Factors Associated with Adolescents' Self-Efficacy to Meet with their Health Care Provider Alone

Adolescents with special health care needs (ASHCNs) must develop self-management skills to effectively transition into adult-based care. This requires having the self-efficacy to meet with their health care provider independent of caregivers. This study aims to identify the factors associated with self-efficacy in meeting with a provider alone among ASHCN preparing for this transition.Eighty-three English-speaking 18-year olds with renal, gastrointestinal, neurologic, or rheumatologic diseases, and their English- or Spanish-speaking caregivers were recruited at a large children's hospital, and completed a one-time assessment as the historical control group for a larger intervention study. The main outcome measure was self-efficacy to meet with their health care provider alone. Factors evaluated for their independent association with self-efficacy using linear regression included Self-Determination Theory constructs (autonomy, competence, and relatedness); importance of meeting with their provider alone; and whether they had met with their provider alone in the past 12 months.Seventy-percent of ASHCN had met alone with their provider in the last 12 months. Female gender, perceived competence, perceived provider support for autonomy, and having met with their provider alone in the last 12 months were associated with self-efficacy in meeting with their provider alone.ASHCNs who feel competent in managing their health and who perceive their providers as supporting their self-management autonomy also feel the most efficacious in meeting with their provider alone. Pediatric providers can help prepare ASHCN for transition by meeting with them alone.