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. 2023 Sep 1;77(3):381-388.
doi: 10.1097/MPG.0000000000003868. Epub 2023 Jun 22.

Validation and Reference Scores of the Transition Readiness Assessment Questionnaire in Adolescent and Young Adult IBD Patients

Martha A C van Gaalen  1 , Emma van Gijn  1 , Merel van Pieterson  1 , Lissy de Ridder  1 , Dimitris Rizopoulos  2 , Johanna C Escher  1
Affiliations

Validation and Reference Scores of the Transition Readiness Assessment Questionnaire in Adolescent and Young Adult IBD Patients

Martha A C van Gaalen et al. J Pediatr Gastroenterol Nutr. .

Abstract

Objectives: Transition readiness can predict a successful transition from pediatric to adult care. This study aimed to validate and develop age-dependent reference scores for the (Dutch version of) Transition Readiness Assessment Questionnaire (TRAQ), in adolescents and young adults (AYAs) with inflammatory bowel disease (IBD).

Methods: TRAQ has 20 items (score 1-5) distributed over 5 domains (total sum score 100) and is completed by AYAs. Following the COnsensus-based Standards for the selection of health Measurement INstruments methodology, we conducted the translation, back-to back translation, pretesting, and validation of the final Dutch version of TRAQ (TRAQ-NL) questionnaire. We used a Rasch model for structural validation, hypothesis testing for construct validity, and Cronbach alpha to demonstrate reliability. Reference scores were calculated using percentiles.

Results: Two hundred fifty TRAQ questionnaires were evaluated in 136 AYAs with IBD [56% Crohn disease, 58% male, median age 17.5 years (range 15.7-20.4)]. The overall mean item score was 3.87 (range 1.45-5). With good reliability (Cronbach alpha 0.87), TRAQ-NL discriminated well between knowledge levels, especially in the lower levels. Transition readiness was defined as low, moderate, adequate, or excellent in patients with TRAQ percentile scores (PC) <25th (<3.375 mean item score), 25th-50th (3.375-3.9), 50th-90th (3.91-4.7), or >90th (>4.7). Younger patients, concomitant illness, fewer visits to the transition clinic, and parental dependence were associated with significantly lower TRAQ scores.

Conclusion: TRAQ(-NL) is reliable and valid, with age-dependent PC to identify (in)adequate transfer readiness. TRAQ can now be more easily used as a patient-reported outcome measure to monitor transition readiness longitudinally in routine care for AYAs IBD patients.

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Conflict of interest statement

Dr Escher served for a scientific advisory board for Janssen and Abbvie, received a research grant from MSD, and a grant from Abbvie for a transitional care project, not concerning the submitted work. Dr de Ridder has done research consults for Takeda and Abbvie and received a research grant from Pfizer outside the submitted work. van Pieterson received a research nursing grant from Erasmus MC, ECCO, and Dr Falk Pharma for a transitional care project, not concerning the submitted work. The remaining authors report no conflicts of interest.

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