Transition needs of adolescent asthma patients in China: a mixed-methods study based on the SMART model

Abstract Background Globally, asthma affects millions of adolescents, yet the transition from paediatric to adult healthcare remains a critical challenge. In China, inadequate transition preparation contributes to poor disease control and disrupted care continuity among adolescent asthma patients. Objective This study aimed to assess transition readiness among adolescents with asthma, explore their transitional needs and transition-related experiences, and integrate the quantitative and qualitative findings using the Social-Ecological Model of Adolescent and Young Adult Readiness for Transition (SMART) Methods A mixed-methods design was used at two Grade A tertiary hospitals in Guangzhou, China. Adolescents aged 14–18 years were recruited by convenience sampling between November 2024 and October 2025. The quantitative component included 100 complete questionnaire sets and used the Self-Management and Transition to Adulthood with Rx (STARx) Questionnaire and the Bronchial Asthma Patient Needs Questionnaire. Eighteen survey participants were purposively selected for one-to-one semi-structured interviews. Data collection and preliminary qualitative analysis proceeded concurrently until the research team judged that the data were sufficiently rich and relevant to address the research question. Results The mean total STARx score was 59.10 (SD 11.81; 95% CI 56.79–61.41; possible range 18–90). Medication management had the highest mean domain score (M = 3.63, SD = 0.54), whereas provider communication had the lowest (M = 2.78, SD = 0.87). The overall mean item score on the needs questionnaire was 2.47 (SD 0.57; 95% CI 2.36–2.58). Mean domain scores were 3.03 for environmental needs (SD 0.71; 95% CI 2.89–3.17), 2.43 for health behaviour-related needs (SD 0.70; 95% CI 2.29–2.57), 2.36 for psychosocial needs (SD 0.71; 95% CI 2.22–2.50), and 2.12 for physiological needs (SD 0.79; 95% CI 1.97–2.27). Qualitative analysis identified five themes concerning autonomy, future planning, social relationships, psychological adaptation, and relationships with family members and healthcare professionals. Conclusions Participants reported comparatively lower readiness in provider communication and independent healthcare-management tasks. Qualitative accounts highlighted concerns relating to autonomy, future planning, social relationships, self-identity, and changing relationships with family members and healthcare professionals. These descriptive findings may inform the future development and evaluation of transition support for adolescents with asthma.