Self-Management of Health Care Among Youth: Implications for Policies on Transitions of Care

Purpose: Transitions from pediatric to adult health care are important milestones for youth. In surveys, providers report that youth lack the motivation or skills to manage their care independently, a prerequisite for successful transitions. To assess the validity of this belief, we surveyed youth regarding their current and desired level of involvement in their care.

Methods: In 2017-2018, we conducted a national text message survey of youth aged 14-24 years. The survey included three open-ended questions assessing participants' independence on three health care tasks (scheduling appointments, attending appointments, and picking up prescriptions) and one open-ended question assessing their desire to be more, less, or equally involved in their care as they are now. We qualitatively analyzed free-text responses to identify themes.

Results: Among 1,214 eligible participants, 805 (66.3%) completed all four questions and were included in the sample. Forty-one percent of youth reported wanting to be more involved in their care. Among young adults aged 18-24 years, 22% were not fully independent on the three health care tasks and reported wanting to be less involved or equally as involved as they are currently.

Conclusion: Many youth should be viewed as partners in health care transitions instead of as barriers, but some youth are at high risk for failed transitions. Policymakers and providers should promote routine screening of youth for their current levels of engagement in care and desire to be more involved.