Table 4 Facilitators to Healthcare Transition using Youth and Clinicians’ Perspectives

1

Trust in Adult Clinician

YLH frequently mentioned that it was easier to transition and adjust to adult care when they were able to trust their adult clinician. YLH valued doctors who they felt made an effort to build a relationship with them and trusted their judgement when it came to care.

2

Social Worker/Case Manager

Case management services before, during, and after the transition helped YLH with logistical and emotional support. YLH often spoke highly of their relationship with their social worker.

3

Warm Handoff

Warm handoffs help establish a relationship with the new clinical team before leaving pediatric care while also leveraging the existing trust between the patient and their old team.

4

Referral from Pediatric Clinicians

Even in the absence of a warm handoff, YLH valued guidance on where to seek adult care and trusted that their pediatric doctor would direct them to a capable clinician.

5

Maintaining Relationship with Pediatric Clinicians

The relationship between patient and pediatric care team is frequently long-standing and emotionally significant. YLH mentioned that it was helpful to retain a relationship with their pediatric team even after transition.

6

Same Location

YLH who were able to stay in the same location appreciated the consistency in routine and the familiar surroundings.

CLINICIAN FACILITATORS

1

Social Worker/Case Management

Having access to case management services before, during and after the transition process creates vital support for YLH in moving to adult care successfully.

2

Transition Preparation

Being educated about the changes that come with transition before moving to adult care helps YLH to anticipate and successfully navigate them as they come.

3

Similar Environment

Transitioning within a clinic that has both pediatric and adult physicians eases the process for YLH as the physical environment and support staff remain the same.

4

Warm Handoff

Having a warm handoff between pediatric and adult clinicians assures that the patient has met and is comfortable with their new clinician and allows medical records to be transitioned between clinics.

5

Adjusted to Diagnosis

When YLH understand the responsibilities that come with their HIV diagnosis and are adjusted to what they need to do to manage their own health, transition will be more successful.

6

Health Literacy

The more YLH are taught about their health, resources available to them, and how to navigate the healthcare system, the more likely they are to transition successfully.