Table 7.

Healthcare providers’ perspectives: qualitative interviews themes

Theme	Related quotes
Practice changes as a result of participating in the study: eg, formalising the process; starting transitioning planning earlier; adjusting communication styles towards emerging adults	I think the project has made me more conscientious of the process of transition. (Physician) When we had to identify youth who were eligible for the study, it made us aware that we didn’t actually have a system in place to identify clients who will be turning 18 and transitioning. (Physician) With increased awareness, we shifted the average age at the transition clinic to 14–15 [from 16–18]. (Physician) Generally when [caregivers] are in the room, I address myself to the youth trying to promote that concept that this is your body, your health, your responsibility. (Nurse) Sometimes people describe the transition experience as that they are falling off a cliff. [The study interventions] are something that we offer young people almost as a bit of a safety net, as a service that is available after they are “discharged” so that if they have questions they can direct them back to the online mentor. One of the most positive things has been being able to offer that as an option. (Occupational therapist)
Ways to optimise Youth KIT use	The Youth KIT was designed … to be self-directed…. Clinicians don’t get a copy of the Youth KIT. The KIT is put into the youth’s hands. …Going to a binder about planning isn’t something that most kids that I work with will do. So what we’ve done we incorporated parts of the Youth KIT into our summer sessions of the teen independence program. (Occupational therapist) So even if it was more of a protocol amongst all physicians who said, at every appointment, please have your Youth KIT… that might encourage the use… If we want to make it a success it has to be integrated, not something outside clinic. (Physician)
Need to bridge the divide between paediatric and adult healthcare systems and to improve continuation of comprehensive care, particularly in the area of developmental disabilities	Once we have raised awareness, parents became very proactive and started asking us questions that we cannot answer. The biggest challenge for me is to find a similar model to our multidisciplinary spina bifida clinic or spasticity clinic to transfer to (as there is no adult counterpart)…. It then falls back to the family doctor who is not always familiar with the issues. (Physician) The adult world is not as trained to handle patients with developmental disabilities. Having a joint meeting or conference to engage adult healthcare providers …may help. (Physician) At age 18… we “let the children go”, and there are a lot of unknowns after that… There is a strong need for some sort of continuity… We need to bridge the divide. (Physician)