52 Assessing the social determinants of health and positive childhood experiences in youth patients transitioning to adult care: A cross-sectional survey

Abstract Background Children and youth with complex healthcare needs often receive specialized care in tertiary care hospitals or multidisciplinary paediatric clinics. In Canada, the mandate transfer of paediatric care to adult services varies by province/territory and type of care, often between 16 to 19 years of age (Toulany et al., 2022). While many resources exist to support youth in this transition, few integrate social determinants of health (SDoH) in this process. Recent literature has shown that positive childhood experiences (PCEs) have an inverse, dose-response relationship with adult mental health and mitigate against adverse childhood experiences (ACEs) (Bethel et al., 2019). By promoting these PCEs and enhancing resilience, we may be able to support youth better in this transition process. Objectives 1) To assess SDoH and PCEs of youth transitioning into adult care; 2) To assess transition readiness. Design/Methods We adapted our previously existing, institutionally approved cross-sectional QI survey exploring prevalence of SDoH and PCEs to include additional questions regarding transition. Youth patients (≧13 years of age) in the Cleft Palate Craniofacial Program at a paediatric tertiary care hospital were invited to complete the paper survey during their clinic appointments. Responses were tabulated using Microsoft Excel. Results From June 4th to October 29th, 2024, a total of 37 out of 41 eligible youth completed the survey, for a response rate of 90%. 33 out of 36 participants (92%) responded that they “always” identify with ≧3 of the 7 PCEs. Of these, 18 participants (55%) felt supported in their transition to adult care and 15 participants (45%) did not respond. For the 4 participants that did not “always” identify with ≧3 out of 7 PCEs, 2 felt supported with transition, 1 did not feel supported, and 1 did not know. Overall, most youth (70%) provided feedback that the survey was important in having their voice heard and for their health provider to know. Conclusion Recognizing and promoting PCEs can be a powerful, strengths-based tool that enhances resilience in youth, especially during times of transition to adult care. Next steps could include secondary analysis of data, which may allow us to identify independent SDoH and PCE factors to assess transition readiness. Our findings will inform the further improvement of our clinic and other hospital programs for transition resources and future planning.