Introduction to the Special Section: Health Care Transitions of Adolescents and Young Adults with Pediatric Chronic Conditions

Over 90% of children with pediatric chronic conditions will survive to adulthood. As a result, an increasing number of adolescents and young adults (A/YA) with a chronic health condition will undergo a health care transition (HCT); the purposeful, planned movement from child-centered to adult-oriented health care systems including primary and subspecialty care (Blum et al., 1993). The purpose of transition is to effectively engage the A/YA in the adult health care system so that they receive developmentally and medically appropriate care to facilitate optimal health outcomes and quality of life (Rosen, Blum, Britto, Sawyer, & Siegel, 2003). The term transfer, often confused with transition, refers to the actual act of moving to a new health care setting, provider, or both (Betz & Redcay, 2003; Betz & Telfair, 2007). The transition to adult-based medical care typically occurs during a vulnerable developmental period and is accompanied by multiple barriers (e.g., difficulty establishing medical care with an adult care provider, difficulties negotiating the unfamiliar adult health care system, lack of communication between pediatric and adult providers, and differences between pediatric and adult approaches to care). Therefore, the HCT presents a number of challenges that patients, families, providers, and the larger health care system is ill equipped to handle. In response, numerous consensus statements have called for multi-disciplinary action to address this critical issue (American Academy of Pediatrics, 2002; Blum et al., 1993; DHHS, 2000). However, theoretical frameworks to guide research and practice in HCT remain underdeveloped and empirical data regarding HCT is extremely limited.