interval; and structural validation using exploratory factor analysis, including principal component analysis and varimax orthogonal rotation, among 170 adolescents with HIV. The average content validity index of the scale was 0.99. The Cronbach's alpha value for the pre-survey was 0.767, and for test-retest reliability, the intra-class correlation coefficient (ICC) was 0.901. With a total of 15 items, the four factors that made up the scale-"Disclosure," "Health Navigation," "Self-Advocacy," and "Health Literacy"-explained 81.73% of the variation. With alpha values of 0.940, 0.917, 0.929, and 0.888 for each of the four domains, the scale's overall Cronbach's alpha value was 0.943. The Chinese version of HARTS demonstrates good reliability and validity, serving as a tool for assessing the medical transition readiness level of adolescents with HIV in China.

References

Gleeson H, Oliveras Rodriguez C, Hatane L, Hart D . Ending AIDS by 2030: the importance of an interlinked approach and meaningful youth leadership. J Int AIDS Soc. 2018; 21 Suppl 1. PMC: 5978642. DOI: 10.1002/jia2.25061. View

Philbin M, Tanner A, Ma A, Chambers B, Ware S, Kinnard E . Adolescent and Adult HIV Providers' Definitions of HIV-Infected Youths' Successful Transition to Adult Care in the United States. AIDS Patient Care STDS. 2017; 31(10):421-427. PMC: 5650713. DOI: 10.1089/apc.2017.0131. View

Zanoni B, Archary M, Sibaya T, Goldstein M, Bergam S, Denton D . Mobile Phone-Based Intervention Among Adolescents Living With Perinatally Acquired HIV Transitioning from Pediatric to Adult Care: Protocol for the Interactive Transition Support for Adolescents Living With HIV using Social Media (InTSHA) Study. JMIR Res Protoc. 2022; 11(1):e35455. PMC: 8817214. DOI: 10.2196/35455. View

Jin Y, Cai C, Qin Q, Chen F, Tang H . [Epidemiological characteristics of newly reported HIV-infected adolescents aged 15-17 years outside school in China, 2011-2019]. Zhonghua Liu Xing Bing Xue Za Zhi. 2022; 43(1):32-36. DOI: 10.3760/cma.j.cn112338-20210915-00734. View

Zanoni B, Archary M, Sibaya T, Musinguzi N, Kelley M, McManus S . Development and validation of the HIV adolescent readiness for transition scale (HARTS) in South Africa. J Int AIDS Soc. 2021; 24(7):e25767. PMC: 8264413. DOI: 10.1002/jia2.25767. View

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

Ferris M, Harward D, Bickford K, Layton J, Ferris M, Hogan S . A clinical tool to measure the components of health-care transition from pediatric care to adult care: the UNC TR(x)ANSITION scale. Ren Fail. 2012; 34(6):744-53. DOI: 10.3109/0886022X.2012.678171. View

Ferris M, Cohen S, Haberman C, Javalkar K, Massengill S, Mahan J . Self-Management and Transition Readiness Assessment: Development, Reliability, and Factor Structure of the STARx Questionnaire. J Pediatr Nurs. 2015; 30(5):691-9. DOI: 10.1016/j.pedn.2015.05.009. View

Sousa V, Rojjanasrirat W . Translation, adaptation and validation of instruments or scales for use in cross-cultural health care research: a clear and user-friendly guideline. J Eval Clin Pract. 2010; 17(2):268-74. DOI: 10.1111/j.1365-2753.2010.01434.x. View

10.

Dean K, Walker Z, Jenkinson C . Data quality, floor and ceiling effects, and test-retest reliability of the Mild Cognitive Impairment Questionnaire. Patient Relat Outcome Meas. 2018; 9:43-47. PMC: 5774743. DOI: 10.2147/PROM.S145676. View

11.

Dantuluri K, Carlucci J, Howard L, Johnson D, Spencer H, Desai N . Optimizing Disclosure of HIV Status to a Diverse Population of HIV-Positive Youth at an Urban Pediatric HIV Clinic. J Adolesc Health. 2020; 68(4):713-718. PMC: 10233458. DOI: 10.1016/j.jadohealth.2020.10.010. View

12.

Toromo J, Apondi E, Nyandiko W, Omollo M, Bakari S, Aluoch J . "I have never talked to anyone to free my mind" - challenges surrounding status disclosure to adolescents contribute to their disengagement from HIV care: a qualitative study in western Kenya. BMC Public Health. 2022; 22(1):1122. PMC: 9167528. DOI: 10.1186/s12889-022-13519-9. View

13.

Song X, Zou S, Li Y, Chen L, Feng P, Xu P . Correlation between negative life events and suicide attempts among Yi adolescents with HIV/AIDS in Liangshan Prefecture. BMC Public Health. 2023; 23(1):1600. PMC: 10463523. DOI: 10.1186/s12889-023-16377-1. View

14.

Nagenda M, Crowley T . Contextual Factors Influencing Self-Management of Adolescents and Youth Living with HIV: A Cross-Sectional Survey in Lesotho. Int J Environ Res Public Health. 2023; 20(1). PMC: 9819797. DOI: 10.3390/ijerph20010238. View

15.

Njuguna I, Beima-Sofie K, Mburu C, Mugo C, Itindi J, Onyango A . Transition to independent care for youth living with HIV: a cluster randomised clinical trial. Lancet HIV. 2022; 9(12):e828-e837. PMC: 10308660. DOI: 10.1016/S2352-3018(22)00244-2. View

16.

Ashaba S, Baguma C, Tushemereirwe P, Nansera D, Maling S, Tsai A . A qualitative analysis of self-management needs of adolescents and young adults living with perinatally acquired HIV in rural, southwestern Uganda. PLOS Glob Public Health. 2024; 4(3):e0003037. PMC: 10947701. DOI: 10.1371/journal.pgph.0003037. View

17.

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

18.

Zhang S, Jike C, Yang S, Liao Q, Yu G, Wang K . Factors related to HIV infection among unmarried youth in rural areas of Southwest China. AIDS Care. 2018; 30(8):1058-1061. DOI: 10.1080/09540121.2018.1446070. View

19.

Harris L, Hoffman H, Griffith C, Lee N, Koay W, Rakhmanina N . Factors Associated with Transition of HIV Care Readiness Among Adolescents and Youth from a Specialty Pediatric HIV Clinic in the United States. AIDS Patient Care STDS. 2021; 35(12):495-502. DOI: 10.1089/apc.2021.0123. View

20.

Mbebe S, Rabie S, Coetzee B . Factors influencing the transition from paediatric to adult HIV care in the Western Cape, South Africa: perspectives of health care providers. Afr J AIDS Res. 2023; 22(3):175-184. DOI: 10.2989/16085906.2023.2246435. View