Virtual transition education of rural adolescents with congenital heart disease: A pilot study

Purpose: Adolescents and young adults (AYA) living in rural communities have lower access to tertiary pediatric care than those in urban settings. However, all AYA with congenital heart disease (CHD) would benefit from transition programming to develop knowledge of their CHD and self-management skills in preparation for adult care. Previous studies have evaluated in-person delivery of transition programs. We sought to investigate the effectiveness of a virtual nurse-led pediatric-to-adult transition education program. Design and methods: We conducted a prospective cohort study investigating the impact of virtual nurse-led transition education on individuals aged 16-25 with CHD who receive cardiology care in outreach cardiology clinics in Alberta, Canada. Individual teaching sessions were led by a cardiology nurse and delivered virtually in a single 1-hour session. Participants were also provided access to the iHeartChange transition website. A pre-post analysis was performed with comparisons between baseline, 1-month, and 6-month follow-up. Outcome measures were CHD knowledge (MyHeart Scale), self-efficacy (Generalized Self-Efficacy Scale), and self-management skills (Transition-Q). Results: Twenty-five participants (56% female, mean age 17.7 ± 2.2 years) completed the virtual transition education and measures at baseline and both follow-ups. Improvements were observed across all outcomes from baseline to 1 month and from baseline to 6 months, except for self-efficacy, which showed an improvement between baseline and 6 months. Conclusions: Nurse-led virtual transition education can be effective at improving rural AYA's knowledge of their CHD and self-efficacy and self-management skills. Practice implications: Pediatric cardiology programs should implement virtual nurse-led transition education for patients who live remotely.