Table 1.

Themes from initial focus groups with patients and providers.

Theme	Example Quotes
Concerns about transition	“My biggest concern, because he’s getting ready to go off to college is he doesn’t open up and let somebody know that he has diabetes.”—Caregiver of adolescent “I think that one of the largest fears we have right now as [son] is getting older and is seeking more responsibility, is seeking more independence, is really how to be able to let go for when he goes to college and have him have a successful college experience while being able to be safe.”—Caregiver of adolescent
Barriers and difficulties during transition	“It has just been my job. So yeah, it is very hard when you’re in control to start relinquishing the control and give them [teen] the independence.”—Caregiver of adolescent “Because there’s only so much time I have left with him. But I still want to stay on him at the same time, but also give him that space. So just finding that balance, stepping back.”—Caregiver of adolescent
Roles and relationships	“I think it’s important that she takes charge of that [ordering supplies], and then I’ll troubleshoot when needed.”—Caregiver of young adult “…diabetes is just that–trusting that you raised your child and set an example, but also providing enough support so your child knows you’re still there.”—Pediatric provider
Transition knowledge and skills	“I mean we all need help, no matter how old we get in life. And this is just–I don’t know. That’s just what families do! They help and look out for each other.”—Adolescent “…we’ve got to do this. He’s got to figure out how to make an appointment every three months. Like a checklist for an 18- or 19-year-old of here’s what you have to do. And handle all on your own.”—Caregiver of adolescent
Problem-solving difficulties	“It’s like ‘If your blood sugars aren’t in range all day then you can’t go out with your friends tonight.’ But I am still a teenager, I still want to have fun, and my blood sugar–it isn’t something that like can affect whether I go out with friends or not. It’s just what I am doing.”—Adolescent
Problem-solving strategies	“We’ve kind of established like a daily check-in time, which we don’t always do. But… just see how things went that day.”—Caregiver of adolescent “So, I think at times when there is an issue, I think what we’re learning to do is just deal with that issue at that time and then give each other some space, and then if we come back to each other when we’re not as filled with anxiety or frustration or anything like that…”—Caregiver of adolescent
Communication difficulties	“I just don’t like feeling punished for something that I can’t control at all. I know I can control short-term my blood sugar and stuff, but like I think something that my parents don’t always understand is that unless you have [it]… you have to like be so intricate with it and do all these steps and it’s just unfair.”—Adolescent
Communication strategies	“Something that my doctor said to me–my adult doctor–is to just look at it as numbers like mathematically. Like there’s no opinion on it, there’s no tone of voice when you talk about it.”—Young adult