The role of executive functioning in health self-management and the transition to adult health care among college students

Abstract

ObjectiveTo examine the role of executive functioning (EF) in health self-management and the transition to adult health care among college students. Participants: A total of 378 undergraduate students from a public university participated in the study. Methods: Participants reported on EF, health self-management skills, and their readiness to transition to adult care. Mediation analyses were conducted to evaluate indirect effects of EF on readiness to transition via health self-management skills. Results: Students with greater EF difficulties were less ready to transition to adult care. Specific aspects of health self-management (Medication management/Appointment keeping) mediated the relationship between EF and readiness to transition. Conclusion: EF is a key developmental aspect of health self-management and transition readiness. Assessing EF strengths/weaknesses in students with suboptimal health self-management skills may provide valuable information for informing the development of individually-tailored transition plans in university health centers, thereby enhancing developmentally appropriate care during the college years.

Keywords: Executive functioning; health education; health self-management; transition.

Figure 1.

Theorized model of how executive functioning relates to transition readiness via healthcare self-management skills among college students. Path values represent unstandardized coefficients, with standard errors in parentheses. The c represents the total effect and c’ represents the direct effect. *p < .01; **p < .001. The model with EF, all mediator variables, and covariates accounted for 22% of the variance in transition readiness (F(8, 368) = 13.14, p < .001). Post-hoc analyses were also conducted to evaluate the role of EF subcomponents (metacognitive and behavioral regulation domains) on self-management and transition readiness. These analyses demonstrated an identical pattern of results (see Supplemental figures S1 and S2).