TRAQ in clinical practice: A narrative review for health care transition readiness

Advances in medical care have dramatically improved survival rates for children and youth with special health care needs (SHCN), with more than 90% now reaching adulthood. As a result, pediatric-to-adult health care transition has become a critical component of lifespan care. Despite national consensus recommendations, fewer than one in four adolescents receive the transition services needed to prepare them for adult-oriented care. Standardized, validated instruments to assess and promote transition readiness are essential to close this gap.

This review describes the practical application of the Transition Readiness Assessment Questionnaire (TRAQ) in ambulatory care settings, to guide clinicians in its administration, interpretation, and integration with evidence-based counseling strategies.

This narrative review synthesizes published literature and the authors' collective clinical experience implementing the TRAQ across ambulatory transition programs. Sources include the three successive TRAQ validation studies, national consensus guidelines, and behavior change literature underpinning the instrument's theoretical framework. The Transtheoretical Model of Behavior Change and Motivational Interviewing are presented alongside a structured clinical framework for iterative assessment, goal-setting, and follow-up.

The TRAQ is a validated, theory-driven instrument spanning four behavioral domains of health and health care self-management. It supports providers in systematically evaluating readiness, identifying skill gaps, and facilitating self-management development across adolescence. Practical guidance is provided for score interpretation, stage-matched counseling approaches, and a TRAQ Companion Individualized Transition Plan (ITP) for structured goal documentation and follow-up.

Systematic use of the TRAQ within a structured transition counseling framework enables clinicians to evaluate readiness and tailor interventions to each youth's stage of change. Integration of the TRAQ and its companion ITP into routine ambulatory practice represents an evidence-informed approach to improving health care transition outcomes for adolescents and young adults (AYAs) with SHCN.