Improving the Transition Readiness Assessment Questionnaire (TRAQ) using Item Response Theory

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Measuring the acquisition of self-management and health care utilization skills are part of evidence based transition practice. The Transition Readiness Assessment Questionnaire (TRAQ) is a validated 20-question and 5-factor instrument with a 5-point Likert response set using a Stages of Change Framework.


To improve the performance of the TRAQ and allow more precise measurement across the full range of transition readiness skills (from precontemplation to initiation to mastery).


On data from 506 previously completed TRAQs collected from several clinical practices we used MPlus v.7.4 to apply a graded response model (GRM), examining item discrimination and difficulty. New questions were written and added across all domains to increase the difficulty and discrimination of the overall scale. To evaluate the performance of new items and the resulting factor structure of the revised scale we fielded a new version of the TRAQ (with a total of 30 items) using an online anonymous survey of first year college students (in process).


We eliminated the five least discriminating TRAQ items with minimal impact to the conditional test information. After item elimination (k = 15) the factor structure of the instrument was maintained with good quality, ?2 (86) = 365.447, CFI = 0.977, RMSEA = 0.079, WRMR = 1.017. We also found that a majority of items could reliably discriminate only across lower levels of transition readiness (precontemplation to initiation) but could not discriminate at higher levels of transition readiness (action and mastery). Therefore we wrote 15 additional items intended to have higher difficulty. On the new 30 item TRAQ, confirmatory factor analysis, internal reliability and IRT results will be reported from a large sample of college students


Using IRT and factor analyses we eliminated 5 of 20 TRAQ items that were poorly discriminating. We found that many of the items in the TRAQ could discriminate among those in the early stages of transition readiness, but could not discriminate among those in later stages of transition readiness. To have a more robust measure of transition readiness we added more difficult items and are evaluating the scale’s psychometric properties.


San Francisco, CA

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