Elsevier

Academic Pediatrics

Volume 14, Issue 4, July–August 2014, Pages 415-422
Academic Pediatrics

Research Methods: Transition Readiness Assessment Questionnaire
The Transition Readiness Assessment Questionnaire (TRAQ): Its Factor Structure, Reliability, and Validity

https://doi.org/10.1016/j.acap.2014.03.008Get rights and content

Abstract

Objective

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.

Methods

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.

Results

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.

Conclusions

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.

Section snippets

Survey Administration

We collected TRAQ responses from 526 adolescent respondents ranging in age from 14 to 26 years; 305 adolescents comprised the first sample, collected in 2011, and 221 adolescents comprised the second sample, collected in 2012 (Figure). The surveys were collected during clinical care from a convenience sample of adolescents attending the University of Florida, JaxHATS in Jacksonville, FL; the Cystic Fibrosis (CF) Center at Boston Children's Hospital and the University of North Carolina (UNC)

Results

The demographic characteristics of the samples for stage 1 (item reduction and EFA sample) and stage 2 (CFA sample) are summarized in Table 1. A total sample of 305 AYA were available for step 1 of the item reduction analysis; of these, 269 had no missing data and were available for EFA. Overall, 16.9% were under 18 years of age. Of those with race data reported, 49.0% were white, 39.6% were African American, and 11.4% were other. Sex was missing in one-quarter of the surveys; however, of those

Discussion

This study builds on our initial development of the TRAQ, when we identified candidate items and conducted initial item reduction and validation. In the current analyses, we analyze TRAQ data on over 500 additional respondents from 3 academic clinical centers to further explore and refine the factor structure of the instrument. We eliminated items that either did not apply to all respondents or had high rates of missing values. We used EFA to identify a 20-item scale with 5 subscales. We

Acknowledgments

Partial support for this work was provided for Dr Sawicki, NHLBI, K23 HL105541-01A1, and for Dr Wood, Florida Department of Health, Children's Medical Services, contract 6119-1307-00-B.

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    The authors declare that they have no conflict of interest.

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