Culturally Targeted Education on Living Kidney Donation

美国印第安人和阿拉斯加原住民（Al/AN）经历了不成比例的终末期肾功能衰竭负担。 疾病，主要是由于任何种族或少数民族的2型糖尿病患病率最高 美国的人口。有许多社会文化，地理和经济障碍， 为急性肾衰竭/急性肾衰竭患者提供活体肾脏捐赠和移植教育。这些障碍必须 采用相关的、基于理论的和文化衍生的方法来解决基于透析中心的教育 对于可能仍然符合移植资格的AI/AN患者。该提案的目的是发展和 检查一种新的针对AI/AN肾的文化LKDT教育干预的初步结果 没有被排除移植资格的透析患者。人际干预 将LKDT教育与人口的口头讲故事传统相结合。有三个总体目标： (1)进行形成性研究，评估AI/AN对LKDT的知识，态度和信念 透析病人(2)为AI/AN透析患者制定针对文化的干预措施，重点是 有关捐赠灵粮堂的知识，以及如何与家人讨论捐赠灵粮堂的事宜。(3)进行 一组随机测试的干预，并检查其效果的结果，知识的LKDT 与家人的相关谈话。该计划由部落研究协调员提供 该设计是一项两组随机试验（N = 100），采用基于社区的 参与式研究方法。为合格AI/AN患者提供服务的透析中心将随机分配至 实验干预或延迟干预控制。作为研究协调员的部落成员将 进行互动式干预。LKDT知识的主要结果在基线时测量， 干预暴露后（或无暴露）。进行LKDT对话的动机准备阶段 与家庭的对话和实际的家庭对话都使用分级算法来测量。这一创新 接触可能符合移植条件的透析患者的方法具有扩散的潜力， 与不同的AI/AN部落甚至其他共享类似健康差异的少数群体进行复制。

American Indians and Alaska Natives (Al/ANs) experience a disproportionate burden of end stage renal disease, primarily due to having the highest prevalence of type 2 diabetes of any racial or ethnic minority population in the United States. There are many sociocultural, geographic, and economic barriers to receiving education on living kidney donation and transplantation (LKDT) for Al/ANs. These barriers must be addressed with a relevant, theory-based and culturally-derived approach to dialysis center based education for AI/AN patients who may still be eligible for transplant. The purpose of this proposal is to develop and examine the preliminary outcomes of a new culturally-targeted LKDT educational intervention for AI/AN renal dialysis patients who have not been ruled out for transplant eligibility. The interpersonal intervention integrates LKDT education with the population's oral tradition of story-telling. There are three overall aims: (1) Conduct a formative study to assess the knowledge, attitudes, and beliefs about LKDT among AI/AN dialysis patients. (2) Develop a culturally-targeted intervention for AI/AN dialysis patients focused on knowledge of LKDT and how to have a conversation with family members about living donation. (3) Conduct a group randomized test of the intervention and examine its effect on the outcomes of knowledge of LKDT and related conversations with family members. The program is delivered by tribal research coordinators through dialysis sites.The design is a two-group randomized trial (N = 100) that employs a community-based participatory research approach. Dialysis sites that serve eligible AI/AN patients will be randomized to the experimental intervention or delayed intervention control. Tribal members who are research coordinators will deliver the interactive intervention. The primary outcome of LKDT knowledge is measured at baseline and after intervention exposure (or no exposure). Stage of motivational readiness to have a LKDT conversation with family and actual family conversations are both measured using a staging algorithm. This innovative approach to reaching dialysis patients who may be transplant eligible has the potential for diffusion and replication with diverse AI/AN tribes and even other minoritv populations who share similar health disparities.