Effect of a Mobile Web App on Kidney Transplant Candidates' Knowledge About Increased Risk Donor Kidneys: A Randomized Controlled Trial.
Effect of a Mobile Web App on Kidney Transplant Candidates' Knowledge About Increased Risk Donor Kidneys: A Randomized Controlled Trial.
复制标题
DOI：
10.1097/tp.0000000000001273
复制
发表时间：
2017-06
期刊：
影响因子：
6.2
通讯作者：
Ison MG
中科院分区：
文献类型：
--
作者：
Gordon EJ;Sohn MW;Chang CH;McNatt G;Vera K;Beauvais N;Warren E;Mannon RB;Ison MG
肾移植候选人（ktc）必须提供知情同意接受来自高风险供体（IRD）的肾脏，但对他们知之甚少。我们进行了一项多站点随机对照试验，以评估移动web应用程序Inform Me在增加对ird的了解方面的功效。在2个移植中心接受移植评估的ktc在常规移植教育（干预）或常规移植教育（对照）后随机使用Inform Me。计算机自适应学习方法通过在每章中嵌入教育材料、初始（测试1）和附加的测试问题（测试2）来加强学习。知识（主要结果）在教育结束后亲自评估（测试1和2），一周后通过电话评估（测试3）。对照组没有收到测试2。在试验1和试验3后评估接受IRD肾脏的意愿（次要结局）。在控制协变量后，使用线性回归检验1知识得分来检验Inform Me暴露的显著性。意向-治疗分析采用多重输入。288个ktc参与。干预组的Test 1知识得分高于对照组（平均差异为6.61,95% CI为5.37 ~ 7.86），比对照组高44%。与对照组测试1的得分相比，干预组参与者的知识得分随教育强化而增加（检验2）（平均差异=9.50;95% CI, 8.27-10.73）。1周后，干预参与者的知识水平仍高于对照组（平均差异=3.63;95% CI, 2.49-4.78）（检验3）。在试验1和试验3中，接受IRD肾脏的意愿在研究组之间没有差异。与常规移植教育相比，使用Inform Me与KTC对IRD肾脏的更多了解相关。
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. KTCs 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. Two hundred-eighty-eight KTCs participated. Intervention participants had higher Test 1 knowledge scores (mean difference=6.61; 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 to 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’ (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. Inform Me use was associated with greater KTC knowledge about IRD kidneys above routine transplant education alone.