Elisa J Gordon1, Min-Woong Sohn, Chih-Hung Chang, Gwen McNatt, Karina Vera, Nicole Beauvais, Emily Warren, Roslyn B Mannon, Michael G Ison. 1. 1 Center for Healthcare Studies, Northwestern University Feinberg School of Medicine, Chicago, IL. 2 Comprehensive Transplant Center, Northwestern University Feinberg School of Medicine, Chicago, IL. 3 Center for Bioethics and Medical Humanities, Northwestern University Feinberg School of Medicine, Chicago, IL. 4 Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA. 5 Rehabilitation Institute of Chicago, Chicago, IL. 6 Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL. 7 Kovler Organ Transplantation Center, Northwestern Memorial Hospital, Chicago, IL. 8 Abdominal Transplant Operations, University of Minnesota Medical Center-Solid Organ Transplantation, Minneapolis, MN. 9 Department of Medicine, Division of Nephrology, Department of Surgery, Division of Transplantation, Comprehensive Transplant Institute, University of Alabama at Birmingham, Birmingham, AL.
Abstract
BACKGROUND:Kidney transplant candidates (KTCs) must provide informed consent to accept kidneys from increased risk donors (IRD), but poorly understand them. We conducted a multisite, randomized controlled trial to evaluate the efficacy of a mobile Web application, Inform Me, for increasing knowledge about IRDs. METHODS:Kidney transplant candidates undergoing transplant evaluation at 2 transplant centers were randomized to use Inform Me after routine transplant education (intervention) or routine transplant education alone (control). Computer adaptive learning method reinforced learning by embedding educational material, and initial (test 1) and additional test questions (test 2) into each chapter. Knowledge (primary outcome) was assessed in person after education (tests 1 and 2), and 1 week later by telephone (test 3). Controls did not receive test 2. Willingness to accept an IRD kidney (secondary outcome) was assessed after tests 1 and 3. Linear regression test 1 knowledge scores were used to test the significance of Inform Me exposure after controlling for covariates. Multiple imputation was used for intention-to-treat analysis. RESULTS:Two hundred eighty-eight KTCs participated. Intervention participants had higher test 1 knowledge scores (mean difference, 6.61; 95% confidence interval [95% CI], 5.37-7.86) than control participants, representing a 44% higher score than control participants' scores. Intervention participants' knowledge scores increased with educational reinforcement (test 2) compared with control arm test 1 scores (mean difference, 9.50; 95% CI, 8.27-10.73). After 1 week, intervention participants' knowledge remained greater than controls' knowledge (mean difference, 3.63; 95% CI, 2.49-4.78) (test 3). Willingness to accept an IRD kidney did not differ between study arms at tests 1 and 3. CONCLUSIONS: Inform Me use was associated with greater KTC knowledge about IRD kidneys above routine transplant education alone.
RCT Entities:
BACKGROUND: Kidney transplant candidates (KTCs) must provide informed consent to accept kidneys from increased risk donors (IRD), but poorly understand them. We conducted a multisite, randomized controlled trial to evaluate the efficacy of a mobile Web application, Inform Me, for increasing knowledge about IRDs. METHODS: Kidney transplant candidates undergoing transplant evaluation at 2 transplant centers were randomized to use Inform Me after routine transplant education (intervention) or routine transplant education alone (control). Computer adaptive learning method reinforced learning by embedding educational material, and initial (test 1) and additional test questions (test 2) into each chapter. Knowledge (primary outcome) was assessed in person after education (tests 1 and 2), and 1 week later by telephone (test 3). Controls did not receive test 2. Willingness to accept an IRD kidney (secondary outcome) was assessed after tests 1 and 3. Linear regression test 1 knowledge scores were used to test the significance of Inform Me exposure after controlling for covariates. Multiple imputation was used for intention-to-treat analysis. RESULTS: Two hundred eighty-eight KTCs participated. Intervention participants had higher test 1 knowledge scores (mean difference, 6.61; 95% confidence interval [95% CI], 5.37-7.86) than control participants, representing a 44% higher score than control participants' scores. Intervention participants' knowledge scores increased with educational reinforcement (test 2) compared with control arm test 1 scores (mean difference, 9.50; 95% CI, 8.27-10.73). After 1 week, intervention participants' knowledge remained greater than controls' knowledge (mean difference, 3.63; 95% CI, 2.49-4.78) (test 3). Willingness to accept an IRD kidney did not differ between study arms at tests 1 and 3. CONCLUSIONS: Inform Me use was associated with greater KTC knowledge about IRD kidneys above routine transplant education alone.
Authors: Paul Kinnersley; Katie Phillips; Katherine Savage; Mark J Kelly; Elinor Farrell; Ben Morgan; Robert Whistance; Vicky Lewis; Mala K Mann; Bethan L Stephens; Jane Blazeby; Glyn Elwyn; Adrian G K Edwards Journal: Cochrane Database Syst Rev Date: 2013-07-06
Authors: Elisa J Gordon; Elizabeth Reddy; Daniela P Ladner; John Friedewald; Michael M Abecassis; Michael G Ison Journal: Clin Transplant Date: 2011-10-14 Impact factor: 2.863
Authors: Dean J Wantland; Carmen J Portillo; William L Holzemer; Rob Slaughter; Eva M McGhee Journal: J Med Internet Res Date: 2004-11-10 Impact factor: 5.428
Authors: Jessica K Stevenson; Zoe C Campbell; Angela C Webster; Clara K Chow; Allison Tong; Jonathan C Craig; Katrina L Campbell; Vincent Ws Lee Journal: Cochrane Database Syst Rev Date: 2019-08-06
Authors: Courtenay M Holscher; Mary G Bowring; Christine E Haugen; Sheng Zhou; Allan B Massie; Sommer E Gentry; Dorry L Segev; Jacqueline M Garonzik Wang Journal: Transplantation Date: 2019-10 Impact factor: 4.939
Authors: Rachel E Patzer; Laura McPherson; Mohua Basu; Sumit Mohan; Michael Wolf; Mariana Chiles; Allison Russell; Jennifer C Gander; John J Friedewald; Daniela Ladner; Christian P Larsen; Thomas Pearson; Stephen Pastan Journal: Am J Transplant Date: 2018-03-26 Impact factor: 8.086
Authors: Noel Engels; Gretchen N de Graav; Paul van der Nat; Marinus van den Dorpel; Anne M Stiggelbout; Willem Jan Bos Journal: BMJ Open Date: 2022-09-21 Impact factor: 3.006
Authors: Johanna Glaser; Sarah Nouri; Alicia Fernandez; Rebecca L Sudore; Dean Schillinger; Michele Klein-Fedyshin; Yael Schenker Journal: Med Decis Making Date: 2020-01-16 Impact factor: 2.583
Authors: Amy D Waterman; John D Peipert; Yujie Cui; Jennifer L Beaumont; Andrea Paiva; Amanda F Lipsey; Crystal S Anderson; Mark L Robbins Journal: Am J Transplant Date: 2020-09-15 Impact factor: 8.086