Transition to adult healthcare for immigrant youth: Practice recommendations

Introduction: The transition from pediatric to adult healthcare is challenging for adolescents and young adults (AYA) with pediatric-onset chronic health conditions. Although barriers faced by AYA during transition are well-documented, previous studies have not considered how migration and settlement impact patient and family experiences.

Objectives: To fill this gap, we conducted a qualitative descriptive study to explore the recommendations for policy and practice from the perspectives of immigrant and refugee AYA living with chronic health conditions in Canada as they transition from pediatric to adult healthcare. We also sought the perspectives of their parents/caregivers and service providers.

Methods: Semi-structured individual interviews and focus groups were conducted with 20 AYA, 14 caregivers, and 5 service providers. AYA were 1st or 2nd generation immigrants to Canada, aged 16-25, with childhood-onset chronic health conditions. Parents or caregivers were 1st generation immigrants, having children with chronic health conditions. Service providers delivered healthcare or other services to immigrant populations.

Results: Recommendations to improve the transition process and mitigate barriers to care included providing more accessible information about patients' health conditions prior to transition, moving the age of transfer beyond age 18, establishing a centralized online health portal for patients who are transitioning to the adult system, providing family case workers, increasing language support, and increasing cross-sector support.

Conclusion: A broad range of recommendations aimed at improving the transition process were provided. Future interventions to support transition from pediatric to adult care for immigrants and refugees should incorporate these recommendations.