Transition readiness: The linkage between adverse childhood experiences (ACEs) and health-related quality of life.

ABSTRACT

Adverse childhood experiences (ACEs) are consistently associated with deleterious health outcomes in adolescence and adulthood. Although research has implicated health-risk behaviors as a possible link in this relationship, the role of health care management skills has yet to be examined in this context. Transition readiness, defined as health care management skills during the transition from adolescence to adulthood, may be relevant in understanding health risk among individuals with ACEs. The present study evaluated health care management skills in adolescents and young adults (AYAs) transitioning to adult services, as AYA skills during this period set the stage for long-term health care management skills. The present study assessed transition readiness as a mediator between ACEs and health-related quality of life (HRQoL). College undergraduates (N = 1,011) between the ages of 18-23 years completed an online battery of self-report measures, including total ACEs (ACES-SF), transition readiness (TRAQ), and physical and emotional HRQoL (SF-36). Total ACE scores were negatively associated with physical and emotional HRQoL, and transition readiness was positively correlated with physical and emotional HRQoL. Transition readiness mediated the relationship between cumulative ACEs and both physical HRQoL (B = -0.079, 95% confidence interval [-0.17, -0.01]) and emotional HRQoL (B = -0.14, 95% confidence interval [-0.28, -0.015]). When examined by sex, this relationship remained significant for females only. Results suggest a need to promote health care management skills to improve transition readiness as means of enhancing health-related outcomes among AYAs with a history of ACEs.