Abstract
Background: Primary care providers (PCPs) can coordinate care, reduce medical exacerbations, and lower healthcare spending during the transition from pediatric to adult healthcare.1 However, a 2022 U.S. national survey estimated 1.9 million adolescents with special healthcare needs did not have a preventative PCP visit, and 9.2 million did not have a medical home.2 These gaps suggest a limited understanding of young adult-perceived connectedness to primary care services that promote positive patient-provider relationships.3,5
Purpose: To examine primary care connectedness among transition-age young adults 18-26 years old with one of nine chronic conditions (e.g., cancer, diabetes), after participation in a randomized control trial (PiCASO) designed to enhance their self-care management.
Methods: A REDCap survey with closed- and open-ended items was developed using a mixed methods design. Data were collected from N=68 participants (n=45 intervention group, n=23 control) via text or email between May-June 2024 after they completed the 12-month PiCASO trial. The Person-Centered Primary Care Measure (PCPCM) was used to assess perceived primary care connectedness, with overall scores ranging from 1 (less) to 4 (greater) connectedness.4 A theoretical framework was employed for the directed content analysis of open-ended responses about relationships and experiences with PCPs.3
Results: Among the 68 participants (mean age=20.8 years, SD=2.1), 66% lived with parents/family, and 40% were unemployed. The mean PCPCM overall score was 3.3 (SD=0.7), with 91% agreeing that their PCP helps them stay healthy over time. Additionally, three qualitative themes emerged: (1) young adult-perceived primary care connection involves characteristics at the individual, family, and healthcare-system levels; (2) interpersonal and social drivers influence the establishment of perceived connectedness; and (3) concurrent health and life transitions influenced perceived well-being.
Conclusion: Our quantitative findings suggest our participants felt connected to their PCP. Most participants lived with their parents/family and almost half were unemployed, suggesting a need for young adult-focused resources (e.g., equitable housing and job opportunities) to target these social drivers of health. Our qualitative findings further suggest the need for PCPs to assess multi-level characteristics and their impact on perceived PCP connection and well-being among young adults with chronic conditions
Notes
References:
1. Punjwani, Z., Patton, M., Alladin-Karan, A., Samborn, S., & Samuel, S. (2024). Role of primary care in enhancing continuity of care for adolescents and young adults with chronic kidney disease undergoing transition to adult health services. Pediatric Nephrology, 39(4), 1077–1084. https://doi.org/10.1007/s00467-023-06140-4
2. Child and Adolescent Health Measurement Initiative. National Survey of Children’s Health Interactive Data Query [2022]. Data Resource Center for Child and Adolescent Health supported by the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB). Retrieved 10/23/2024 from www.childhealthdata.org
3. Phillips-Salimi, C. R., Haase, J. E., & Kooken, W. C. (2012). Connectedness in the context of patient-provider relationships: A concept analysis. Journal of Advanced Nursing, 68(1), 230–245. https://doi.org/10.1111/j.1365-2648.2011.05763.x
4. Etz, R. S., Zyzanski, S. J., Gonzalez, M. M., Reves, S. R., O'Neal, J. P., & Stange, K. C. (2019). A new comprehensive measure of high-value aspects of primary care. Annals of Family Medicine, 17(3), 221–230. https://doi.org/10.1370/afm.2393
5. Cassidy, M., Doucet, S., Luke, A., Goudreau, A., & MacNeill, L. (2022). Improving the transition from paediatric to adult healthcare: A scoping review on the recommendations of young adults with lived experience. BMJ Open, 12(12), e051314. https://doi.org/10.1136/bmjopen-2021-051314
Sigma Membership
Beta Theta at-Large
Type
Poster
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Mixed/Multi Method Research
Keywords:
Primary Care, Public and Community Health, Health Equity or Social Determinants of Health, Adolescents, Young Adults, Patient-Provider Relationships
Recommended Citation
Girdwood, Tyra; Silva, Susan; Misiewicz, Remi; Baba, Madison; Khan, Madiha; Reddy, Manasvi; Zhang, Angelina; Hart, Stephanie; Kayle, Mariam; Maslow, Gary; and Docherty, Sharron, "Primary Care Connectedness Among Young Adults With Chronic Conditions: A Mixed Methods Design" (2025). International Nursing Research Congress (INRC). 164.
https://www.sigmarepository.org/inrc/2025/posters_2025/164
Conference Name
36th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Seattle, Washington, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Primary Care Connectedness Among Young Adults With Chronic Conditions: A Mixed Methods Design
Seattle, Washington, USA
Background: Primary care providers (PCPs) can coordinate care, reduce medical exacerbations, and lower healthcare spending during the transition from pediatric to adult healthcare.1 However, a 2022 U.S. national survey estimated 1.9 million adolescents with special healthcare needs did not have a preventative PCP visit, and 9.2 million did not have a medical home.2 These gaps suggest a limited understanding of young adult-perceived connectedness to primary care services that promote positive patient-provider relationships.3,5
Purpose: To examine primary care connectedness among transition-age young adults 18-26 years old with one of nine chronic conditions (e.g., cancer, diabetes), after participation in a randomized control trial (PiCASO) designed to enhance their self-care management.
Methods: A REDCap survey with closed- and open-ended items was developed using a mixed methods design. Data were collected from N=68 participants (n=45 intervention group, n=23 control) via text or email between May-June 2024 after they completed the 12-month PiCASO trial. The Person-Centered Primary Care Measure (PCPCM) was used to assess perceived primary care connectedness, with overall scores ranging from 1 (less) to 4 (greater) connectedness.4 A theoretical framework was employed for the directed content analysis of open-ended responses about relationships and experiences with PCPs.3
Results: Among the 68 participants (mean age=20.8 years, SD=2.1), 66% lived with parents/family, and 40% were unemployed. The mean PCPCM overall score was 3.3 (SD=0.7), with 91% agreeing that their PCP helps them stay healthy over time. Additionally, three qualitative themes emerged: (1) young adult-perceived primary care connection involves characteristics at the individual, family, and healthcare-system levels; (2) interpersonal and social drivers influence the establishment of perceived connectedness; and (3) concurrent health and life transitions influenced perceived well-being.
Conclusion: Our quantitative findings suggest our participants felt connected to their PCP. Most participants lived with their parents/family and almost half were unemployed, suggesting a need for young adult-focused resources (e.g., equitable housing and job opportunities) to target these social drivers of health. Our qualitative findings further suggest the need for PCPs to assess multi-level characteristics and their impact on perceived PCP connection and well-being among young adults with chronic conditions
Description
Adolescents with chronic conditions are not engaging with primary care providers (PCPs), and limited knowledge exists from the young adult’s perspective on their connections with PCPs. We used mixed methods to assess primary care connectedness among 68 young adults with chronic conditions using a validated measure and open-ended items. Our findings suggest PCP connectedness is characterized across socioecological levels, by key drivers of health, and by co-occurring life and health transitions.