Culturally Targeted Education on Living Kidney Donation

美国印第安人和阿拉斯加原住民(Al/ANS)经历了不成比例的终末期肾脏负担 疾病，主要是由于在任何种族或少数民族中2型糖尿病的患病率最高 美国的人口。有许多社会文化、地理和经济障碍 接受Al/ANS活体肾脏捐献和移植(LKDT)教育。这些障碍必须是 以相关的、基于理论和文化派生的方法解决以透析中心为基础的教育 对于仍有资格进行移植的AI/AN患者。这项提议的目的是发展和 检查一项针对AI/AN肾脏的新的文化定向LKDT教育干预的初步结果 未被排除移植资格的透析患者。人际干预 将LKDT教育与当地人讲故事的口头传统结合起来。总体目标有三个： (1)进行形成性研究，评估AI/AN中关于LKDT的知识、态度和信念 透析患者。(2)为AI/AN透析患者开发有文化针对性的干预 了解LKDT知识，以及如何与家人就活体捐赠进行对话。(3)品行 干预措施的团体随机检验及其对LKDT知识转归的影响 以及与家人的相关对话。该计划由部落研究协调员提供 通过透析站点。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。为符合条件的AI/AN患者提供服务的透析地点将被随机分配到 实验干预或延迟干预对照。担任研究协调员的部落成员将 提供交互式干预。LKDT知识的主要结果是在基线和 干预后暴露(或不暴露)。激励准备阶段，准备进行LKDT对话 家庭对话和实际的家庭对话都是使用分段算法来衡量的。这是一项创新 接触可能符合移植条件的透析患者的方法有可能扩散和 与不同的AI/AN部落，甚至具有相似健康差距的其他少数族裔群体进行复制。

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.