A Program to Increase Living Donations in African Ameri*

描述（由申请人提供）： 尽管医疗保险基金提供了财政保证，但在肾移植方面仍然存在种族差异。非洲裔美国人占南卡罗来纳州等候名单的80%以上，并获得一半的尸体肾脏采购。造成这种差异的一个主要原因是非洲裔美国人社区的器官捐赠率很低。虽然活体移植为患有终末期肾病的非洲裔美国人患者提供了最佳治疗选择，但非洲裔美国人中只有13%的移植肾来自活体供体。在尸体捐赠的背景下，黑人社区的器官捐赠有几个公认的障碍，但关于活体器官捐赠的信息很少。我们的总体假设是，非裔美国人肾移植受者及其家属的活体器官捐赠的具体障碍可以通过积极的干预计划来确定和克服，并将导致活体器官捐赠率的显着提高。首先将进行一项调查，以确定非洲裔美国人社区活体供体移植的具体障碍。其次，正在接受肾移植评估的终末期肾病非裔美国患者将被随机分配到对照组或干预组。对照组中的非裔美国人患者和家庭将在接受者评估时接受移植团队的非少数民族成员提供的标准教育。随机分配到积极干预组（AIG）的非裔美国人家庭将接受少数民族护士协调员的标准教育。教育工作者将确保信息内容统一，并以文化敏感的方式传达。AIG非裔美国人受益人和家庭发言人将与少数族裔协调员举行额外的教育会议。来自当地社区的以前的肾脏接受者和捐赠者非裔美国人家庭将与干预组（AIG）的接受者和家庭会面。来自地区健康教育联盟、国家肾脏基金会、少数民族皮迪健康和生命礼物基金会的当地志愿者将提供社区支持，鼓励活体器官捐赠。除了教育干预措施外，经确认有严重经济困难的美国国际集团家庭将获得援助，如旅行券和酒店优惠券、儿童保育支助，并可能一次性补偿工资损失。预计在积极干预组中打破活体器官捐赠的障碍将显著提高捐赠率。这将导致更多的非洲裔美国人接受肾移植，提高移植和患者的生存率。

DESCRIPTION (provided by applicant): Racial disparities continue to exist in kidney transplantation despite the financial assurances provided by Medicare funding. African Americans make up more than 80% of the waiting list in South Carolina and receive half the cadaver kidneys procured. A major reason for this discrepancy is the poor organ donation rate in the African American community. Although living-donor transplantation offers the best therapeutic option for African American patients with end stage renal disease, only 13% of the transplanted kidneys in African Americans are from live donors. There are several recognized barriers to organ donation in the black community in the context of cadaver donation, but there is a paucity of information about live organ donation. Our overall hypothesis is that specific barriers to live organ donation in African American kidney transplant recipients and their families can be identified and overcome by an active intervention program and will lead to significantly improved live organ donation rates. A survey will first be conducted to identify specific barriers to live donor transplants in the African American community. Secondly, African American patients with end stage renal disease who are being evaluated for a kidney transplant will be randomized into a control or intervention group. African American patients and families in the control group will receive standard education provided by a non-minority member of the transplant team at the time of recipient evaluation. African American families randomized to the active intervention group (AIG) will receive the standard education from a minority nurse coordinator. An educator will ensure that content of information is uniform and is conveyed in a culturally sensitive manner. The AIG African American recipient and the family spokesperson will have additional educational sessions with the minority coordinator. Previous kidney recipient and donor African American families from the local community will meet with the recipients and families of the intervention group (AIG). Local volunteers from Area Health Education Consortium, National Kidney Foundation, Minority Pee Dee Health and Gift of Life Foundation will provide community support encouraging live organ donation. In addition to the educational interventions, AIG families identified as having significant financial hardships will be offered assistance such as travel vouchers and hotel coupons, child care support and possibly a one time reimbursement for loss of pay. It is expected that breaking down the barriers to live organ donation in the active intervention group will significantly increase donation rates. This will result in more number of African Americans receiving kidney transplants and improved graft and patient survival.