Communicating about Choices in Transplantation: An Educational Intervention

描述(由申请人提供)：目前有超过111,000名美国人正在等待实体器官移植，其中约89,000人需要可移植的肾脏。与持续透析或已故供者移植(DDT)相比，活体供者移植(LDT)具有更好的患者和移植物存活率。虽然移植中心通常会向新列入名单的候选人提供关于移植的基本教育，但肾移植候选人追求LDT的一个主要障碍是缺乏与家人和朋友(例如，社交网络)的沟通。这项研究建议开发和试行一种教育干预措施，即关于移植选择的沟通(COACH)，旨在增加肾移植候选人对DDT和LDT的知识，以及他们在社交网络中讨论这些移植选择，特别是LDT的信心和能力。将召集一个社区咨询委员会(CAB)，以协助对文化敏感的Coach计划的最终设计和实施，该计划将向移植患者传授与其社交网络成员讨论LDT和DDT所需的沟通技能。COACH计划的效果将通过实验设计进行评估。具体地说，一项随机对照试验将提供关于该计划对候选人的LDT/DDT知识、沟通能力、自我效能、与家人和朋友讨论移植方案的意图以及自我报告的讨论的影响的初步数据。 LDT/DDT。在大西洋中部两个移植中心被列为肾移植候选者的个人(n=158)将被邀请参加。同意的候选人将被随机分配到两个研究部门中的一个：1)由移植中心提供的标准教育；或2)由中心提供的标准教育与COACH计划相结合。该申请有以下具体目的：目标1.开发与文化相关的沟通干预措施，以提高肾移植候选人对LDT和DDT相关过程、好处和风险的了解，并增强候选人的关系和沟通能力、自我效能、沟通恐惧以及举行移植讨论的沟通相关障碍；对该计划进行试点测试，以评估其对移植候选人的LDT和DDT知识、关系和沟通能力、自我效能、沟通相关障碍、与家人和朋友讨论移植的意图以及对两种移植方案的自我报告讨论的影响。

DESCRIPTION (provided by applicant): There are currently over 111,000 Americans awaiting a solid organ transplant, approximately 89,000 of which are in need of a transplantable kidney. As compared to sustained dialysis or deceased donor transplantation (DDT), live donor transplantation (LDT) is associated with better patient and graft survival. Although transplant centers routinely provide basic education on transplantation to newly listed candidates, a major barrier to kidney transplant candidates' pursuit of LDT is lack of communication about the topic with family members and friends (e.g., social networks). This study proposes to develop and pilot test an educational intervention, communicating about Choices in Transplantation (COACH), designed to increase kidney transplant candidates' knowledge of DDT and LDT as well as their confidence and ability discussing these transplant options, specifically LDT, within their social networks. A Community Advisory Board (CAB) will be convened to assist in the final design and implementation of the culturally-sensitive COACH Program that will teach transplant candidates the communication skills needed to discuss LDT and DDT with members of their social networks. The efficacy of the COACH Program will be evaluated using an experimental design. Specifically, a randomized, controlled trial will provide preliminary data on the effects f the program on candidates' LDT/DDT knowledge, communication competence, self-efficacy, intent to discuss their transplant options with family and friends, and self-reported discussion of LDT/DDT. Individuals (n=158) listed as candidates for kidney transplantation at two mid-Atlantic transplant centers will be invited to participate. Consenting candidates will be randomized to one of two study arms: 1) standard education provided by the transplant center; or, 2) standard education provided by the center coupled with the COACH Program. The application has the following specific aims: Aim 1. Develop a culturally-relevant communication intervention to improve kidney transplant candidates' understanding of the process, benefits and risks associated with LDT and DDT and to enhance candidates' relational and communication competence, self-efficacy, communication apprehension, and communication-related barriers to holding discussions about transplantation; Aim2. Conduct a pilot test of the program to evaluate its impact on transplant candidates' knowledge of LDT and DDT, relational and communication competence, self-efficacy, communication-related barriers, intent to discuss transplantation with family and friends, and self-reported discussion of the two transplant options.