Supplemental Evidence and Data Request on Transitions of Care From Pediatric to Adult Services for Children With Special Healthcare Needs, 77463-77465 [2020-26569]
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Federal Register / Vol. 85, No. 232 / Wednesday, December 2, 2020 / Notices
Interested parties are
invited to submit written comments to
the FDIC by any of the following
methods:
• Agency website: https://
www.FDIC.gov/regulations/laws/
federal/notices.html.
• Email: comments@fdic.gov. Include
the name and number of the collection
in the subject line of the message.
• Mail: Manny Cabeza, Regulatory
Counsel, MB–3128, Federal Deposit
Insurance Corporation, 550 17th Street
NW, Washington, DC 20429.
• Hand Delivery: Comments may be
hand-delivered to the guard station at
the rear of the 17th Street building
(located on F Street), on business days
between 7:00 a.m. and 5:00 p.m.
All comments should refer to
‘‘Household Survey’’. A copy of the
comments may also be submitted to the
OMB desk officer for the FDIC: Office of
Information and Regulatory Affairs,
Office of Management and Budget, New
Executive Office Building, Washington,
DC 20503.
FOR FURTHER INFORMATION CONTACT:
Manny Cabeza, Regulatory Counsel,
202–898–3767, mcabeza@fdic.gov, MB–
3128, Federal Deposit Insurance
Corporation, 550 17th Street NW,
Washington, DC 20429.
SUPPLEMENTARY INFORMATION: The FDIC
is requesting OMB approval for the
following collection of information:
Title: Survey of Household Use of
Banking and Financial Services.
OMB Number: 3064–NEW.
Frequency of Response: Once.
Affected Public: Individuals residing
in U.S. Households.
Estimated Number of Respondents:
40,000.
Average time per response: 9 minutes
(0.15 hours) per respondent.
Estimated Total Annual Burden:
6,000 hours.
General Description of Collection: The
Survey of Household Use of Banking
and Financial Services (Household
Survey) supports the FDIC’s mission of
maintaining public confidence in the
U.S. financial system. The Household
Survey is also a key component of the
FDIC’s compliance with a Congressional
mandate contained in section 7 of the
Federal Deposit Insurance Reform
Conforming Amendments Act of 2005
(Reform Act) (Pub. L. 109–173), which
calls for the FDIC to conduct ongoing
surveys ‘‘on efforts by insured
depository institutions to bring those
individuals and families who have
rarely, if ever, held a checking account,
a savings account or other type of
transaction or check cashing account at
an insured depository institution
ADDRESSES:
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Jkt 253001
(hereafter in this section referred to as
the ‘unbanked’) into the conventional
finance system.’’ Section 7 further
instructs the FDIC to consider several
factors in its conduct of the surveys,
including: (1) ‘‘what cultural, language
and identification issues as well as
transaction costs appear to most prevent
‘unbanked’ individuals from
establishing conventional accounts’’;
and (2) ‘‘what is a fair estimate of the
size and worth of the ‘‘unbanked’’
market in the United States.’’
The Household Survey collects
information on bank account ownership
which provides a factual basis for
measuring the number and percentage
of households that are unbanked. The
Household Survey is the only
population-representative survey
conducted at the national level that
provides state-level estimates of the size
and characteristics of unbanked
households for all 50 states and the
District of Columbia. The Household
Survey also collects information from
unbanked households about the reasons
that they do not have a bank account
and their interest in having a bank
account. Increasingly, financial
products and services are provided by
nonbanks, many through the use of a
mobile phone app. Households are
selecting different combinations of bank
and nonbank financial products and
services to meet their core banking
needs. Consequently, the Household
Survey has broadened its focus to
include a wide range of bank and
nonbank financial products and services
and to collect information on whether
and how households are using these in
combination.
To obtain this information, the FDIC
partners with the U.S. Census Bureau,
which administers the Household
Survey supplement (FDIC Supplement)
to households that participate in the
CPS. The supplement has been
administered every other year since
January 2009. The previous survey
questionnaires and survey results can be
accessed through the following link:
https://www.economicinclusion.gov/
surveys/.
Consistent with the statutory mandate
to conduct the surveys on an ongoing
basis, the FDIC already has in place
arrangements for conducting the
seventh Household Survey as a
supplement to the June 2021 CPS.
Prior to finalizing the 2021 survey
questionnaire, the FDIC seeks to solicit
public comment on whether changes to
the existing instrument are desirable
and, if so, to what extent. It should be
noted that, as a supplement of the CPS
survey, the Household Survey needs to
adhere to specific parameters that
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77463
include limits in the length and
sensitivity of the questions that can be
asked of CPS respondents. Interested
members of the public may obtain a
copy of the proposed survey
questionnaire on the following web
page: https://www.fdic.gov/regulations/
laws/federal/2020/2021-survey-ofhousehold-use-of-banking-andfinancial-services.pdf.
Request for Comment
Comments are invited on: (a) Whether
the collection of information is
necessary for the proper performance of
the FDIC’s functions, including whether
the information has practical utility; (b)
the accuracy of the estimates of the
burden of the information collections,
including the validity of the
methodology and assumptions used; (c)
ways to enhance the quality, utility, and
clarity of the information to be
collected; and (d) ways to minimize the
burden of the collection of information
on respondents, including through the
use of automated collection techniques
or other forms of information
technology. All comments will become
a matter of public record.
Federal Deposit Insurance Corporation.
Dated at Washington, DC, on November 27,
2020.
James P. Sheesley,
Assistant Executive Secretary.
[FR Doc. 2020–26572 Filed 12–1–20; 8:45 am]
BILLING CODE 6714–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Agency for Healthcare Research and
Quality
Supplemental Evidence and Data
Request on Transitions of Care From
Pediatric to Adult Services for Children
With Special Healthcare Needs
Agency for Healthcare Research
and Quality (AHRQ), HHS.
ACTION: Request for Supplemental
Evidence and Data Submissions.
AGENCY:
The Agency for Healthcare
Research and Quality (AHRQ) is seeking
scientific information submissions from
the public. Scientific information is
being solicited to inform our review on
Transitions of Care from Pediatric to
Adult Services for Children with Special
Healthcare Needs, which is currently
being conducted by the AHRQ’s
Evidence-based Practice Centers (EPC)
Program. Access to published and
unpublished pertinent scientific
information will improve the quality of
this review.
SUMMARY:
E:\FR\FM\02DEN1.SGM
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77464
Federal Register / Vol. 85, No. 232 / Wednesday, December 2, 2020 / Notices
Submission Deadline on or
before January 4, 2021.
ADDRESSES:
Email submissions: epc@
ahrq.hhs.gov.
Print submissions:
Mailing Address: Center for Evidence
and Practice Improvement, Agency for
Healthcare Research and Quality,
ATTN: EPC SEADs Coordinator, 5600
Fishers Lane, Mail Stop 06E53A,
Rockville, MD 20857.
Shipping Address (FedEx, UPS, etc.):
Center for Evidence and Practice
Improvement, Agency for Healthcare
Research and Quality, ATTN: EPC
SEADs Coordinator, 5600 Fishers Lane,
Mail Stop 06E77D, Rockville, MD
20857.
DATES:
FOR FURTHER INFORMATION CONTACT:
Jenae Benns, Telephone: 301–427–1496
or Email: epc@ahrq.hhs.gov.
SUPPLEMENTARY INFORMATION: The
Agency for Healthcare Research and
Quality has commissioned the
Evidence-based Practice Centers (EPC)
Program to complete a review of the
evidence for Transitions of Care from
Pediatric to Adult Services for Children
with Special Healthcare Needs. AHRQ
is conducting this systematic review
pursuant to Section 902 of the Public
Health Service Act, 42 U.S.C. 299a.
The EPC Program is dedicated to
identifying as many studies as possible
that are relevant to the questions for
each of its reviews. In order to do so, we
are supplementing the usual manual
and electronic database searches of the
literature by requesting information
from the public (e.g., details of studies
conducted). We are looking for studies
that report on Transitions of Care from
Pediatric to Adult Services for Children
with Special Healthcare Needs,
including those that describe adverse
events. The entire research protocol is
available online at: https://
effectivehealthcare.ahrq.gov/products/
transitions-care-pediatric-adult/
protocol.
This is to notify the public that the
EPC Program would find the following
information on Transitions of Care from
Pediatric to Adult Services for Children
with Special Healthcare Needs helpful:
■ A list of completed studies that
your organization has sponsored for this
indication. In the list, please indicate
whether results are available on
ClinicalTrials.gov along with the
ClinicalTrials.gov trial number.
■ For completed studies that do not
have results on ClinicalTrials.gov, a
summary, including the following
elements: Study number, study period,
design, methodology, indication and
diagnosis, proper use instructions,
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17:39 Dec 01, 2020
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inclusion and exclusion criteria,
primary and secondary outcomes,
baseline characteristics, number of
patients screened/eligible/enrolled/lost
to follow-up/withdrawn/analyzed,
effectiveness/efficacy, and safety results.
■ A list of ongoing studies that your
organization has sponsored for this
indication. In the list, please provide the
ClinicalTrials.gov trial number or, if the
trial is not registered, the protocol for
the study including a study number, the
study period, design, methodology,
indication and diagnosis, proper use
instructions, inclusion and exclusion
criteria, and primary and secondary
outcomes.
■ Description of whether the above
studies constitute ALL Phase II and
above clinical trials sponsored by your
organization for this indication and an
index outlining the relevant information
in each submitted file.
Your contribution is very beneficial to
the Program. Materials submitted must
be publicly available or able to be made
public. Materials that are considered
confidential; marketing materials; study
types not included in the review; or
information on indications not included
in the review cannot be used by the EPC
Program. This is a voluntary request for
information, and all costs for complying
with this request must be borne by the
submitter.
The draft of this review will be posted
on AHRQ’s EPC Program website and
available for public comment for a
period of 4 weeks. If you would like to
be notified when the draft is posted,
please sign up for the email list at:
https://www.effectivehealthcare
.ahrq.gov/email-updates.
The systematic review will answer the
following questions. This information is
provided as background. AHRQ is not
requesting that the public provide
answers to these questions.
Key Questions (KQs)
• KQ1: What are the effectiveness,
comparative effectiveness, harms, and
costs of care interventions for transition
from pediatric to adult medical care
services, including primary care, for
children with special healthcare needs
and their families/caregivers?
Æ KQ1a: How do outcomes vary by
intervention characteristics or
components?
Æ KQ1b: How do outcomes vary by
patient/caregiver or provider
characteristics or setting?
Æ KQ1c: What are the barriers and
facilitators to effective transitions?
Æ KQ1d: What are the gaps in
evidence for the effectiveness of the
interventions?
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• KQ2: What are the effectiveness,
comparative effectiveness, harms, and
costs of implementation strategies for
care interventions for transition,
including provider-related training?
Æ KQ2a: How do outcomes vary by
intervention characteristics or
components?
Æ KQ2b: How do outcomes vary by
patient/caregiver or provider
characteristics or setting?
Æ KQ2c: What are the barriers and
facilitators to effective implementation?
Æ KQ2d: What are the gaps in
evidence for the effectiveness of the
interventions?
• KQ3: What is the effectiveness,
comparative effectiveness, harms, and
costs of tools to facilitate
communication between pediatric and
adult providers for care transitions from
pediatric to adult medical care for
children with special healthcare needs
and their families/caregivers?
Æ KQ3a: How do outcomes vary by
intervention characteristics or
components?
Æ KQ3b: How do outcomes vary by
patient/caregiver or provider
characteristics or setting?
Æ KQ3c: What are the barriers and
facilitators to effective tools to facilitate
communication?
Æ KQ3d: What are the gaps in
evidence for the effectiveness of the
interventions?
Contextual Questions
In addition to the identified key
questions, the report will include a
mixed-methods evaluation of the
contexts in which interventions for
transitioning children with special
healthcare needs from pediatric to adult
services are developed and used.
Contextual questions to be evaluated
include:
1. How is effectiveness defined and
measured for transitions of care from
pediatric to adult services for children
with special healthcare needs?
2. What transition care training and
other implementation strategies are
available to prepare pediatric medical
providers (e.g., pediatricians and other
specialists) and adult medical providers
(e.g., primary care providers, nurse
practitioners, physician assistants) for
transitioning children with special
healthcare needs to adult care?
3. What training is available for
linguistic- and culturally competent
care?
4. What transition care training and
other implementation strategies are
available to prepare pediatric patients
and their families for transitioning
children with special healthcare needs
to adult care?
E:\FR\FM\02DEN1.SGM
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Federal Register / Vol. 85, No. 232 / Wednesday, December 2, 2020 / Notices
5. What care interventions including
primary care have been used for
transition from pediatric to adult
medical care for children with special
healthcare needs?
6. What strategies have been proposed
to increase availability of adult care
77465
providers for people transitioning from
pediatric to adult care?
PICOTS (POPULATIONS, INTERVENTIONS, COMPARATORS, OUTCOMES, TIMING, SETTINGS)
PICOT
KQ1: Benefits and harms of care intervention
KQ2: Implementation strategies
KQ3: Communication tools
Population ...........
Adolescents and young adults (diagnosed with
cancer or other special healthcare condition
before 21 years old) with a chronic physical
or mental illness or physical, intellectual, or
developmental disability, also including parents and/or care givers.
Patient subgroups: Disease condition (including cancer), age of diagnosis, sex/sexual
orientation, race/ethnicity, religion, socioeconomic status, adverse childhood events.
Provider subgroups: Age, sex, race/ethnicity,
education, socioeconomic status, specialty,
care setting.
Intervention related to the care transition from
pediatric to adult medical care (e.g., any single or multi-component intervention that addresses the Six Core Elements of
healthcare transition such as educational
materials, patient care documents, processes, etc. There are not widely established
neat packages of intervention components;
interventions vary widely in their components, structure, and processes.). No
healthcare transition intervention is explicitly
excluded. However, transition interventions
that address the full spectrum of transition to
adult life, such as transition to independent
living from foster care or among people with
developmental disabilities, will be excluded.
Comparator required, but no exclusion based
on comparator type.
Æ Transition readiness (e.g., patient, family,
provider, and system level).
Æ Quality of life.
Æ Mortality.
Æ Morbidity.
Æ Disease-specific clinical outcomes.
Æ Wellness visits/screenings (e.g., depression,
anxiety, STIs, other risk and resiliency factors such as alcohol use, substance abuse,
violence).
Æ Treatment or care adherence.
Æ Engagement in care (e.g., no shows, time
between provider, satisfaction, loss to follow-up, time between leaving pediatric setting to going to adult).
Æ Satisfaction (patient and family).;
Æ Family caregiver outcomes.
Æ Harms.
Æ Unintended consequences (e.g., ethics of
transition).
Æ Psychosocial (e.g., social-emotional, mental
health, etc.).
Æ Insurance.
Æ Cost.
Æ Resource utilization (ER visit, hospitalization, length of stay).
At least 6 months post transition for tests of
interventions. No exclusions for qualitative
or mixed studies for barriers and facilitators
subquestion.
All settings (e.g., primary care, specialty care,
schools, rural, resource limited settings, and
telehealth).
Multi-disciplinary care providers (e.g., primary
care/family medicine physicians, specialty
care physicians, nurse practitioners, physician assistant, etc.) caring for adolescents
and young adults with a special healthcare
need.
Patient subgroups: Disease condition (including cancer), age of diagnosis, sex/sexual
orientation, race/ethnicity, religion, socioeconomic status, adverse childhood events.
Provider subgroups: Age, sex, race/ethnicity,
education, socioeconomic status, specialty,
care setting.
Implementation strategies, including training
(e.g., any single or multi-component intervention that addresses implementing the Six
Core Elements of healthcare transition such
as trainings).
Multi-disciplinary care providers (e.g., primary
care/family medicine physicians, specialty
care physicians, nurse practitioners, physician assistant, etc.) providers caring for adolescents and young adults with a special
need.
Patient subgroups: Disease condition (including cancer), age of diagnosis, sex/sexual
orientation, race/ethnicity, religion, socioeconomic status, adverse childhood events.
Provider subgroups: Age, sex, race/ethnicity,
education, socioeconomic status, specialty,
care setting.
Tools for provider communication (e.g., any
single or multi-component intervention that
addresses communication that supports the
Six Core Elements of healthcare transition
such as patient care documents).
Comparator required, but no exclusion based
on comparator type.
Æ Intervention.
D Adoption.
D Fidelity.
D Sustainability.
D Feasibility.
D Acceptability.
Æ Satisfaction (physician and other formal
caregiver).
Æ Quality of life.
Æ Mortality.
Æ Morbidity.
Æ Disease-specific clinical outcomes.
Æ Family Caregiver outcomes.
Æ Harms.
Æ Unintended consequences (e.g., ethics of
transition.
Æ Cost of implementation.
Æ Insurance.
Comparator required, but no exclusion based
on comparator type.
Æ Transition readiness.
Æ Quality of life.
Æ Mortality.
Æ Morbidity.
Æ Disease-specific clinical outcomes.
Æ Treatment or care adherence.
Æ Engagement in care (e.g., no shows, time
between providers, satisfaction, loss to follow-up, time between leaving pediatric setting to going to adult).
Æ Satisfaction (patient and family).
Æ Family Caregiver outcomes.
Æ Harms.
Æ Unintended consequences (e.g., ethics of
transition).
Æ Insurance.
Æ Cost.
Æ Resource utilization (ER visit, hospitalization, length of stay).
At least 6 months for tests of interventions. No
exclusions for qualitative or mixed studies
for barriers and facilitators subquestion.
At least 6 months for tests of interventions. No
exclusions for qualitative or mixed studies
for barriers and facilitators subquestion.
All settings (e.g., primary care, specialty care,
schools, rural, resource limited settings, and
telehealth).
All settings (e.g., primary care, specialty care,
schools, rural, resource limited settings, and
telehealth).
Intervention .........
Comparators .......
Outcomes ...........
Timing .................
Setting .................
Dated: November 27, 2020.
Marquita Cullom,
Associate Director.
[FR Doc. 2020–26569 Filed 12–1–20; 8:45 am]
BILLING CODE 4160–90–P
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]]>Agencies
[Federal Register Volume 85, Number 232 (Wednesday, December 2, 2020)]
[Notices]
[Pages 77463-77465]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2020-26569]
=======================================================================
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Agency for Healthcare Research and Quality
Supplemental Evidence and Data Request on Transitions of Care
From Pediatric to Adult Services for Children With Special Healthcare
Needs
AGENCY: Agency for Healthcare Research and Quality (AHRQ), HHS.
ACTION: Request for Supplemental Evidence and Data Submissions.
-----------------------------------------------------------------------
SUMMARY: The Agency for Healthcare Research and Quality (AHRQ) is
seeking scientific information submissions from the public. Scientific
information is being solicited to inform our review on Transitions of
Care from Pediatric to Adult Services for Children with Special
Healthcare Needs, which is currently being conducted by the AHRQ's
Evidence-based Practice Centers (EPC) Program. Access to published and
unpublished pertinent scientific information will improve the quality
of this review.
[[Page 77464]]
DATES: Submission Deadline on or before January 4, 2021.
ADDRESSES:
Email submissions: [email protected].
Print submissions:
Mailing Address: Center for Evidence and Practice Improvement,
Agency for Healthcare Research and Quality, ATTN: EPC SEADs
Coordinator, 5600 Fishers Lane, Mail Stop 06E53A, Rockville, MD 20857.
Shipping Address (FedEx, UPS, etc.): Center for Evidence and
Practice Improvement, Agency for Healthcare Research and Quality, ATTN:
EPC SEADs Coordinator, 5600 Fishers Lane, Mail Stop 06E77D, Rockville,
MD 20857.
FOR FURTHER INFORMATION CONTACT: Jenae Benns, Telephone: 301-427-1496
or Email: [email protected].
SUPPLEMENTARY INFORMATION: The Agency for Healthcare Research and
Quality has commissioned the Evidence-based Practice Centers (EPC)
Program to complete a review of the evidence for Transitions of Care
from Pediatric to Adult Services for Children with Special Healthcare
Needs. AHRQ is conducting this systematic review pursuant to Section
902 of the Public Health Service Act, 42 U.S.C. 299a.
The EPC Program is dedicated to identifying as many studies as
possible that are relevant to the questions for each of its reviews. In
order to do so, we are supplementing the usual manual and electronic
database searches of the literature by requesting information from the
public (e.g., details of studies conducted). We are looking for studies
that report on Transitions of Care from Pediatric to Adult Services for
Children with Special Healthcare Needs, including those that describe
adverse events. The entire research protocol is available online at:
https://effectivehealthcare.ahrq.gov/products/transitions-care-pediatric-adult/protocol.
This is to notify the public that the EPC Program would find the
following information on Transitions of Care from Pediatric to Adult
Services for Children with Special Healthcare Needs helpful:
[squf] A list of completed studies that your organization has
sponsored for this indication. In the list, please indicate whether
results are available on ClinicalTrials.gov along with the
ClinicalTrials.gov trial number.
[squf] For completed studies that do not have results on
ClinicalTrials.gov, a summary, including the following elements: Study
number, study period, design, methodology, indication and diagnosis,
proper use instructions, inclusion and exclusion criteria, primary and
secondary outcomes, baseline characteristics, number of patients
screened/eligible/enrolled/lost to follow-up/withdrawn/analyzed,
effectiveness/efficacy, and safety results.
[squf] A list of ongoing studies that your organization has
sponsored for this indication. In the list, please provide the
ClinicalTrials.gov trial number or, if the trial is not registered, the
protocol for the study including a study number, the study period,
design, methodology, indication and diagnosis, proper use instructions,
inclusion and exclusion criteria, and primary and secondary outcomes.
[squf] Description of whether the above studies constitute ALL
Phase II and above clinical trials sponsored by your organization for
this indication and an index outlining the relevant information in each
submitted file.
Your contribution is very beneficial to the Program. Materials
submitted must be publicly available or able to be made public.
Materials that are considered confidential; marketing materials; study
types not included in the review; or information on indications not
included in the review cannot be used by the EPC Program. This is a
voluntary request for information, and all costs for complying with
this request must be borne by the submitter.
The draft of this review will be posted on AHRQ's EPC Program
website and available for public comment for a period of 4 weeks. If
you would like to be notified when the draft is posted, please sign up
for the email list at: https://www.effectivehealthcare .ahrq.gov/email-
updates.
The systematic review will answer the following questions. This
information is provided as background. AHRQ is not requesting that the
public provide answers to these questions.
Key Questions (KQs)
KQ1: What are the effectiveness, comparative
effectiveness, harms, and costs of care interventions for transition
from pediatric to adult medical care services, including primary care,
for children with special healthcare needs and their families/
caregivers?
[cir] KQ1a: How do outcomes vary by intervention characteristics or
components?
[cir] KQ1b: How do outcomes vary by patient/caregiver or provider
characteristics or setting?
[cir] KQ1c: What are the barriers and facilitators to effective
transitions?
[cir] KQ1d: What are the gaps in evidence for the effectiveness of
the interventions?
KQ2: What are the effectiveness, comparative
effectiveness, harms, and costs of implementation strategies for care
interventions for transition, including provider-related training?
[cir] KQ2a: How do outcomes vary by intervention characteristics or
components?
[cir] KQ2b: How do outcomes vary by patient/caregiver or provider
characteristics or setting?
[cir] KQ2c: What are the barriers and facilitators to effective
implementation?
[cir] KQ2d: What are the gaps in evidence for the effectiveness of
the interventions?
KQ3: What is the effectiveness, comparative effectiveness,
harms, and costs of tools to facilitate communication between pediatric
and adult providers for care transitions from pediatric to adult
medical care for children with special healthcare needs and their
families/caregivers?
[cir] KQ3a: How do outcomes vary by intervention characteristics or
components?
[cir] KQ3b: How do outcomes vary by patient/caregiver or provider
characteristics or setting?
[cir] KQ3c: What are the barriers and facilitators to effective
tools to facilitate communication?
[cir] KQ3d: What are the gaps in evidence for the effectiveness of
the interventions?
Contextual Questions
In addition to the identified key questions, the report will
include a mixed-methods evaluation of the contexts in which
interventions for transitioning children with special healthcare needs
from pediatric to adult services are developed and used. Contextual
questions to be evaluated include:
1. How is effectiveness defined and measured for transitions of
care from pediatric to adult services for children with special
healthcare needs?
2. What transition care training and other implementation
strategies are available to prepare pediatric medical providers (e.g.,
pediatricians and other specialists) and adult medical providers (e.g.,
primary care providers, nurse practitioners, physician assistants) for
transitioning children with special healthcare needs to adult care?
3. What training is available for linguistic- and culturally
competent care?
4. What transition care training and other implementation
strategies are available to prepare pediatric patients and their
families for transitioning children with special healthcare needs to
adult care?
[[Page 77465]]
5. What care interventions including primary care have been used
for transition from pediatric to adult medical care for children with
special healthcare needs?
6. What strategies have been proposed to increase availability of
adult care providers for people transitioning from pediatric to adult
care?
PICOTS (Populations, Interventions, Comparators, Outcomes, Timing,
Settings)
------------------------------------------------------------------------
KQ1: Benefits
and harms of KQ2: KQ3:
PICOT care Implementation Communication
intervention strategies tools
------------------------------------------------------------------------
Population......... Adolescents and Multi- Multi-
young adults disciplinary disciplinary
(diagnosed with care providers care providers
cancer or other (e.g., primary (e.g., primary
special care/family care/family
healthcare medicine medicine
condition physicians, physicians,
before 21 years specialty care specialty care
old) with a physicians, physicians,
chronic nurse nurse
physical or practitioners, practitioners,
mental illness physician physician
or physical, assistant, assistant,
intellectual, etc.) caring etc.)
or for adolescents providers
developmental and young caring for
disability, adults with a adolescents
also including special and young
parents and/or healthcare need. adults with a
care givers. special need.
Patient Patient Patient
subgroups: subgroups: subgroups:
Disease Disease Disease
condition condition condition
(including (including (including
cancer), age of cancer), age of cancer), age
diagnosis, sex/ diagnosis, sex/ of diagnosis,
sexual sexual sex/sexual
orientation, orientation, orientation,
race/ethnicity, race/ethnicity, race/
religion, religion, ethnicity,
socioeconomic socioeconomic religion,
status, adverse status, adverse socioeconomic
childhood childhood status,
events. events. adverse
Provider Provider childhood
subgroups: Age, subgroups: Age, events.
sex, race/ sex, race/ Provider
ethnicity, ethnicity, subgroups:
education, education, Age, sex, race/
socioeconomic socioeconomic ethnicity,
status, status, education,
specialty, care specialty, care socioeconomic
setting. setting. status,
specialty,
care setting.
Intervention....... Intervention Implementation Tools for
related to the strategies, provider
care transition including communication
from pediatric training (e.g., (e.g., any
to adult any single or single or
medical care multi-component multi-
(e.g., any intervention component
single or multi- that addresses intervention
component implementing that addresses
intervention the Six Core communication
that addresses Elements of that supports
the Six Core healthcare the Six Core
Elements of transition such Elements of
healthcare as trainings). healthcare
transition such transition
as educational such as
materials, patient care
patient care documents).
documents,
processes, etc.
There are not
widely
established
neat packages
of intervention
components;
interventions
vary widely in
their
components,
structure, and
processes.). No
healthcare
transition
intervention is
explicitly
excluded.
However,
transition
interventions
that address
the full
spectrum of
transition to
adult life,
such as
transition to
independent
living from
foster care or
among people
with
developmental
disabilities,
will be
excluded.
Comparators........ Comparator Comparator Comparator
required, but required, but required, but
no exclusion no exclusion no exclusion
based on based on based on
comparator type. comparator type. comparator
type.
Outcomes........... [cir] Transition [cir] [cir]
readiness Intervention. Transition
(e.g., patient, [ssquf] readiness.
family, Adoption.. [cir] Quality
provider, and [ssquf] of life.
system level). Fidelity.. [cir]
[cir] Quality of [ssquf] Mortality.
life.. Sustainability.. [cir]
[cir] Mortality. [ssquf] Morbidity.
[cir] Morbidity. Feasibility.. [cir] Disease-
[cir] Disease- [ssquf] specific
specific Acceptability.. clinical
clinical [cir] outcomes.
outcomes.. Satisfaction [cir] Treatment
[cir] Wellness (physician and or care
visits/ other formal adherence.
screenings caregiver).. [cir]
(e.g., [cir] Quality of Engagement in
depression, life.. care (e.g., no
anxiety, STIs, [cir] Mortality. shows, time
other risk and [cir] Morbidity. between
resiliency [cir] Disease- providers,
factors such as specific satisfaction,
alcohol use, clinical loss to follow-
substance outcomes.. up, time
abuse, [cir] Family between
violence).. Caregiver leaving
[cir] Treatment outcomes.. pediatric
or care [cir] Harms..... setting to
adherence.. [cir] Unintended going to
[cir] Engagement consequences adult).
in care (e.g., (e.g., ethics [cir]
no shows, time of transition.. Satisfaction
between [cir] Cost of (patient and
provider, implementation.. family).
satisfaction, [cir] Insurance. [cir] Family
loss to follow- Caregiver
up, time outcomes.
between leaving [cir] Harms.
pediatric [cir]
setting to Unintended
going to consequences
adult).. (e.g., ethics
[cir] of
Satisfaction transition).
(patient and [cir]
family).;. Insurance.
[cir] Family [cir] Cost.
caregiver [cir] Resource
outcomes.. utilization
[cir] Harms..... (ER visit,
[cir] Unintended hospitalizatio
consequences n, length of
(e.g., ethics stay).
of transition)..
[cir]
Psychosocial
(e.g., social-
emotional,
mental health,
etc.)..
[cir] Insurance.
[cir] Cost......
[cir] Resource
utilization (ER
visit,
hospitalization
, length of
stay)..
Timing............. At least 6 At least 6 At least 6
months post months for months for
transition for tests of tests of
tests of interventions. interventions.
interventions. No exclusions No exclusions
No exclusions for qualitative for
for qualitative or mixed qualitative or
or mixed studies for mixed studies
studies for barriers and for barriers
barriers and facilitators and
facilitators subquestion. facilitators
subquestion. subquestion.
Setting............ All settings All settings All settings
(e.g., primary (e.g., primary (e.g., primary
care, specialty care, specialty care,
care, schools, care, schools, specialty
rural, resource rural, resource care, schools,
limited limited rural,
settings, and settings, and resource
telehealth). telehealth). limited
settings, and
telehealth).
------------------------------------------------------------------------
Dated: November 27, 2020.
Marquita Cullom,
Associate Director.
[FR Doc. 2020-26569 Filed 12-1-20; 8:45 am]
BILLING CODE 4160-90-P
