Self-Management and Transition Readiness Assessment: Development, Reliability, and Factor Structure of the STARx Questionnaire

Introduction The Self-Management and Transition to Adulthood with Rx = Treatment (STAR x ) Questionnaire was developed to collect information on self-management and health care transition (HCT) skills, via self-report, in a broad population of adolescents and young adults (AYAs) with chronic conditions. Methods Over several iterations, the STAR x questionnaire was created with AYA, family, and health provider input. The development and pilot testing of the STAR x Questionnaire took place with the assistance of 1219 AYAs with different chronic health conditions, in multiple institutions and settings over three phases: item development, pilot testing, reliability and factor structuring. Results The three development phases resulted in a final version of the STAR x Questionnaire. The exploratory factor analysis of the third version of the 18-item STAR x identified six factors that accounted for about 65% of the variance: Medication management, Provider communication, Engagement during appointments, Disease knowledge, Adult health responsibilities, and Resource utilization. Reliability estimates revealed good internal consistency and temporal stability, with the alpha coefficient for the overall scale being .80. The STAR x was developmentally sensitive, with older patients scoring significantly higher on nearly every factor than younger patients. Conclusion The STAR x Questionnaire is a reliable, self-report tool with adequate internal consistency, temporal stability, and a strong, multidimensional factor structure. It provides another assessment strategy to measure self-management and transition skills in AYAs with chronic conditions.