A Culturally Targeted Transplant Program to Increase Live Donation in Hispanics
旨在增加西班牙裔活体捐赠的文化针对性移植计划
基本信息
- 批准号:9893861
- 负责人:
- 金额:$ 64.48万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2016
- 资助国家:美国
- 起止时间:2016-03-20 至 2022-08-31
- 项目状态:已结题
- 来源:
- 关键词:AccountingAddressAfrican AmericanBeliefBusinessesCaringChicagoClient satisfactionClinicalCommunicationCommunitiesDialysis patientsEducationEnd stage renal failureEvaluationFamilyFrightGraft SurvivalHealthHigh PrevalenceHispanicsHome environmentHuman ResourcesImmigrantInterventionIntervention StudiesKidneyKidney TransplantationKnowledgeLanguageLatin AmericanLatinoLearningLife ExpectancyLinguisticsLos AngelesMedia CampaignMedicalMedicineMethodsMinority GroupsModelingNeeds AssessmentNot Hispanic or LatinoOperative Surgical ProceduresOrganOrgan TransplantationOutcomePatient EducationPatientsPersonal SatisfactionPhysiciansProtocols documentationPublishingQuality of lifeResearchSiteSocial WorkersTransplant RecipientsTransplantationUnited StatesUniversitiesWait TimeWaiting Listsbasebilingualismbudget impactcostcultural valuesethnic minority populationexperienceimprovedinnovationinterestintervention programliving kidney donornovel strategiesoutreachoutreach programpatient populationpreferenceprogramspublic health relevanceracial and ethnicsatisfactiontransplant centerstransplant modeltreatment choice
项目摘要
DESCRIPTION (provided by applicant): The shortage of organs for kidney transplantation for patients with end-stage renal disease (ESRD) is magnified in Hispanics/Latin Americans. Hispanics have a disproportionately higher prevalence of ESRD, yet receive fewer kidney transplants compared to non-Hispanic whites. Living donor kidney transplant (LDKT) is the treatment of choice for ESRD as it confers better patient and graft survival, shorter waiting time,
and better quality of life than deceased donor kidney transplantation. However, compared to their representation on the waiting list, fewer Hispanics received a LDKT than non-Hispanic whites in 2013: 4 percent versus 10 percent. Barriers to LDKT for Hispanics include: lack of knowledge, cultural concerns, and language barriers. The disparity will likely worsen without intervention as Hispanics are the largest and fastest growing minority group in the US. Few available culturally competent interventions have led to increased LDKT rates. Interventions rarely address Hispanic cultural concerns, and there are no published models of transplant center-based only programs. The Chicago Northwestern Medicine's(r) Hispanic Kidney Transplant Program (HKTP), a culturally and linguistically competent program, has increased Hispanic LDKTs. The mean annual ratio of Hispanic to non-Hispanic white LDKTs grew from 0.20 in 2001-2006 to 0.34 in 2008-2013, a 70 percent increase (p<0.001). The objective of this study is to implement and evaluate the HKTP, a culturally-competent transplant center-based intervention, at two transplant centers serving large Hispanic populations (Dallas, TX, and Los Angeles, CA), with Northwestern University serving as the Study Coordinating Center. The pre-post HKTP intervention study will evaluate the effect of the HKTP's key culturally sensitive components (outreach, communication, education) on Hispanic LDKT rates, compared to matched controls. The specific aims are to: 1. Implement the HKTP at two transplant centers by conducting a needs assessment of barriers and using a "learning collaborative" model to deliver HKTP protocols, scripts, and materials. 2. Conduct a pre-post HKTP intervention evaluation with matched controls to assess if the HKTP is associated with an increase in: a) the ratio of Hispanic to non-Hispanic white LDKTs as a function of an absolute increase in Hispanic LDKTs, b) ESRD Hispanic patient additions to the waiting list, c) Hispanic potential donors per potential recipient, and d) Hispanic patients' satisfaction with care. 3. Formatively evaluate the fidelity and innovative adaptations to HKTP's outreach, communication, and education at both study sites to identify effective components of the HTKP, using mixed methods. As an exploratory aim, a budget impact analysis will be conducted to construct a business case for transplant centers and permit estimates of HKTP scalability. The proposed study will provide valuable knowledge about the potential to rapidly disseminate the HKTP as a novel approach to increase Hispanic LDKTs nationally, improve health outcomes for Hispanics, and close the LDKT disparity gap.
描述(由申请人提供):在西班牙裔/拉丁美洲人中,终末期肾病(ESRD)患者的肾移植器官短缺情况更为严重。西班牙裔人的ESRD患病率不成比例地高,但与非西班牙裔白人相比,接受的肾移植较少。活体供肾移植(LDKT)是ESRD的首选治疗方法,因为它可以提高患者和移植物的存活率,缩短等待时间,
和更好的生活质量比死亡供体肾移植。然而,与他们在等候名单上的代表相比,2013年西班牙裔获得LDKT的人数少于非西班牙裔白人:4%对10%。拉丁美洲裔的障碍包括:缺乏知识,文化问题和语言障碍。如果不进行干预,这种差距可能会恶化,因为拉美裔是美国最大和增长最快的少数民族。 几乎没有文化上可行的干预措施导致了LDKT比率的增加。干预措施很少解决西班牙裔的文化问题,也没有公布的移植中心为基础的唯一程序的模型。芝加哥西北医学部的(r)西班牙裔肾移植计划(HKTP),一个文化和语言能力强的计划,增加了西班牙裔LDKT。西班牙裔与非西班牙裔白色LDKT的平均年比率从2001-2006年的0.20增长到2008-2013年的0.34,增长了70%(p<0.001)。 本研究的目的是实施和评估HKTP,一个文化能力移植中心为基础的干预,在两个移植中心服务于大型西班牙裔人口(达拉斯,德克萨斯州和洛杉矶,加利福尼亚州),与西北大学作为研究协调中心。前后HKTP干预研究将评估HKTP的关键文化敏感的组成部分(外展,沟通,教育)对西班牙裔LDKT率的影响,与匹配的控制。具体目标是:1.在两间移植中心推行香港移植计划,评估需要,并采用“学习合作”模式,提供香港移植计划的方案、脚本和材料。 2.使用匹配对照进行HKTP干预前后评价,以评估HKTP是否与以下增加相关:a)西班牙裔与非西班牙裔白色LDKT的比率(作为西班牙裔LDKT绝对增加的函数),B)ESRD西班牙裔患者增加到等候名单,c)西班牙裔潜在供体/潜在受体,以及d)西班牙裔患者对护理的满意度。 3.采用混合方法,正式评估两个研究地点在香港主题公园的外展、沟通和教育方面的忠诚度和创新适应性,以确定HTKP的有效组成部分。 作为探索性目标,将进行预算影响分析,以构建移植中心的商业案例,并允许估计HKTP的可扩展性。拟议的研究将提供有关快速传播HKTP作为一种新方法的潜力的宝贵知识,以增加西班牙裔LDKT全国,改善西班牙裔的健康结果,并缩小LDKT差距。
项目成果
期刊论文数量(5)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
Preoperative portal vein recanalization-transjugular intrahepatic portosystemic shunt for chronic obliterative portal vein thrombosis: Outcomes following liver transplantation.
- DOI:10.1002/hep4.1914
- 发表时间:2022-07
- 期刊:
- 影响因子:5.1
- 作者:
- 通讯作者:
Implementation and modification of an organizational-level intervention: a prospective analysis.
- DOI:10.1186/s43058-022-00296-0
- 发表时间:2022-06-03
- 期刊:
- 影响因子:0
- 作者:
- 通讯作者:
Implementing culturally competent transplant care and implications for reducing health disparities: A prospective qualitative study.
- DOI:10.1111/hex.13124
- 发表时间:2020-12
- 期刊:
- 影响因子:0
- 作者:Gordon EJ;Romo E;Amórtegui D;Rodas A;Anderson N;Uriarte J;McNatt G;Caicedo JC;Ladner DP;Shumate M
- 通讯作者:Shumate M
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Juan C Caicedo其他文献
Juan C Caicedo的其他文献
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{{ truncateString('Juan C Caicedo', 18)}}的其他基金
A Culturally Targeted Transplant Program to Increase Live Donation in Hispanics
旨在增加西班牙裔活体捐赠的文化针对性移植计划
- 批准号:
9028726 - 财政年份:2016
- 资助金额:
$ 64.48万 - 项目类别:
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