Wood David L, Sawicki Gregory S, Miller M David, Smotherman Carmen, Lukens-Bull Katryne, Livingood William C, Ferris Maria, Kraemer Dale F
Department of Pediatrics, College of Medicine-Jacksonville, University of Florida, Jacksonville, Fla; Center for Health Equity and Quality Research, University of Florida, Jacksonville, Fla.
Boston Children's Hospital, Harvard Medical School, Boston, Mass.
Acad Pediatr. 2014 Jul-Aug;14(4):415-22. doi: 10.1016/j.acap.2014.03.008.
National consensus statements recommend that providers regularly assess the transition readiness skills of adolescent and young adults (AYA). In 2010 we developed a 29-item version of Transition Readiness Assessment Questionnaire (TRAQ). We reevaluated item performance and factor structure, and reassessed the TRAQ's reliability and validity.
We surveyed youth from 3 academic clinics in Jacksonville, Florida; Chapel Hill, North Carolina; and Boston, Massachusetts. Participants were AYA with special health care needs aged 14 to 21 years. From a convenience sample of 306 patients, we conducted item reduction strategies and exploratory factor analysis (EFA). On a second convenience sample of 221 patients, we conducted confirmatory factor analysis (CFA). Internal reliability was assessed by Cronbach's alpha and criterion validity. Analyses were conducted by the Wilcoxon rank sum test and mixed linear models.
The item reduction and EFA resulted in a 20-item scale with 5 identified subscales. The CFA conducted on a second sample provided a good fit to the data. The overall scale has high reliability overall (Cronbach's alpha = .94) and good reliability for 4 of the 5 subscales (Cronbach's alpha ranging from .90 to .77 in the pooled sample). Each of the 5 subscale scores were significantly higher for adolescents aged 18 years and older versus those younger than 18 (P < .0001) in both univariate and multivariate analyses.
The 20-item, 5-factor structure for the TRAQ is supported by EFA and CFA on independent samples and has good internal reliability and criterion validity. Additional work is needed to expand or revise the TRAQ subscales and test their predictive validity.
全国共识声明建议医疗服务提供者定期评估青少年及青年（AYA）的过渡准备技能。2010年，我们开发了一个包含29个条目的过渡准备评估问卷（TRAQ）版本。我们重新评估了条目性能和因子结构，并重新评估了TRAQ的信度和效度。
我们对来自佛罗里达州杰克逊维尔、北卡罗来纳州教堂山和马萨诸塞州波士顿的3家学术诊所的青少年进行了调查。参与者为年龄在14至21岁之间、有特殊医疗需求的AYA。从306名患者的便利样本中，我们进行了条目缩减策略和探索性因子分析（EFA）。在第二个包含221名患者的便利样本上，我们进行了验证性因子分析（CFA）。通过Cronbach's α评估内部信度，并评估效标效度。分析采用Wilcoxon秩和检验和混合线性模型进行。
条目缩减和EFA产生了一个包含20个条目的量表，确定了5个分量表。在第二个样本上进行的CFA对数据拟合良好。总体量表总体具有较高的信度（Cronbach's α = 0.94），5个分量表中有4个具有良好的信度（合并样本中Cronbach's α范围为0.90至0.77）。在单变量和多变量分析中，18岁及以上青少年的5个分量表得分均显著高于18岁以下青少年（P < 0.0001）。
TRAQ的20个条目、5因子结构在独立样本上得到了EFA和CFA的支持，具有良好的内部信度和效标效度。需要开展更多工作来扩展或修订TRAQ分量表并测试其预测效度。
