NAVIGATE: Transition Coaching to build health literacy, self-advocacy and healthy lifestyle behaviours for Queensland Adolescents with Aacquired Brain Injury and their caregivers.

Phase 1: Information Gathering - a comprehensive needs assessment will be undertaken with young people with ABI, caregivers, clinicians and stakeholders to understand transition experiences, identify service gaps and inform the development of a Queensland specific ABI transition model and resources. Please note Phase 1 is NOT an intervention. Phase 2: Co-Design. (Please note Phase 2 is not an intervention). Phase 2 is a structured co-design process to adapt evidence-based ABI transition programs for the Queensland context and develop the Queensland ABI Transition Model, Transition Protocol Toolkit, training resources, and implementation strategies. Who delivers it and their relevant expertise? - Project investigators and facilitators with expertise in ABI rehabilitation, co-design methodology, implementation science, and transition care. Participants include young people with ABI, caregivers, clinicians, service providers, and consumer representatives. How is it delivered? - Structured co-design workshops involving collaborative discussion, prioritisation activities, review of evidence, and adaptation of program components. How often and for how long? Three co-design workshops. Each workshop is anticipated to run for approximately 2 to 4 hours. Delivered over a 2-month period (Months 4-6 of the project). Where is it delivered? - Face-to-face at participating health service or community venues, online via videoconference, or using a hybrid format. Adherence (e.g. reminders, monitoring) - Workshop attendance will be monitored and participants will receive meeting invitations, agendas, and reminders. Workshop outputs and participation will be documented by the research team. Participants in Phase 2 will not be involved in Phase 3. Phase 3: Transition Program Implementation What is the intervention? - The Queensland ABI Transition Program, comprising structured transition support for adolescents with moderate-to-severe ABI moving from paediatric to adult services. The program is expected to include transition coaching, transition planning, educational resources, care coordination processes, clinician support, and use of the Queensland ABI Transition Toolkit developed during Phases 1 and 2. Who delivers it and their relevant expertise? - Paediatric Rehabilitation allied health clinicians with expertise in acquired brain injury and transition care, Providers will receive training in the Queensland ABI Transition Model and associated resources. How is it delivered? Individual transition coaching and planning sessions Care coordination activities - Individualised transition planning, referral facilitation, liaison with paediatric and adult healthcare providers, coordination of community supports, service navigation support, and monitoring of progress towards transition goals. Delivered throughout the intervention period as required Educational and self-management resources - study-specific educational materials and self-management resources developed through a co-design process, including worksheets, visual aids, transition planning tools, session summaries and health education materials to support transition readiness, self-management and service navigation. Provided throughout the intervention period. Communication and support involving adolescents, caregivers, and clinicians - Motivational Interviewing-based transition coaching, health education, goal setting, self-advocacy training, family support, service liaison and, where required, targeted psychological support. Delivered through one initial session, up to 12 coaching sessions over 6 months, and one follow-up session 3 months post-intervention. Delivery may occur face-to-face, by telehealth, or through a combination of both. How often and for how long? - The duration of the transition program for participants is approximately 9 months in total. The final frequency and duration will be determined through the co-design process. At this stage, participants will receive 1 initial session (up to 2 hours), up to 12 transition coaching sessions (typically 45-60 minutes with flexibility up to 1-2 hours per session) and ongoing care coordination, education and support activities as needed. There will also be 1 follow up session approximately 3 months after completion of the intervention period. The number and duration of contacts will be recorded and monitored during implementation. Where is it delivered? - Queensland Health outpatient and rehabilitation services, community settings, and participants' homes via telehealth where appropriate. Adherence (e.g. reminders, monitoring) - Participant engagement will be monitored through attendance records, completion of transition planning activities, and utilisation of program resources. Appointment reminders, follow-up contact from clinicians and Nurse Navigators, and routine monitoring of intervention fidelity will be used to support adherence. Phase 4: Translation and Evaluation The Queensland ABI Transition Program will be evaluated to assess its implementation, acceptability, feasibility and potential for wider adoption, with findings used to refine transition pathways, workforce training and future service delivery. Please note Phase 4 is NOT an intervention.