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。在南卡罗来纳州，非洲裔美国人占等待名单的80%以上，获得了一半的身体肾脏。造成这种差异的一个主要原因是非裔美国人社区的器官捐赠率很低。尽管活体移植为患有终末期肾病的非裔美国人提供了最佳的治疗选择，但非洲裔美国人移植的肾脏中只有13%来自活体捐赠者。在身体捐赠的背景下，黑人社区对器官捐赠存在几个公认的障碍，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人活体器官捐赠的特定障碍可以通过积极的干预计划来识别和克服，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中活体捐赠者移植的具体障碍。其次，正在接受肾脏移植评估的非裔美国人终末期肾病患者将被随机分为对照组或干预组。对照组中的非洲裔美国人患者和家属将在接受评估时接受移植团队非少数族裔成员提供的标准教育。被随机分为积极干预组(AIG)的非裔美国家庭将从少数族裔护士协调员那里接受标准教育。教育工作者将确保信息的内容是统一的，并以文化敏感的方式传达。AIG的非裔美国人接受者和家庭发言人将与少数族裔协调员举行额外的教育会议。来自当地社区的前肾脏接受者和捐赠者非洲裔美国人家庭将与干预小组(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Pee Dee Health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，被确定为有严重经济困难的AIG家庭将获得诸如旅行代金券和酒店优惠券、儿童保育支助以及可能的一次性工资损失补偿等援助。预计，打破主动干预组活体器官捐献的壁垒，将显著提高捐献率。这将导致更多的非裔美国人接受肾脏移植，并提高移植肾和患者的存活率。

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.