CF RISE: Implementing a Clinic-Based Transition Program

Pediatr Allergy Immunol Pulmonol. 2015 Dec;28(4):250-254. doi: 10.1089/ped.2015.0594.

Abstract

During the period of healthcare transition, adolescents should increase responsibility for managing their health. Transition services are associated with improved outcomes; however, many youth with chronic conditions such as cystic fibrosis (CF) are not receiving guideline-based transition services. Individual CF centers have transition programs, yet no specific program is widely disseminated. A transition program CF: Responsibility, Independence, Self-care, Education CF RISE was recently developed and implemented at 10 CF centers. We conducted a process evaluation of CF RISE implementation based on the Consolidated Framework of Implementation Research (CFIR). CF healthcare providers (23/25 [95%]) from the 10 sites completed an online survey about their experiences 6 months after initiating the program. Open-ended survey questions were coded into central themes addressing domains of implementation. Providers reported that CF RISE facilitated communication with the family, particularly the knowledge and skills assessments. All providers rated the program as valuable with 60% finding the program very or extremely valuable. Time was the biggest implementation barrier (96%) followed by planning for the visit (61%). Ninety-five percent felt the program could become a sustainable part of the clinic, and 91% felt that it was somewhat or completely likely that they would be using the program 1 year from now. Providers also appreciated the flexibility of the program. CF healthcare providers positively evaluated CF RISE during its initial implementation period. The feedback provides insight into the sustainability and challenges that must be considered as wider implementation plans are developed. It is critical to evaluate the effectiveness of programs such as CF RISE on the outcomes during the transition period.