{"id":282,"date":"2023-01-04T14:05:56","date_gmt":"2023-01-04T14:05:56","guid":{"rendered":"https:\/\/cdci.w3.uvm.edu\/blog\/healthcare-transition\/?page_id=282"},"modified":"2023-03-14T01:37:21","modified_gmt":"2023-03-14T01:37:21","slug":"research-summaries","status":"publish","type":"page","link":"https:\/\/cdci.w3.uvm.edu\/blog\/healthcare-transition\/research-summaries\/","title":{"rendered":"Research Summaries"},"content":{"rendered":"
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Healthcare transition is a very complex process.\u00a0<\/span>You may think of many more things that impact a successful transition.\u00a0<\/span><\/p>\n

As a summary of healthcare transition models in autism, y<\/span>ou can review the research presented in the table below.<\/span><\/h2>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/section>\n
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    \n
  • \n

    Which aspects of these models do you like?<\/span><\/strong><\/h3>\n<\/li>\n
  • \n

    What’s missing?<\/h3>\n<\/li>\n
  • \n

    What questions do you have about applying this research to Vermont?<\/span><\/h3>\n<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/section>\n\n\n\n\n\n\n\n
    Side-by-side comparison of Healthcare Transition models<\/strong><\/caption>\n
    \n

    #1: Medical HOME & Managed care<\/strong><\/span><\/p>\n<\/th>\n

    		\n

    #2: Fearless Tearless Transition<\/strong><\/span><\/p>\n<\/th>\n

    		\n

    #3. Experiences at a Large Healthcare System<\/strong><\/span><\/p>\n<\/th>\n

    		\n

    #4: Center for Autism within a primary care practice (CAST)<\/strong><\/span><\/p>\n<\/th>\n

    		\n

    #5: Group Family Education \u201cTransitioning Together\u201d<\/strong><\/span><\/p>\n<\/th>\n<\/tr>\n

    Survey of<\/td>\nPre-post design and Survey of<\/td>\nPhone interviews<\/td>\nFocus group and chart review<\/td>\nPre-post design and survey<\/td>\n<\/tr>\n
    129 caregivers<\/p>\n

     <\/td>\n

    		22 caregivers<\/p>\n

     <\/td>\n

    		14 Autistic participants
    \n17 Caregivers
    \n8 providers<\/td>\n    		10 Autistic adults without ID
    \n74 charts<\/td>\n    		11 caregivers<\/p>\n

     <\/td>\n<\/tr>\n

    Specialty autism clinic
    \nProviding primary care,
    \ncare coordinator and other services in the same clinicFunded by Medicaid and private insurance as a HMO<\/td>\n    		Shared care communication book
    \nTransition manager meets youth with pediatrician
    \nTransition assessment
    \nTransition plan
    \nTraining portal for provider
    \nNetwork of specialists
    \nResource Guide<\/td>\n    		<\/td>\nClinic for Autistic adolescents and adults.
    \nIn a primary care, medical home clinic.
    \nPre-visit phone call Accommodations
    \n60 min for first visit
    \nTraining videos
    \n\u201cHappy Visits\u201d<\/td>\n    		2 individual sessions to set up goals
    \n8 group sessions for parents only (1.5h)Topics covered:
    \nAdult Autism, transition planning, problem solving, home- family-behavior, independence, community access, health, legal issues.<\/td>\n<\/tr>\n
    All ages<\/p>\n

    Complex needs<\/p>\n

    Transition at age 22<\/p>\n

    Salt Lake City
    \nPop. 200,000<\/td>\n

    		Starts at age 15<\/p>\n

    Complex needs<\/p>\n

    Progressive age 16-18<\/p>\n

    Melbourne, Australia
    \nPop. 5 million<\/td>\n

    		All ages<\/p>\n

    All levels of needs<\/p>\n

    Transition at age 18<\/p>\n

    Northern California
    \nPop. 4.5 million<\/td>\n

    		All ages<\/p>\n

    All levels of needs<\/p>\n

    No set age<\/p>\n

    Columbus Ohio
    \nPop. 900 000<\/td>\n

    		Ages 15-18, all needs<\/p>\n

     <\/p>\n

     <\/p>\n

     <\/p>\n

    USA<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

     <\/p>\n\n\n\n\n\n
    Outcomes<\/strong><\/caption>\n
    \n

    #1. Medical HOME & Managed care<\/strong><\/span><\/p>\n<\/th>\n

    		\n

    #2: Fearless Tearless Transition<\/strong><\/span><\/p>\n<\/th>\n

    		\n

    #3. Experiences at a Large Healthcare System<\/strong><\/span><\/p>\n<\/th>\n

    		\n

    #4: Center for Autism within a primary care practice (CAST)<\/strong><\/span><\/p>\n<\/th>\n

    		\n

    #5: Group Family Education \u201cTransitioning Together\u201d<\/strong><\/span><\/p>\n<\/th>\n<\/tr>\n

    Compared to national data<\/td>\nNo comparison.<\/td>\n<\/td>\nNo comparison.<\/td>\nNo comparison.<\/td>\n<\/tr>\n
    \n
      \n
    • More family-centered<\/li>\n
    • More shared decisions<\/li>\n
    • More coordination of care<\/li>\n
    • More access to medical home model<\/li>\n
    • Less stress with bills<\/li>\n
    • Easier to get care<\/li>\n
    • More discussion of transition<\/li>\n<\/ul>\n<\/td>\n
    		\n
      \n
    • 67% found it useful<\/li>\n
    • More prepared<\/li>\n
    • Not more confident<\/li>\n
    • Less concerns and unmet needs<\/li>\n<\/ul>\n

      Improved:<\/strong><\/p>\n

        \n
      • Self-care of health needs<\/li>\n
      • Home-family life, lifestyle (diet, exercise, etc.)<\/li>\n
      • Funding for healthcare<\/li>\n
      • Work<\/li>\n
      • emotional wellbeing\/mental health<\/li>\n
      • friends and activities<\/li>\n<\/ul>\n

        No change: <\/strong><\/p>\n

          \n
        • sexual health<\/li>\n
        • Age 16 reported for first transition discussion<\/li>\n<\/ul>\n<\/td>\n
    		Autistics and caregivers want:<\/strong><\/p>\n
      \n
    • To be included in decisions<\/li>\n
    • Skills to transition<\/li>\n
    • Support for change in parent role<\/li>\n
    • More preventative, not reactive care<\/li>\n
    • Sexual healthcare<\/li>\n
    • Gradual transition<\/li>\n<\/ul>\n

      Providers want:<\/strong><\/p>\n

        \n
      • Transition coordinator<\/li>\n
      • Information and tools to better care for autistics<\/li>\n
      • Longer visits for transition care<\/li>\n<\/ul>\n<\/td>\n
    		\n
      \n
    • 23% of Autistics needed a modified visit<\/li>\n
    • 7 of 17 had difficulty completing part of the exam<\/li>\n
    • Difficulty waiting and noises were the most common challenges<\/li>\n
    • Skipping the waiting room was most common change to practice<\/li>\n
    • Able to decrease follow-up visit to 20 min as expertise developed<\/li>\n
    • Growing quickly<\/li>\n
    • Funding of extra services is challenging<\/li>\n<\/ul>\n<\/td>\n
    		Improved:<\/strong><\/p>\n
      \n
    • Learned about their teens<\/li>\n
    • Learned about services<\/li>\n
    • Improved relationships<\/li>\n
    • More positive view of teen<\/li>\n
    • Improved predicting child behavior<\/li>\n<\/ul>\n

      No changes:<\/strong><\/p>\n

        \n
      • No change in behavior<\/li>\n
      • No change in parent stress<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n","protected":false},"excerpt":{"rendered":"

        Healthcare transition is a very complex process.\u00a0You may think of many more things that impact a successful transition.\u00a0 As a summary of healthcare transition models in autism, you can review the research presented in the table below. Which aspects of these models do you like? What’s missing? What questions do you have about applying this […]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"class_list":["post-282","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/cdci.w3.uvm.edu\/blog\/healthcare-transition\/wp-json\/wp\/v2\/pages\/282","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cdci.w3.uvm.edu\/blog\/healthcare-transition\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/cdci.w3.uvm.edu\/blog\/healthcare-transition\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/cdci.w3.uvm.edu\/blog\/healthcare-transition\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/cdci.w3.uvm.edu\/blog\/healthcare-transition\/wp-json\/wp\/v2\/comments?post=282"}],"version-history":[{"count":20,"href":"https:\/\/cdci.w3.uvm.edu\/blog\/healthcare-transition\/wp-json\/wp\/v2\/pages\/282\/revisions"}],"predecessor-version":[{"id":632,"href":"https:\/\/cdci.w3.uvm.edu\/blog\/healthcare-transition\/wp-json\/wp\/v2\/pages\/282\/revisions\/632"}],"wp:attachment":[{"href":"https:\/\/cdci.w3.uvm.edu\/blog\/healthcare-transition\/wp-json\/wp\/v2\/media?parent=282"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}