Communicating about Choices in Transplantation: An Educational Intervention

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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.