Increasing Donation by Helping Recipients Ask

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DESCRIPTION (provided by applicant): As a Social and Health Psychologist at Washington University School of Medicine (WUSM), I am pursuing a Mentored Research Scientist Development Award (K01) in order to specialize in the clinical area of transplantation, receive scholarly training, and conduct research to increase living donation rates. I am committed to becoming an independent transplantation researcher and am supported in this goal by my proposed K01 mentors at WUSM: Barry Hong, Ph.D., a Transplant Psychologist, and Daniel Brennan, M.D., Transplant Nephrologist and Director of Barnes-Jewish Transplant Center (BJTC). I seek additional formal training in health education, survey design, advanced statistical analyses, ethics, and the clinical care of transplant patients. Building on existing collaborations and preliminary studies, the overall purpose of my proposed research project is to increase living donation rates by assisting kidney recipients in asking living donors to donate. My past research has shown that many kidney recipients are very uncomfortable discussing living donation with prospective donors and, because of this discomfort, will not consider living donation. The national availability of living donor kidneys is limited because willing living donors are never asked. Targeted health education for living donors has already been shown to increase living donation rates significantly. Education that ethically and effectively increases recipients' comfort asking living donors may be a second way to increase living donation. Utilizing kidney recipients from BJTC, the proposed K01 research project has three aims: Aim 1: To determine which factors predict recipient discomfort in asking living donors to donate and whether level of discomfort predicts recipients' time to transplantation. Aim 2: To develop two types of health education to help recipients ask living donors to donate: (A) recipient training on how to make the donation request (i.e., the direct approach) and (B) a living donor website for the recipient to refer living donors (i.e., the indirect approach). Aim 3: To conduct a group-randomized controlled trial of 225 potential recipients to compare the effectiveness of the direct and indirect educational approaches compared to standard-of-care on three important outcomes: recipient comfort asking, number of living donors evaluated, and number of recipients transplanted. At the conclusion of this project, I will have developed and validated two health education interventions that may help recipients ask living donors to donate. I also will have collected pilot data for a future R01 submission.