Healthcare Transitions for Adolescents with Chronic Life-Threatening Conditions using a Delphi Method to Identify Research Priorities for Clinicians and Academics in Canada

Fletcher-Johnston et al. (2011) full text summary PDF

For which topic were research priorities identified?

healthcare transitions

In which location was the research priority setting conducted?

North America - Canada

Why was it conducted at all?

Despite the lack of evidence from the literature, the transition of children and families to adult healthcare systems has been the topic of numerous panels, conferences and policy statements from various societies, agencies and foundations (Therrien et al. 2001; American Academy of Pediatrics et al. 2002; Schor 2003; Bloorview Research Institute 2006; Williams et al. 2006). The goals of an organized and efficient transition for adolescents have been articulated in many of these statements. Despite many agreed upon transition principles and proposed models of care (Scal et al. 1999; Madge & Bryon 2002), there are little outcome data to support any of the models. To best understand healthcare transitions for this population, it is important that future studies are founded upon a strategic programme of research addressing the most urgent topics. Therefore, a research study using a well-established Delphi method was conducted as a formal approach for identifying research priorities.

What was the objective?

to identify pertinent research priorities for academics and clinicians in adolescent healthcare transitions and prioritize a framework for an ongoing program of research

What was the outcome?

a ranking list of 5 research questions

How long did the research prioritization take?

No information provided.

Which methods were used to identify research priorities?

Delphi; workshop

How were the priorities for research identified exactly?

Step 1: workshop: to identify needs and opportunities for research and clinical progress in healthcare transitions for adolescents with chronic life threatening conditions, brainstorming session, 10 questions identified. Step 2: Delphi round 1: participants were asked to read the list of questions and consider whether they wished to submit a maximum of two additional questions to the list. Step 3: review of submissions, resulting in list of 35 questions. Step 4: Delphi round 2: participants were asked to rate each question. Step 5: Delphi round 3: participants were asked to identify the top five questions

Which stakeholders took part?

Clinicians and academics. Workshop: researchers, clinicians and stakeholders. Delphi round 1: 22 participants, Delphi round 2: 24 participants. Delphi round 3: 25 participants.

How were stakeholders recruited?

A diverse panel of participants was actively recruited. ‘Experts' were identified by conducting an environmental scan of all transition programs listed at every children's hospital in Canada. In addition to general transition programs, paediatric subspecialty program websites at each hospital were searched for reference to subspecialty-specific transition programs. Any links to adult subspecialty programs were also searched. Also, links to disease-specific organizations and foundations were researched for any mention of transition and healthcare professionals involved in the transition process linked to that site. A further website search of disease-specific organizations, healthcare organizations and foundations yielded the names of individuals on committees related to adolescent health care and adolescent healthcare consensus statements. As to recruiting academics, a review of the literature for the last 5 years on adolescent healthcare transitions was achieved by reviewing all papers on Medline (2004-2009) and CINHAL. In addition, a search of the last 5 years of all abstracts submitted to the Society of Adolescent Medicine, European Adolescent Research Association and Society for Research on Adolescence was conducted for any abstract related to adolescent healthcare transitions. Finally, all university websites in Canada were searched for the same terms for researchers with an interest in adolescent healthcare transition. the participant must still reside in Canada and a valid email within Canada at the beginning of the survey would be required.

Were stakeholders actively involved or did they just participate?

Stakeholders were mere participants of the research prioritization process; they were not actively involved in the process.