CONTEXT: Given the shortage of kidneys available for transplantation, a community-based intervention trial was implemented to assess the impact of an educational program on patients' access to live donor kidney transplantation (LDKT). OBJECTIVE: To compare the short-term impact of a basic intervention and an enhanced intervention on patients' readiness to pursue LDKT. DEGISN: Baseline data and data from 1 week after interventions were analyzed. PARTICIPANTS: 214 transplant-eligible hemodialysis patients attending 14 dialysis facilities in Maryland, Virginia, and Pennsylvania. INTERVENTIONS: In the basic intervention, 107 patients watched a 10-minute videotape on the experience of recipients and live donors of a kidney. In the enhanced intervention, 107 patients watched the same videotape and had a discussion with a health educator on the risks and benefits of LDKT, who could be a donor, and how to address the barriers they were encountering when seeking a live kidney donor. MAIN OUTCOME MEASURE: Patient reported whether they were considering LDKT, had talked with family or friends about LDKT, and had asked someone for a kidney. RESULTS: Over half of transplant-eligible patients were not pursuing LDKT at baseline (64% in the basic intervention group, 61% in the enhanced intervention group). One week after the intervention, the odds of considering LDKT were higher among African Americans (odds ratio [OR], 2.28; confidence interval [CI], 1.22-4.25), younger patients (OR, 0.94; CI, 0.91-0.97), and patients who spent less time on dialysis (OR, 0.90; CI, 0.83-0.97). The odds of asking for a kidney were higher among African Americans (OR, 4.94; CI, 2.54-9.60) and patients who perceived they were in poor to fair health (OR, 3.30; CI, 1.12-9.67). CONCLUSIONS: Although both interventions helped patients consider LDKT and ask for a kidney, more time and expanded educational content might be needed to facilitate patients' discussion about LDKT with their loved ones.
CONTEXT: Given the shortage of kidneys available for transplantation, a community-based intervention trial was implemented to assess the impact of an educational program on patients' access to live donor kidney transplantation (LDKT). OBJECTIVE: To compare the short-term impact of a basic intervention and an enhanced intervention on patients' readiness to pursue LDKT. DEGISN: Baseline data and data from 1 week after interventions were analyzed. PARTICIPANTS: 214 transplant-eligible hemodialysis patients attending 14 dialysis facilities in Maryland, Virginia, and Pennsylvania. INTERVENTIONS: In the basic intervention, 107 patients watched a 10-minute videotape on the experience of recipients and live donors of a kidney. In the enhanced intervention, 107 patients watched the same videotape and had a discussion with a health educator on the risks and benefits of LDKT, who could be a donor, and how to address the barriers they were encountering when seeking a live kidney donor. MAIN OUTCOME MEASURE: Patient reported whether they were considering LDKT, had talked with family or friends about LDKT, and had asked someone for a kidney. RESULTS: Over half of transplant-eligible patients were not pursuing LDKT at baseline (64% in the basic intervention group, 61% in the enhanced intervention group). One week after the intervention, the odds of considering LDKT were higher among African Americans (odds ratio [OR], 2.28; confidence interval [CI], 1.22-4.25), younger patients (OR, 0.94; CI, 0.91-0.97), and patients who spent less time on dialysis (OR, 0.90; CI, 0.83-0.97). The odds of asking for a kidney were higher among African Americans (OR, 4.94; CI, 2.54-9.60) and patients who perceived they were in poor to fair health (OR, 3.30; CI, 1.12-9.67). CONCLUSIONS: Although both interventions helped patients consider LDKT and ask for a kidney, more time and expanded educational content might be needed to facilitate patients' discussion about LDKT with their loved ones.
Authors: James R Rodrigue; Matthew J Paek; Jesse D Schold; Martha Pavlakis; Didier A Mandelbrot Journal: J Racial Ethn Health Disparities Date: 2016-09-08
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