Table 2.

Study Description and Characteristics

#	Author/Year	Location of Study	Study Design and Methods	Purpose/Aims	Sample (size, description)	Quality	Level of Evidence
1a	Allen, Channon, Lowes, Atwell, & Lane, 2011	United Kingdom	Qualitative; longitudinal qualitative case studies, semi- structured interviews; recruited from 5 different diabetes services throughout the UK	To explore young adults’ and caregivers’ experiences during transition from child to adult diabetes services	Adolescents ages 14-22 with T1D (n=46), & mothers (n=39).	10	C
2a	Allen et al., 2012	England	Mixed methods; semi- structured interviews, selected observation, case studies & surveys; recruited from the diabetes services in England	To identify the mechanisms of a smooth transition to adult diabetes care and the service components through which these can be achieved	Interviews of health care professionals (n=38), young adults (n=46), and caregivers (n=39); surveys of young adults (n=82).	10	C
3	Begley, 2013	Ireland	Mixed-methods; surveys with closed and open-ended questions; surveys sent to all known consultants, MDs, CNS's, and APN's	To clarify how the transition from childhood to adult healthcare is managed in young people with cystic fibrosis (CF) and T1D	Consultants, MDs, CNS's, and APN's caring for teens with CF and T1D; (n=71; 54% response rate)	8	C
4	Busse et al., 2007	Germany	Quantitative; cross-sectional structured survey administered through phone interview; Sample eligibility criteria: at least 18 years of age, at least 6 months had elapsed after transition and the patient had no other chronic disorder apart from diabetes	To determine the patients’ perception of transfer arrangements and to analyze health care use and metabolic control	Cases identified through diabetes registry of the Clinic and Policlinic for Children and Adolescents, University of Leipzig, Germany; (n=101)	10	C
5	Cadario et al., 2009	Italy	Quantitative; retrospective cohort study; comparison group of PDS patients discharged with an unstructured transfer; exposure group discharged with structured transition	To investigate the outcomes of a structured transition program to an unstructured one	Adolescents and young adults (n=62) discharged from the pediatric diabetes service (PDS) to the adult pediatric service (ADS)	9	C
6	de Beaufort, Jarosz-Chobot, Frank, de Bart, & Deja, 2010	International	Quantitative; cross-sectional questionnaire	To evaluate the practices of diabetes health care providers concerning the transition from pediatric to adult diabetes care	Email with survey link sent to all members of the International Society for Pediatric and Adolescent Diabetes (n=92; 16% response rate)	9	C
7b	Dovey-Pearce, Doherty, & May, 2007	England	Qualitative; thematic analysis of audio recorded interviews; recruited from young adults served by specialist diabetes services	To describe and understand the influence of diabetes upon psychosocial development and to highlight the implications for healthcare teams.	16-25 year olds with T1D (n=19); 8 males; 11 females	10	C
8b	Dovey-Pearce, Hurrell, May, Walker, & Doherty, 2005	England	Qualitative; semi-structured interviews and focus groups; recruited from young adults served by specialist diabetes services	To understand the opinions of young adults with diabetes who were receiving secondary care services about the provision of diabetes services	16-25 year olds with T1D (n=19); 8 males; 11 females	10	C
9c	Garvey et al., 2014	United States of America	Qualitative; focus group interviews; recruited from emerging adults receiving adult diabetes care at a single center	To explore the experience of transition from pediatric to adult diabetes care reported by post- transition emerging adults with T1D	Young adults with T1D, 22- 30 years old, diagnosed with diabetes at ≤18 years of age (n=26)	8	C
10	Garvey et al., 2013	United States of America	Quantitative; cross-sectional survey; recruited from emerging adults with T1D who had been previously followed in the pediatric diabetes clinic at Boston Children's hospital	To describe the current status of adult diabetes care in young adults with T1D and examine associations between health care transition experiences and care utilization	205 surveys sent to sample, 65 returned (32% response rate)	9	C
11	Garvey et al., 2012	United States of America	Quantitative; cross-sectional survey; recruited from emerging adults with T1D aged 22-30 years, under the care of any adult diabetes specialist at the Joslin Diabetes Center	To examine characteristics of the transition from pediatric to adult care in emerging adults with T1D and evaluate associations between transition characteristics and glycemic control	484 mailed surveys, 258 collected (53% response rate)	10	C
12	Gerber, Solomon, Shaffer, Quinn, & Lipton, 2007	United States of America	Quantitative; cohort study; no control; one intervention group followed; sample eligibility criteria: fluent in English, diagnosed with diabetes prior to 18th birthday, over 18 years of age at time of recruitment	To evaluate the effectiveness of an internet-based transition support program, STYLE, in an urban cohort of individuals between 19-26 years of age	19 participants given intervention, only 12 attended feedback sessions for analysis	4	C
13	Hanna et al., 2013	United States of America	Quantitative; longitudinal study; pre-post test design; three consecutive years of recruiting students with T1D in their last 6 months of high school	To examine: (1) how diabetes care responsibility changed in relation to time and living situation and (2) the association of diabetes self-efficacy, gender and glycemic control with changes in diabetes care responsibility	n = 113 (17-19 year olds with T1D);	10	B
14	Helgeson et al., 2013	United States of America	Quantitative; questionnaire with repeated samples; time 1 during senior year of high school; time 2 one year later; recruited from a previous study in the Children's Hospital of Pittsburgh in 2002-2004	To describe the transition of youth with T1D from pediatric to adult healthcare services and examine the link of this transition with self- care and glycemic control and distinguish medical treatment from different physicians	118 adolescents who utilize either a pediatric endocrinologist or adult physician	10	C
15	Hilliard et al., 2014	United States of America	Mixed methods; surveys with open ended questions; pre- transition group was recruited from a pediatric diabetes clinic; post-transition recruited from 18-22 year olds who were treated at the same clinic	To describe the concerns, expectations, preferences, and experiences of youth and parents before and after transitioning from pediatric to adult care.	Pre-transition: adolescents aged 15-17 with T1D (n=20) Post-transition: young adults aged 18-22 (n=59)	9	C
16	Holmes- Walker, Llewellyn, & Farrell, 2007	Australia	Quantitative; simple interrupted time series design; young adults aged 15-25 with T1D were referred to the program that was based at a tertiary adult referral hospital in July 2001	To determine if a transition support program could maintain attendance at a specialist clinic, improve diabetes control, and reduce acute hospital admissions in 15-25 year olds with T1D	Patients (n=191) referred were seen in a young adult diabetes clinic and did not routinely meet the transition coordinator or adult diabetes specialist	4	B
17	Huang et al., 2014	United States of America	Quantitative; randomized Clinical Trial; recruited from 1 pediatric tertiary care academic medical center	To evaluate whether a internet- and mobile phone-delivered disease management intervention improves disease management, self-efficacy, and communication outcomes	Adolescents (n=81) aged 12- 22 with either inflammatory bowel disease, cystic fibrosis, or T1D	7	A
18	Kime, 2013	United Kingdom	Qualitative; focus groups	To report on the transition process and the role of community nurses in young peoples’ diabetes care	9 acute trusts across the region and more than 300 participants, parents, and professionals	7	C
19	Lotstein et al., 2013	United States of America	Quantitative; retrospective cohort study; utilized SEARCH for Diabetes in Youth Study data to find those who completed at least 1 follow up visit after age 18	Describe sociodemographic and clinical correlates of poor glycemic control associated with transfer of care of youth with T1D diagnosed in adolescence	185 American adolescents (ages 13-18) with T1D	10	B
20	Lundin, Ohrn, & Danielson, 2008	Sweden	Qualitative; ethnographic approach with formal and informal interviews; participants observed from 2 pediatric diabetes clinics and 2 adult diabetes clinics	Describe care culture in pediatric and adult diabetes outpatient clinics and implications for care of adolescents	Observations of 51 participants; interviews of 10 physicians	9	C
21	Markowitz & Laffel, 2012	United States of America	Quantitative; pre-post test design to evaluate group support program; interested patients recruited through flyers	To examine the effects of a group support program	15 emerging adults with T1D; ages 18-30	10	C
22	Nakhla, Daneman, To, Paradis, & Guttmann, 2009	Canada	Quantitative; retrospective cohort study; examined health administrative and survey data from Ontario Diabetes Database	Compare rates of DM related hospitalization & retinopathy screening before and after transition to adult care.	1507 young adults with T1D	10	B
23	Neu et al., 2010	Germany	Quantitative; pre-post questionnaire after transition to adult care; recruited from a single hospital	Identify the type of clinical care received by young T1D patients who transition to adult care, and assess the metabolic status of long term treatment after transition	99 patients (28 drop outs, 28.2%) average age at transition: 21.8 years	10	C
24	Perry, Steinbeck, Dunbabin, & Lowe, 2010	Australia	Quantitative; retrospective cohort study; case note audits at 6 diabetes clinics	To document diabetes health services use and indices of glycemic management of young people with T1D	239 young adults with T1D ages 18-28;	10	C
25	Price et al., 2011	United Kingdom	Qualitative; semi-structured interviews; recruited from adolescents attending a diabetes clinic	To evaluate the transition pathway in diabetes using qualitative methods in order to explore the experiences and suggestions of the young people	11 young adults aged 16-18 with T1D	8	C
26c	Ritholz et al., 2014	United States of America	Qualitative; focus group interviews; recruited from emerging adults receiving adult diabetes care at a single center	To explore perceptions emerging adults with T1D have of their patient-provider relationships across the transition from pediatric to adult care	Young adults with T1D, 22- 30 years old, diagnosed with diabetes at ≤18 years of age (n=26)	8	C
27	Scott, Vallis, Charette, Murray, & Latta, 2005	Canada	Mixed-methods; questionnaire followed by telephone interview; invitation letters were sent to former patients of a tertiary pediatric diabetes care center	To understand why young adults drop out of diabetes care during transition from pediatric to adult health care and to obtain information as how the care could better meet their needs	76 participants returned questionnaires (33.3% response rate); 19 telephone interviews	7	C
28	van Staa, Jedeloo, van Meeteren, & Latour, 2011	Netherlands	Qualitative; semi-structured interviews on young adult patients and on their parents and healthcare providers; potential participants were randomly selected from a list of young adult patients officially discharged in the previous 2 years	To examine the expectation and experience with transfer and perceived quality of care in pediatric care and adult services	3 of the 24 randomly selected participants were diagnosed with diabetes; aged 15-22; 24 parents; 17 healthcare providers	8	C
29	Van Walleghem, MacDonald, & Dfan, 2008	Canada	Quantitative; 2 year prospective cohort study with follow up every 6 months; data gathered from database review and audit of medical records	To report clinical outcomes and identify barriers to care for young adults with T1D after transfer from pediatric to adult care	Two cohorts followed: Younger group aged 18 years (n=84) from the “Maestro Project” Older group aged 19-25 (n=64) who were transferred to adult care without the initial support	6	C
30	Vanelli et al., 2004	Italy	Quantitative; 8 year retrospective cohort study; data gathered from T1D patients at a hospital	To report the effects of a protocol for an uninterrupted procedure to transfer adolescents with T1D from pediatric to adult clinic in a hospital	73 patients with T1D, average age of 26.5 years (sd=2.6)	8	C
31	Wilson, 2010	United States of America	Qualitative; semi-structured phone interviews; convenience sample recruited from colleges and universities	To explore the experiences of young adults managing T1D at college or university	23 young adults with T1D; aged 17-19	6	C

^aindicates studies utilizing same dataset or sample

^bindicates studies utilizing same dataset or sample

^cindicates studies utilizing same dataset or sample