Reducing disparities in living donor transplant among African Americans
减少非裔美国人活体捐赠者移植方面的差异
基本信息
- 批准号:9919556
- 负责人:
- 金额:$ 23.11万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2017
- 资助国家:美国
- 起止时间:2017-08-01 至 2022-05-31
- 项目状态:已结题
- 来源:
- 关键词:AchievementAcuteAfrican AmericanBehavioralClinicalCommunicationComplementCost SavingsCountryCoupledDataDialysis procedureDonor personDoseEducationEducational BackgroundEducational InterventionEducational MaterialsEducational StatusEnd stage renal failureEnvironmentEvaluationFamilyFriendsFundingGoalsGraft SurvivalGrantHealth Care CostsHealth systemIndividualInterventionIntervention StudiesKidneyKidney TransplantationKnowledgeLightLiving DonorsMediatingModelingMotivationNational Institute of Diabetes and Digestive and Kidney DiseasesOnline SystemsOutcomePamphletsParticipantPathway interactionsPatientsProcessProviderPublic HealthQuality of lifeRandomizedRandomized Controlled TrialsRecordsResearchSamplingSelf EfficacySouth CarolinaSoutheastern United StatesSystemTestingTimeTransplant RecipientsTransplantationUnited StatesUnited States Health Resources and Services AdministrationVisionWait TimeWaiting Listsbehavior changecomparison interventiondisparity reductionfollow up assessmentfollow-uphealth disparityhospitalization ratesinsightinterestintervention effectliving kidney donoroptimal treatmentsprimary outcomeprogramsracial disparityrecruitsecondary analysissecondary outcomeskillsstatisticsstemtransplant centerstrial designweb site
项目摘要
Abstract
For most of the patients in the United States with end stage renal disease (ESRD), kidney transplantation
represents the optimal treatment. Moreover, living donor kidney transplantation (LDKT) offers numerous
advantages over deceased donor kidney transplant such as better kidney quality, increased short- and long-
term graft survival, lower rates of acute rejection, and reduced health care cost. Nevertheless, there are
pervasive racial disparities in access to LDKT, with white ESRD patients four times more likely to receive a
LDKT than African American ESRD patients. The long-term objective of this program of research is to
understand the combined effect of a systems-level intervention that enhances communication between dialysis
facility and transplant center clinicians (Transplant Referral EXchange or T-REX) and a culturally-sensitive
individual-level educational intervention (web-based Living ACTS: About Choices in Transplantation and
Sharing) on racial disparities in access to LDKT. The specific aims of the study are: (a) To develop and refine
a web-based version of Living ACTS; (b) To conduct an outcome evaluation of the newly created web-based
Living ACTS intervention by comparing the percent of patients with at least one inquiry from a potential living
donor among patients who receive Living ACTS compared to those who receive a control website with an
embedded educational video; and (c) To conduct a process evaluation of the newly created web-based Living
ACTS intervention by adapting commonly used process evaluation constructs (context, reach, dose received,
fidelity, and recruitment) for an online environment.
We will conduct a randomized controlled trial among a sample of 800 African American ESRD patients in the
southeastern United States (ESRD Network 6 in Georgia and South Carolina), the region of the country with
the largest proportion of African American ESRD patients on the waiting list. Patients will be randomly
assigned to one of two study conditions (intervention or control). Participants at all four collaborating transplant
centers will be seen by providers who utilize T-REX, thus allowing us to test the independent effect of
individual-level education on a systems-level intervention. The primary outcome is the percent of patients with
at least one living donor inquiry. Secondary outcomes will test the effect of the intervention on key constructs
of the Information-Motivation-Behavioral Skills model to determine possible mediating pathways. Participants
will undergo baseline assessment, access either the intervention or control educational materials, and
complete an immediate follow-up assessment. Living donor inquiries will be examined over the subsequent 12
months. The process evaluation will utilize transplant center administrative records, immediate follow-up data
from participants, website usage statistics, and study records. It is anticipated that achievement of these aims
will yield outcomes with great clinical and public health impact.
抽象的
对于美国大多数患有终末期肾病 (ESRD) 的患者来说,肾移植
代表最佳治疗。此外,活体肾移植(LDKT)提供了许多
与已故供体肾移植相比的优势,例如更好的肾脏质量、增加的短期和长期肾移植
移植物足月存活、急性排斥反应率降低以及医疗费用降低。尽管如此,还是有
在获得 LDKT 方面存在普遍的种族差异,白人 ESRD 患者接受治疗的可能性是其他患者的四倍
LDKT 高于非裔美国 ESRD 患者。该研究计划的长期目标是
了解增强透析之间沟通的系统级干预的综合效果
机构和移植中心的临床医生(移植转介交换或 T-REX)以及具有文化敏感性的人员
个人层面的教育干预(基于网络的 Living ACTS:关于移植和移植的选择)
分享)关于获得 LDKT 的种族差异。研究的具体目标是: (a) 开发和完善
Living ACTS 的网络版本; (b) 对新创建的网络进行成果评价
生活 ACTS 干预,通过比较至少接受过一次潜在生活询问的患者百分比
接受 Living ACTS 的患者与接受对照网站的患者的捐赠者相比
嵌入式教育视频; (c) 对新创建的网络生活进行过程评估
通过采用常用的过程评估结构(背景、范围、接受的剂量、
保真度和招聘)用于在线环境。
我们将对美国 800 名非裔美国 ESRD 患者进行随机对照试验
美国东南部(乔治亚州和南卡罗来纳州的 ESRD 网络 6),该国的地区
等候名单上非裔美国 ESRD 患者所占比例最大。患者将被随机
分配给两种研究条件之一(干预或对照)。所有四次合作移植的参与者
使用 T-REX 的提供商将看到中心,从而使我们能够测试 T-REX 的独立效果
系统级干预的个体级教育。主要结果是患有以下疾病的患者的百分比
至少进行一次活体捐赠者询问。次要结果将测试干预措施对关键结构的影响
信息-动机-行为技能模型以确定可能的中介途径。参加者
将接受基线评估,获取干预或对照教育材料,并且
立即完成后续评估。活体捐赠者询问将在接下来的 12 年内进行审查
几个月。过程评估将利用移植中心的管理记录、即时后续数据
来自参与者、网站使用统计数据和研究记录。预计这些目标的实现
将产生具有巨大临床和公共卫生影响的结果。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Kimberly Ruth Jacob Arriola其他文献
Kimberly Ruth Jacob Arriola的其他文献
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{{ truncateString('Kimberly Ruth Jacob Arriola', 18)}}的其他基金
Mitigating the Effects of Structural Racism on Chronic Kidney Disease Disparities among African Americans
减轻结构性种族主义对非裔美国人慢性肾病差异的影响
- 批准号:
10742680 - 财政年份:2023
- 资助金额:
$ 23.11万 - 项目类别:
Reducing disparities in living donor transplant among African Americans
减少非裔美国人活体捐赠者移植方面的差异
- 批准号:
10202568 - 财政年份:2017
- 资助金额:
$ 23.11万 - 项目类别:
Enhancing the Effectiveness of a Culturally Sensitive Organ Donation Intervention
提高文化敏感器官捐献干预措施的有效性
- 批准号:
7930187 - 财政年份:2009
- 资助金额:
$ 23.11万 - 项目类别:
Project ACTS II: Increasing Donor Registration among African Americans
项目 ACTS II:增加非裔美国人的捐助者登记
- 批准号:
8513980 - 财政年份:2007
- 资助金额:
$ 23.11万 - 项目类别:
Project ACTS II: Increasing Donor Registration among African Americans
项目 ACTS II:增加非裔美国人的捐助者登记
- 批准号:
8371082 - 财政年份:2007
- 资助金额:
$ 23.11万 - 项目类别:
Project ACTS II: Increasing Donor Registration among African Americans
项目 ACTS II:增加非裔美国人的捐助者登记
- 批准号:
9062436 - 财政年份:2007
- 资助金额:
$ 23.11万 - 项目类别:
Enhancing the Effectiveness of a Culturally Sensitive Organ Donation Intervention
提高文化敏感器官捐献干预措施的有效性
- 批准号:
7900367 - 财政年份:2007
- 资助金额:
$ 23.11万 - 项目类别:
Enhancing the Effectiveness of a Culturally Sensitive Organ Donation Intervention
提高文化敏感器官捐献干预措施的有效性
- 批准号:
7337850 - 财政年份:2007
- 资助金额:
$ 23.11万 - 项目类别:
Enhancing the Effectiveness of a Culturally Sensitive Organ Donation Intervention
提高文化敏感器官捐献干预措施的有效性
- 批准号:
7668594 - 财政年份:2007
- 资助金额:
$ 23.11万 - 项目类别:
Project ACTS II: Increasing Donor Registration among African Americans
项目 ACTS II:增加非裔美国人的捐助者登记
- 批准号:
8880184 - 财政年份:2007
- 资助金额:
$ 23.11万 - 项目类别:
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