The impact of a patient navigator on readiness assessment scores in youth transitioning to adult health care in Alberta

Background: At ages 16-21, youth with chronic medical conditions transition from pediatric to adult specialty care and often feel unprepared. Transition readiness assessments, including the validated Transition Readiness Assessment Questionnaire (TRAQ), may guide preparation; however, longitudinal evaluation is needed to determine their utility in supporting successful transitions. Objective: (1) To compare changes in TRAQ scores between baseline, 12, and 24 months among individuals enrolled in a randomized controlled trial (RCT); and (2) to highlight insights from youth with lived expertise transitioning to adult healthcare. Methods: This sub-study of the Transition Navigator Trial, a pragmatic RCT evaluating a patient navigator intervention, examined overall TRAQ scores among 129 participants. Group comparisons used the Mann-Whitney U test, and mixed models with random intercepts assessed associations between navigator access, time, and TRAQ scores. Fifteen youth partners with lived experience contributed perspectives through ongoing meetings and structured reflection on study findings; this involvement constitutes patient-oriented research and should not be interpreted as formal qualitative methodology. Results: At baseline, mean TRAQ scores did not differ significantly between intervention and control groups (β=0.05, p = 0.58, 95% CI -0.12, 0.22). Regardless of treatment allocation, mean TRAQ scores increased from baseline to 12 months (β=0.54, p < 0.001, 95% CI 0.44, 0.63) and from baseline to 24 months (β=0.68, p < 0.001, 95% CI 0.59, 0.78). Conclusions: Access to a patient navigator did not significantly influence TRAQ score trajectories; however, TRAQ scores increased significantly over time in both groups. These findings suggest that transition readiness, as measured by the TRAQ, may improve through lived experience during the transition period regardless of navigator access. Both groups received shared transition-related resources throughout the study, which may have contributed to the observed increases. Notably, the TRAQ was implemented as an indirect parallel measure in this study rather than a primary intervention target, and this should be considered when interpreting the null between-group finding. Partnering with youth enhanced interpretation of findings and underscored the importance of centering lived expertise when evaluating transition readiness outcomes.