---
title: "COCCOS study protocol: evaluating a co-designed transition program for AYAs with chronic conditions"
id: "pubmed-42607051"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42607051"
content_type: "clinical_feed_article"
specialty: "Pharmacology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42607051/"
doi: "10.1371/journal.pone.0353932"
published_at: "2026-08-17T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# COCCOS study protocol: evaluating a co-designed transition program for AYAs with chronic conditions
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42607051
- **Specialty:** [Pharmacology](https://medichelpline.com/clinical-feed/pharmacology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42607051/)
- **DOI:** [10.1371/journal.pone.0353932](https://doi.org/10.1371%2Fjournal.pone.0353932)
- **Published At:** 2026-08-17T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- The COCCOS study is a multicentric quasi-experimental pretest-posttest protocol evaluating a co-designed **healthcare transition program (TP)** for adolescents and young adults (AYAs) with chronic conditions in two Belgian university hospitals. - Target participants are AYAs aged 17–18 years with **type 1 diabetes**, **asthma**, or **obesity**. Participants will be allocated to either the COCCOS intervention or usual care (control). - The intervention comprises four structured consultations delivered over 13–16 months, with content focused on transition preparation, fostering autonomy, and supporting continuity of care during transfer from paediatric to adult services. - The primary outcome is **transition readiness**, measured with the **Transition Readiness Assessment Questionnaire**. Secondary outcomes include patient empowerment, medication adherence, health-related quality of life, and mental health. - Data collection points are baseline, at transfer, and four months post-transfer. A health economic analysis will assess cost-effectiveness from a healthcare payer perspective using **quality-adjusted life years (QALYs)**. - A mixed-methods process evaluation will examine implementation fidelity, acceptability, and contextual influences using observations, surveys, and interviews. - The study is registered on ClinicalTrials.gov (NCT07145671). The protocol aims to generate evidence on feasibility, preliminary effectiveness, cost-effectiveness, and implementation to inform programme refinement and the design of a future large-scale trial. - The authors report no competing interests. The full trial is reported as an open-access protocol in PLoS One, with affiliations across Ghent University, University of Antwerp, Antwerp University Hospital, and Ghent University Hospital.
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Affiliations Expand ### Affiliations * 1 Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium. * 2 Department of Nursing and Midwifery, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium. * 3 Department of Pediatrics, Antwerp University Hospital, Antwerp, Belgium. * 4 Laboratory of Experimental Medicine and Pediatrics (LEMP), University of Antwerp, Antwerp, Belgium. * 5 Ghent University Hospital, Ghent, Belgium. * 6 Department of Patient Care, Antwerp University Hospital, Antwerp, Belgium. * PMID: **42607051** * DOI: [ 10.1371/journal.pone.0353932 ](https://doi.org/10.1371/journal.pone.0353932) Item in Clipboard Multicenter Study # The COCCOS study: A protocol for a multicentric quasi-experimental study of a healthcare transition program for young people with chronic conditions Lisa Van Wilder et al. PLoS One. 2026. Show details Display options Display options Format Abstract PubMed PMID PLoS One Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22PLoS+One%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22PLoS+One%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42607051/) . 2026 Aug 17;21(8):e0353932. doi: 10.1371/journal.pone.0353932. eCollection 2026. ### Authors [Lisa Van Wilder](https://pubmed.ncbi.nlm.nih.gov/?term=Van+Wilder+L&cauthor_id=42607051)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42607051/#short-view-affiliation-1 "Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium."), [Natwarin Janssens](https://pubmed.ncbi.nlm.nih.gov/?term=Janssens+N&cauthor_id=42607051)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42607051/#short-view-affiliation-1 "Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42607051/#short-view-affiliation-2 "Department of Nursing and Midwifery, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium."), [Kim Van Hoorenbeeck](https://pubmed.ncbi.nlm.nih.gov/?term=Van+Hoorenbeeck+K&cauthor_id=42607051)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42607051/#short-view-affiliation-3 "Department of Pediatrics, Antwerp University Hospital, Antwerp, Belgium.")[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42607051/#short-view-affiliation-4 "Laboratory of Experimental Medicine and Pediatrics \(LEMP\), University of Antwerp, Antwerp, Belgium."), [Karsten Vanden Wyngaert](https://pubmed.ncbi.nlm.nih.gov/?term=Vanden+Wyngaert+K&cauthor_id=42607051)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42607051/#short-view-affiliation-5 "Ghent University Hospital, Ghent, Belgium."), [Eva Goossens](https://pubmed.ncbi.nlm.nih.gov/?term=Goossens+E&cauthor_id=42607051)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42607051/#short-view-affiliation-1 "Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.")[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42607051/#short-view-affiliation-6 "Department of Patient Care, Antwerp University Hospital, Antwerp, Belgium."), [Delphine De Smedt](https://pubmed.ncbi.nlm.nih.gov/?term=De+Smedt+D&cauthor_id=42607051)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42607051/#short-view-affiliation-1 "Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.") ### Affiliations * 1 Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium. * 2 Department of Nursing and Midwifery, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium. * 3 Department of Pediatrics, Antwerp University Hospital, Antwerp, Belgium. * 4 Laboratory of Experimental Medicine and Pediatrics (LEMP), University of Antwerp, Antwerp, Belgium. * 5 Ghent University Hospital, Ghent, Belgium. * 6 Department of Patient Care, Antwerp University Hospital, Antwerp, Belgium. * PMID: **42607051** * DOI: [ 10.1371/journal.pone.0353932 ](https://doi.org/10.1371/journal.pone.0353932) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Introduction:** The growing number of adolescents and young adults (AYAs) living with chronic conditions highlights the need for effective healthcare transition programmes (TPs) to support the transfer from paediatric to adult care. Despite existing recommendations, many AYAs experience inadequate preparation, resulting in disrupted care and adverse health outcomes. The COCCOS project developed a co-designed TP to address these challenges. This study presents the protocol for an evaluation of this programme. **Methods and analysis:** A multicentric quasi-experimental pretest-posttest study will be conducted in two Belgian university hospitals. AYAs aged 17-18 years with type 1 diabetes, asthma, or obesity will be recruited into an intervention group receiving the COCCOS TP or a control group receiving usual care. The intervention consists of four structured consultations over 13-16 months, focusing on transition preparation, autonomy, and continuity of care. Primary outcome is transition readiness, measured using the Transition Readiness Assessment Questionnaire. Secondary outcomes include patient empowerment, medication adherence, health-related quality of life, and mental health. Data will be collected at baseline, transfer, and four months post-transfer. Cost-effectiveness will be assessed from a healthcare payer perspective using quality-adjusted life years. A mixed-methods process evaluation will examine implementation fidelity, acceptability, and contextual factors through observations, surveys, and interviews. The study is registered on ClinicalTrials.gov under identifier [NCT07145671](http://clinicaltrials.gov/show/NCT07145671 "See in ClinicalTrials.gov"). **Discussion and conclusion:** This study will provide comprehensive evidence on the feasibility, preliminary effectiveness, cost-effectiveness, and implementation of a co-designed TP in real-world clinical practice. By integrating clinical, economic, and process outcomes, it addresses key gaps in transitional care research. Findings will inform refinement of the programme and the design of a future large-scale trial, contributing to the development of sustainable, patient-centred transition care for AYAs with chronic conditions. Copyright: © 2026 Van Wilder et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Conflict of interest statement The authors have declared that no competing interests exist. ## Publication types * Multicenter Study Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Multicenter+Study%22%5Bpt%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Multicenter+Study) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42607051/) ## MeSH terms * Adolescent Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Adolescent%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Adolescent) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42607051/) * Asthma / therapy Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Asthma%2Ftherapy%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Asthma) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42607051/) * Belgium Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Belgium%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Belgium) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42607051/) * Chronic Disease / therapy Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Chronic+Disease%2Ftherapy%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Chronic+Disease) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42607051/) * Cost-Benefit Analysis Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Cost-Benefit+Analysis%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Cost-Benefit+Analysis) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42607051/) * Diabetes Mellitus, Type 1 / therapy Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Diabetes+Mellitus%2C+Type+1%2Ftherapy%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Diabetes+Mellitus%2C+Type+1) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42607051/) * Female Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Female%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Female) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42607051/) * Humans Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Humans%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Humans) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42607051/) * Male Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Male%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Male) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42607051/) * Obesity / therapy Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Obesity%2Ftherapy%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Obesity) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42607051/) * Quality of Life Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Quality+of+Life%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Quality+of+Life) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42607051/) * Transition to Adult Care* Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Transition+to+Adult+Care%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Transition+to+Adult+Care) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42607051/) * Young Adult Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Young+Adult%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Young+Adult) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42607051/) ## Associated data * ClinicalTrials.gov/NCT07145671 Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=NCT07145671%5BSecondary+Source+ID%5D "Search in PubMed") * [ Search in ClinicalTrials.gov ](http://clinicaltrials.gov/show/NCT07145671 "Search in ClinicalTrials.gov") [x] Cite Copy Download .nbib .nbib Format: AMA APA MLA NLM **Send To**
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