A pilot to develop and test an Interactive Computer-adaptive Chronic Kidney Disease education program for hospitalized African American patients (I-C-CKD)

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PROJECT SUMMARY African Americans with chronic kidney disease (CKD) experience disparities in the quality of their medical care, self-care and preparation for end stage renal disease (ESRD). Patient education can help African American patients with advanced CKD decide to engage in self-care to delay progression to ESRD and to learn about ESRD treatment options. Hospitalization represents a “missed opportunity” to provide CKD education and ESRD planning to help patients make informed choices about their care that align with their preferences. Many patients are hospitalized within three months of dialysis initiation. The hospital also captures patients who are not otherwise well-linked to the medical system. In prior work, our team developed and implemented a culturally-tailored, multi-modality patient education intervention for hospitalized African American patients with advanced CKD using a racially concordant in-person educator and literacy-sensitive education materials. Our intervention was feasible and effective. However, using an in-person patient educator is resource-intensive. In this proposal, we will develop an interactive, computer adaptive patient education intervention that benefits from the convenience of electronic media with the patient-centered benefits of an in-person educator. We will also determine the efficacy of the computer-adaptive education in improving knowledge for hospitalized African American patients with advanced chronic CKD as compared to usual care. We have assembled a strong team with skills in chronic kidney disease health disparities, hospital-based interventions, culturally-tailored patient- education, motivational interviewing, and technology-based interventions for patient education. This R21 pilot and feasibility trial will enable the team to build and test the efficacy and acceptability of the computer-adaptive education intervention prior to a larger scale randomized R01-level study.