The LETS Study: A Longitudinal Evaluation of Transition Services

NCT ID: NCT00975338

Last Updated: 2023-10-23

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

149 participants

Study Classification

OBSERVATIONAL

Study Start Date

2009-09-30

Study Completion Date

2016-07-12

Brief Summary

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This project will describe and evaluate the impact of a unique partnership model designed to coordinate transfer of care by formally linking pediatric and adult heath care services. The experiences of young people receiving this model of care will be compared and contrasted against the experiences of young people receiving the current standard of care. Young people with a diagnosis of Cerebral Palsy (CP), Acquired Brain Injury in childhood (ABIc), and Spina Bifida (SB) will be followed during the transition period. Preparation for transition, health care, and transfer of care service delivery will be detailed in a process evaluation. An outcome evaluation will measure the ability of the two models of service to enable youth to maintain continuity within the health care system after transitioning from pediatric to adult care. Secondary outcomes, including how health, well-being, social participation, transition readiness, and health care utilization are affected will also be explored.

Detailed Description

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Due to advances in medical treatment, most children with disabilities such as cerebral palsy or acquired brain injury can expect to live normal lifespans. As children, these individuals are cared for by expert healthcare providers working in coordinated teams in specialized pediatric settings. As these children reach adulthood, the availability of services and expertise drops dramatically because the adult health care system has not evolved to meet their specialized needs. In addition, transitioning from pediatric to adult services is often very difficult and stressful. Young people and their families must leave familiar healthcare settings and providers, and secure care in unfamiliar adult health care environments.

This proposed project will describe and evaluate the impact of a unique partnership model designed to coordinate transfer of care by formally linking pediatric and adult health care services. The LIFEspan model aims to (a) prepare youth and their families to adapt to adult healthcare provision, (b) provide a coordinated transfer process from pediatric to adult providers, and (c) establish sustainable access and appropriate adult care. The project will detail the specific service delivery that occurs with respect to preparation for transition and transfer of care in a process evaluation. An outcome evaluation will measure the effectiveness of the model in terms of its abilities to enable youth to maintain continuity within the health care system after transitioning from pediatric to adult care. Secondary outcomes, including how health, well-being, social participation, transition readiness, and health care utilization are affected by the LIFEspan model, will also be explored.

Conditions

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Cerebral Palsy Brain Injuries Spinal Dysraphism

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Prospective LIFEspan

LIFEspan youths with Cerebral Palsy or Acquired Brain Injury

LIFEspan

Intervention Type OTHER

Rehabilitation services provided by an inter-disciplinary team of health professionals addressing the transfer of care to adult services and emerging needs related to transition to adulthood. LIFEspan staff are cross-appointed to both a pediatric and an adult hospital through a formally linked model of care.

Prospective Non-LIFEspan

LIFEspan youths with Spina Bifida

Non-LIFEspan

Intervention Type OTHER

Standard of care in the absence of a formal partnership between a pediatric and an adult hospital.

Retrospective Non-LIFEspan

Non-LIFEspan youths with Cerebral Palsy or Acquired Brain Injury

Non-LIFEspan

Intervention Type OTHER

Standard of care in the absence of a formal partnership between a pediatric and an adult hospital.

LIFEspan Staff

All staff affiliated with the LIFEspan model of linked transition care

LIFEspan

Intervention Type OTHER

Rehabilitation services provided by an inter-disciplinary team of health professionals addressing the transfer of care to adult services and emerging needs related to transition to adulthood. LIFEspan staff are cross-appointed to both a pediatric and an adult hospital through a formally linked model of care.

Caregivers

Parents of participating youths

LIFEspan

Intervention Type OTHER

Rehabilitation services provided by an inter-disciplinary team of health professionals addressing the transfer of care to adult services and emerging needs related to transition to adulthood. LIFEspan staff are cross-appointed to both a pediatric and an adult hospital through a formally linked model of care.

Interventions

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LIFEspan

Rehabilitation services provided by an inter-disciplinary team of health professionals addressing the transfer of care to adult services and emerging needs related to transition to adulthood. LIFEspan staff are cross-appointed to both a pediatric and an adult hospital through a formally linked model of care.

Intervention Type OTHER

Non-LIFEspan

Standard of care in the absence of a formal partnership between a pediatric and an adult hospital.

Intervention Type OTHER

Other Intervention Names

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LIFEspan model of linked transition care

Eligibility Criteria

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Inclusion Criteria

* Prospective groups: 16th Birthday between September 2008 - August 2009, diagnosis of cerebral palsy or acquired brain injury, spina bifida
* Retrospective group: 16th Birthday between September 2002 - August 2003, diagnosis of cerebral palsy or acquired brain injury

Exclusion Criteria

* N/A
Minimum Eligible Age

16 Years

Maximum Eligible Age

23 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ontario Neurotrauma Foundation

OTHER

Sponsor Role collaborator

Holland Bloorview Kids Rehabilitation Hospital

OTHER

Sponsor Role lead

Responsible Party

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Shauna Kingsnorth

Clinical Study Investigator, Bloorview Research Institute

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Colin Macarthur, PhD

Role: PRINCIPAL_INVESTIGATOR

The Hospital for Sick Children

Mark Bayley, MD

Role: PRINCIPAL_INVESTIGATOR

Toronto Rehab Institute

Locations

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Holland Bloorview Kids Rehabilitation Hospital

Toronto, Ontario, Canada

Site Status

Toronto Rehabilitation Institute

Toronto, Ontario, Canada

Site Status

Countries

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Canada

References

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Tsybina I, Kingsnorth S, Maxwell J, Bayley M, Lindsay S, McKeever P, Colantonio A, Hamdani Y, Healy H, Macarthur C. Longitudinal Evaluation of Transition Services ("LETS Study"): protocol for outcome evaluation. BMC Pediatr. 2012 May 15;12:51. doi: 10.1186/1471-2431-12-51.

Reference Type BACKGROUND
PMID: 22587415 (View on PubMed)

Kingsnorth, S., Lindsay, S., Maxwell, J., Tsybina, I., Seo, H., Macarthur, C., & Bayley, C. (2011). Implementing the LIFEspan model of transition care for youth with childhood onset disabilities. International Journal of Adolescent & Child Health, 3(4), 547-560.https://www.novapublishers.com/catalog/product _info.php?products_id=23001

Reference Type RESULT

Hamdani Y, Proulx M, Kingsnorth S, Lindsay S, Maxwell J, Colantonio A, Macarthur C, Bayley M. The LIFEspan model of transitional rehabilitative care for youth with disabilities: healthcare professionals' perspectives on service delivery. J Pediatr Rehabil Med. 2014;7(1):79-91. doi: 10.3233/PRM-140271.

Reference Type RESULT
PMID: 24919941 (View on PubMed)

Lindsay S, Proulx M, Maxwell J, Hamdani Y, Bayley M, Macarthur C, Colantonio A. Gender and Transition From Pediatric to Adult Health Care Among Youth With Acquired Brain Injury: Experiences in a Transition Model. Arch Phys Med Rehabil. 2016 Feb;97(2 Suppl):S33-9. doi: 10.1016/j.apmr.2014.04.032. Epub 2015 Feb 4.

Reference Type RESULT
PMID: 25660004 (View on PubMed)

Kingsnorth S, Lindsay S, Maxwell J, Hamdani Y, Colantonio A, Zhu J, Bayley MT, Macarthur C. Bridging Pediatric and Adult Rehabilitation Services for Young Adults With Childhood-Onset Disabilities: Evaluation of the LIFEspan Model of Transitional Care. Front Pediatr. 2021 Sep 17;9:728640. doi: 10.3389/fped.2021.728640. eCollection 2021.

Reference Type RESULT
PMID: 34631624 (View on PubMed)

Kingsnorth S, Hamdani Y, Cheng C, Lindsay S, Maxwell J, Colantonio A, Bayley M, Macarthur C. Health status and health care utilization profiles of adolescents with disabilities. Health Care Transit. 2023 Jun 21;1:100004. doi: 10.1016/j.hctj.2023.100004. eCollection 2023.

Reference Type RESULT
PMID: 39713020 (View on PubMed)

Other Identifiers

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2008-ABI-LSMODEL-706

Identifier Type: -

Identifier Source: org_study_id

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