{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T05:55:51Z","timestamp":1781330151337,"version":"3.54.1"},"reference-count":34,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T00:00:00Z","timestamp":1768262400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T00:00:00Z","timestamp":1768262400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1 TR002243"],"award-info":[{"award-number":["UL1 TR002243"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["3R01DK115545\u201005S1"],"award-info":[{"award-number":["3R01DK115545\u201005S1"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["K23DK143333"],"award-info":[{"award-number":["K23DK143333"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["K12DK133995"],"award-info":[{"award-number":["K12DK133995"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100020526","name":"Vanderbilt Diabetes Research and Training Center, Vanderbilt University Medical Center","doi-asserted-by":"publisher","award":["DK20593"],"award-info":[{"award-number":["DK20593"]}],"id":[{"id":"10.13039\/100020526","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet Med"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Emerging adulthood is a developmental stage, which presents psychosocial, economic and academic challenges to individuals, which are further complicated for people with type 1 diabetes (T1D). While paediatric\u2010based care systems have developed programmes to address the needs of young adults with T1D, adult\u2010based systems have been slower to recognize this need. This qualitative study sought to understand the care experiences of emerging adults to identify barriers to engagement in adult\u2010based care systems.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 20 young adults with T1D (mean age 26.5\u2009\u00b1\u20094.5) participated in five focus groups. Focus groups obtained participant reflections on care received during and after transfer to adult\u2010based care. Data were analyzed and coded using thematic analysis and organized using the social ecological model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Key themes across each social ecological model strata emerged from focus group discussions. Provider and clinic\u2010level factors were frequently cited as key barriers to engagement in adult\u2010based clinical practices. In addition, system\u2010 and institutional\u2010level gaps led young adults to express a sense that systems at all levels were poorly adapted to address their care needs. Specifically, participants noted a need for high levels of self\u2010advocacy to obtain needed support, difficulty navigating complex health systems and gaps in care coordination between providers and clinics as key barriers to care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The findings of this study highlight the importance of adapting adult care systems and providers' approaches to meet the self\u2010identified needs of young adults to improve engagement with care and potentially avoid adverse outcomes in this high\u2010risk people population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dme.70214","type":"journal-article","created":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T08:28:44Z","timestamp":1768292924000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Qualitative care experiences of emerging adults with type 1 diabetes after transfer to adult care providers"],"prefix":"10.1111","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0664-032X","authenticated-orcid":false,"given":"Daniel R.","family":"Tilden","sequence":"first","affiliation":[{"name":"Division of Endocrinology, Diabetes &amp; Clinical Pharmacology, Department of Medicine University of Kansas Medical Center  Kansas City Kansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Bergner","sequence":"additional","affiliation":[{"name":"Division of Pediatric Psychology, Department of Pediatrics Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kashope","family":"Anifowoshe","sequence":"additional","affiliation":[{"name":"Division of Pediatric Psychology, Department of Pediatrics Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sydney","family":"Garretson","sequence":"additional","affiliation":[{"name":"Division of Pediatric Psychology, Department of Pediatrics Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nkemjika","family":"Okonkwo","sequence":"additional","affiliation":[{"name":"Division of Pediatric Psychology, Department of Pediatrics Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kemberlee","family":"Bonnet","sequence":"additional","affiliation":[{"name":"Department of Psychology Vanderbilt University  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah S.","family":"Jaser","sequence":"additional","affiliation":[{"name":"Division of Pediatric Psychology, Department of Pediatrics Vanderbilt University Medical Center  Nashville Tennessee 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