Reducing Racial Disparities in Access to Kidney Transplantation: the RaDIANT Regional Study

 描述（由申请人提供）：东南部肾移植（SEKTx）联盟是肾脏疾病社区合作伙伴之间的学术-社区合作，他们的共同目标是消除生活在格鲁吉亚、北卡罗来纳州和南卡罗来纳州的非裔美国人终末期肾病（ESRD）在获得肾移植方面的健康差异。这个以社区为基础的联盟的志愿者成员包括终末期肾病和移植患者、透析设施工作人员和提供者、移植中心、质量改进组织和患者倡导组织。CKD和ESRD的负担在东南部最高，但肾移植率在全国最低。此外，我们的研究表明，获得移植的种族差异集中在东南部，非洲裔美国人（AA）不太可能获得移植过程中的每一步。2014年，我们的SEKTx联盟在GA进行了一项随机多组分干预（减少肾移植机会的差异[RaDIANT]）社区研究，GA是全国肾移植率最低的州，包括以患者和提供者为中心的教育和参与干预措施，旨在增加AA ESRD患者的移植评估转诊。这项研究是有效的，以改善转介肾移植AA在GA中，但努力改善获得肾移植必须扩大超越GA，并应包括干预措施，目标是超越转诊到移植中心的医疗评估的步骤。SEKTx联盟的长期目标是消除肾移植过程中每一步的种族差异。我们的目标是：具体目标1。确定GA、NC和SC透析患者肾移植医学评估中种族差异的原因。具体目标2：在GA、NC和SC实施RaDIANT区域研究，目标是提高转诊率、医学评估率和等待率，并减少差异 在这些关键步骤中。具体目标3：对RaDIANT区域研究干预措施进行过程和结果评价。该提案的总体影响是改善东南部AA ESRD人群的移植机会，并减少移植中的健康差异。

 DESCRIPTION (provided by applicant): The Southeastern Kidney Transplant (SEKTx) Coalition is an academic-community collaboration between partners in the kidney disease community who share the common goal of eliminating health disparities in access to kidney transplantation among African American End Stage Renal Disease (ESRD) living in Georgia, North Carolina, and South Carolina. Volunteer members of this community-based coalition include ESRD and transplant patients, dialysis facility staff and providers, transplant centers, quality improvement organizations, and patient advocacy organizations. The burden of CKD and ESRD is highest in the Southeast, and yet the rate of kidney transplantation is the lowest in the nation. Further, our research suggests that racial disparities in access to transplant are concentrated in the Southeast, where African Americans (AA) are less likely to access each step in the transplant process. In 2014, our SEKTx Coalition conducted a randomized, multicomponent intervention (Reducing Disparities In Access to kidNey Transplantation [RaDIANT]) Community Study in GA, the state with the lowest kidney transplant rates in the nation, consisting of patient- and provider-focused educational and engagement interventions designed to increase referral for transplant evaluation among AA ESRD patients. This study was effective in improving referral for kidney transplantation among AA in GA, but efforts to improve access to kidney transplantation must be expanded beyond GA and should include interventions targeting steps beyond referral to the medical evaluation at the transplant center. The long-term goal of the SEKTx Coalition is to eliminate racial disparities in every step of the kidney transplant process. Our Specific Aims are: Specific Aim 1. Determine reasons for racial disparities in medical evaluation for kidney transplantation among dialysis patients in GA, NC and SC. Specific Aim 2: Implement the RaDIANT Regional Study in GA, NC, and SC with the goal of increasing rates of referral, medical evaluation, and waitlisting, and reducing disparities in these key steps. Specific Aim 3: Conduct a process and outcome evaluation of the RaDIANT Regional Study interventions. The overall impact of this proposal is to improve transplant access among the AA ESRD population in the Southeast and reduce health disparities in transplantation.