52 Assessing the social determinants of health and positive childhood experiences in youth patients transitioning to adult care: A cross-sectional survey
Bibliographic record
Abstract
Abstract Background Children and youth with complex healthcare needs often receive specialized care in tertiary care hospitals or multidisciplinary paediatric clinics. In Canada, the mandate transfer of paediatric care to adult services varies by province/territory and type of care, often between 16 to 19 years of age (Toulany et al., 2022). While many resources exist to support youth in this transition, few integrate social determinants of health (SDoH) in this process. Recent literature has shown that positive childhood experiences (PCEs) have an inverse, dose-response relationship with adult mental health and mitigate against adverse childhood experiences (ACEs) (Bethel et al., 2019). By promoting these PCEs and enhancing resilience, we may be able to support youth better in this transition process. Objectives 1) To assess SDoH and PCEs of youth transitioning into adult care; 2) To assess transition readiness. Design/Methods We adapted our previously existing, institutionally approved cross-sectional QI survey exploring prevalence of SDoH and PCEs to include additional questions regarding transition. Youth patients (≧13 years of age) in the Cleft Palate Craniofacial Program at a paediatric tertiary care hospital were invited to complete the paper survey during their clinic appointments. Responses were tabulated using Microsoft Excel. Results From June 4th to October 29th, 2024, a total of 37 out of 41 eligible youth completed the survey, for a response rate of 90%. 33 out of 36 participants (92%) responded that they “always” identify with ≧3 of the 7 PCEs. Of these, 18 participants (55%) felt supported in their transition to adult care and 15 participants (45%) did not respond. For the 4 participants that did not “always” identify with ≧3 out of 7 PCEs, 2 felt supported with transition, 1 did not feel supported, and 1 did not know. Overall, most youth (70%) provided feedback that the survey was important in having their voice heard and for their health provider to know. Conclusion Recognizing and promoting PCEs can be a powerful, strengths-based tool that enhances resilience in youth, especially during times of transition to adult care. Next steps could include secondary analysis of data, which may allow us to identify independent SDoH and PCE factors to assess transition readiness. Our findings will inform the further improvement of our clinic and other hospital programs for transition resources and future planning.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".