Stages of change and transitioning for adolescent patients with obesity and hypertension.

When exploring an adolescent patient's readiness to transition his/her health care to adult practice, it is important to understand the processes that allow for change and which promote self-efficacy and self-care. The large numbers of adolescents with hypertension and obesity, possible antecedents to adult kidney disease, require attention be paid to promoting lifestyle changes and adherence to treatment regimens as these patients enter adulthood. Transitioning to adult care is in many cases an externally imposed change, but a young patient's readiness for this change may be amenable to intervention based on the Stages of Change Model. This article reviews the impact of adolescent obesity and hypertension on future health, the application of the Stages of Change Model in health care and specifically with adolescents, and the concept of transitioning for young patients with special health care needs. The authors suggest that the application of the Stages of Change Model, including the use of motivation interviewing and cognitive-behavioral techniques, may encourage lifestyle change and treatment adherence and assist in preparing patients for transition to the adult health care setting.