Transition Readiness and Problem Focused Coping - EMJ

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Transition Readiness Improved with Problem Focused Coping

Key Summary:

  • Transition readiness improved with problem focused coping in young adults with sickle cell disease.
  • Problem focused coping and social support were associated with higher transition readiness scores.
  • Findings highlighted potential targets to strengthen transition readiness during transfer to adult care.

TRANSITION readiness was higher among young adults with sickle cell disease who reported greater use of problem focused coping strategies, according to a cross-sectional analysis of baseline data from a multicentre randomised clinical trial.  

The findings also showed an association between stronger social support and improved readiness for transfer from paediatric to adult haematology services. 

The study analysed baseline data from 373 young adults aged 17–25 years who were planning to transition to an adult sickle cell clinic within the following 12 months. Participants were recruited between 15 January 2019 and 31 December 2022 across five institutions in Connecticut, New York, Ohio, and Pennsylvania. Data were analysed between 30 September 2024 and 30 June 2025. 

Transition readiness was assessed using the Transition Readiness Assessment Questionnaire. Social (TRAQ) support was measured using the emotional and informational subscale of the Medical Outcomes Study Social Support Survey (MOS-SSS), while coping strategies were evaluated using the Brief COPE questionnaire. 

Social Support Also Showed a Positive Association 

The final cohort had a mean age of 18.9 years, with 190 female participants representing 51.5% of the study population. Most participants identified as Black and as non-Hispanic or Latino. 

In unadjusted analyses, overall coping, problem focused coping, and emotional and informational social support were all associated with higher transition readiness scores. The strongest association was observed for problem focused coping: (mean difference: 0.18; 95% CI: 0.09–0.27; P<0.001). Emotional and informational social support was also associated with higher readiness scores: (mean difference: 0.13; 95% CI: 0.07–0.19; P<0.001). 

After adjustment for age, gender, disease severity, worry, recruitment site, and social support, only problem focused coping remained independently associated with transition readiness: (mean difference: 0.10; 95% CI: 0.003–0.19; P=0.04). 

Findings Identified Potential Intervention Targets 

The investigators concluded that problem focused coping may represent an important factor in preparing adolescents and young adults with sickle cell disease for successful transition to adult healthcare. Although social support was associated with higher transition readiness in unadjusted analyses, problem focused coping remained significant after adjustment for potential confounding factors. 

Reference 

Iyengar AS et al. Coping strategies and social support for transition readiness among youth with sickle cell disease. JAMA Netw Open. 2026;9;(7):e2622753. 

Featured image: Lumi Stock Studio on Adobe Stock. 

 

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