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Adaptation of the Transition Readiness Assessment Questionnaire for Pediatric-Onset Multiple Sclerosis: Protocol for
Claudia Gambrah-Lyles1, Aaron W Abrams2, Sara Loud3
1Department of Neurology, School of Medicine, Washington University in St. Louis, 1 Children's Place, St. Louis, MO, 63110, United States, 1 314 471 2986.
Insights
This study adapts a transition readiness tool for youth with pediatric-onset multiple sclerosis (POMS), addressing unique challenges for better lifelong care. The adapted measure will improve transition planning for POMS patients.
Area of Science:
- Neurology
- Implementation Science
- Patient Transition Care
Background:
- Pediatric-onset multiple sclerosis (POMS) requires lifelong management and a coordinated transition from pediatric to adult care.
- Current transition readiness assessments lack POMS-specific considerations like fluctuating disability and cognitive issues.
- A tailored transition readiness measure is needed for POMS patients.
Purpose of the Study:
- To describe a protocol for adapting the Transition Readiness Assessment Questionnaire (TRAQ) version 6.0 for youth with POMS.
- To incorporate stakeholder input and implementation science principles.
- To address the unique developmental and clinical needs of POMS patients.
Main Methods:
- Utilizing adaptation and participatory research strategies.
- Administering surveys to patients, caregivers, and clinicians to identify transition barriers and self-management competencies.
- Refining competencies via Delphi consensus and assessing the adapted measure through cognitive interviewing and focus groups.
Main Results:
- A consensus-driven set of POMS-specific transition competencies will be generated.
- The TRAQ 6.0 will be systematically adapted for the POMS population.
- Data collection is ongoing, with results anticipated in 2027.
Conclusions:
- This protocol offers a rigorous approach to adapting a transition readiness measure for POMS.
- The adapted TRAQ 6.0 will enhance evidence-based transition planning for POMS patients.
- This work will inform future research to improve care for aging POMS patients.
Background:
Pediatric-onset multiple sclerosis (POMS) is a chronic, progressive neurologic condition requiring lifelong management and coordinated transition from pediatric to adult care. Evidence-based guidelines identify transition readiness assessment as a core component of successful transition; however, most POMS clinics do not formally assess readiness, and existing tools do not address POMS-specific challenges, such as fluctuating disability, complex treatment regimens, and cognitive impairment. This gap underscores the need for a transition readiness measure tailored to POMS.
Objective:
This paper aims to describe a stakeholder-engaged, implementation science-guided protocol for adapting the Transition Readiness Assessment Questionnaire (TRAQ) version 6.0 to reflect the unique developmental and clinical needs of youth with POMS.
Methods:
Using adaptation and participatory research as our guiding implementation strategies, surveys will be administered to patients, caregivers, and clinicians to identify barriers to and facilitators of transition to adult care and define essential self-management competencies in POMS. Survey content will be informed by constructs from the dynamic adaptation process framework and existing TRAQ 6.0 domains. Identified competencies will be refined using a Delphi consensus process. Through cognitive interviewing and a multidisciplinary focus group of collaborators, the adapted measure will be reviewed to assess clarity, relevance, and perceived clinical utility.
Results:
This project will generate a consensus-driven set of POMS-specific transition competencies and systematically adapt the TRAQ 6.0 to the POMS population. This study was funded in July 2025. The health care provider survey was disseminated in November 2025 across the 27 sites in the US Network of Pediatric Multiple Sclerosis Centers. The patient and caregiver surveys have been finalized, and distribution is projected to begin in June 2026, with a target of 15 patients and 15 caregivers. As of manuscript submission, no patients or caregivers have been recruited, and data analysis has not yet started. Data collection is expected to conclude by the end of 2026, and results are anticipated for publication in 2027.
Conclusions:
This protocol outlines a rigorous, replicable approach to adapting a validated transition readiness measure to POMS. The adapted TRAQ 6.0 will support evidence-based transition planning and inform future psychometric testing and implementation research to improve the care of patients with POMS as they age.
