Cross-Cultural Validation of the HIV Adolescent Readiness for Transition Scale (HARTS) in China

For adolescents infected with the Human Immunodeficiency Virus (HIV), transitioning from pediatric to adult healthcare requires thorough preparation to maintain care continuity and optimal health outcomes. In China, a dedicated scale for assessing their transition readiness is lacking. The HIV Adolescent Readiness for Transition Scale (HARTS) addresses this by evaluating transition readiness across vital domains, with its 15-item design predicting post-transition viral suppression-a key indicator of a successful transition. With no equivalent tool in China, the HARTS's cross-cultural adaptation holds significant potential for enhancing personalized transition strategies and health management. To validate the HIV Adolescent Readiness for Transition Scale (HARTS) among adolescents with HIV in China, the validation was conducted from October 2023 to February 2024, following a five-step process: translation and back-translation; content validity examination by 13 experts; pre-survey with 30 adolescents with HIV; test-retest reliability assessment with 40 adolescents with HIV over a 10-day interval; and structural validation using exploratory factor analysis, including principal component analysis and varimax orthogonal rotation, among 170 adolescents with HIV. The average content validity index of the scale was 0.99. The Cronbach's alpha value for the pre-survey was 0.767, and for test-retest reliability, the intra-class correlation coefficient (ICC) was 0.901. With a total of 15 items, the four factors that made up the scale-"Disclosure," "Health Navigation," "Self-Advocacy," and "Health Literacy"-explained 81.73% of the variation. With alpha values of 0.940, 0.917, 0.929, and 0.888 for each of the four domains, the scale's overall Cronbach's alpha value was 0.943. The Chinese version of HARTS demonstrates good reliability and validity, serving as a tool for assessing the medical transition readiness level of adolescents with HIV in China.