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Enhancing Kidney Donation Through Live Organ Video Educated Donors (LOVED)

通过受过教育的活体器官视频捐赠者加强肾脏捐赠（喜爱）

基本信息

批准号：
9132776
负责人：
PRABHAKAR K BALIGA
金额：
$ 25.81万
依托单位：
MEDICAL UNIVERSITY OF SOUTH CAROLINA
依托单位国家：
美国
项目类别：
财政年份：
2012
资助国家：
美国
起止时间：
2012-09-30 至 2018-01-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9132776
关键词：
Address Adherence African American Attitude Behavior Behavioral Cadaver Chronic Kidney Failure Clip Communication Communities Data Development Diagnosis Dialysis procedure Discrimination Disease Drops Education Effectiveness Electronic Mail End stage renal failure Ethnic Origin Evaluation Feedback Focus Groups Fostering Health Health Care Costs Health Personnel Health Technology High Prevalence Home environment Hospitals Intervention Kidney Kidney Transplantation Life Linguistics Living Donors Longevity Medical Motivation Organ Outcome Participant Patient-Focused Outcomes Patients Perception Phase Process Program Acceptability Provider Quality of life Randomized Randomized Controlled Trials Recommendation Research Research Methodology Risk Self Efficacy South Carolina Staging Technology Text Time Transplantation Trust Universities Videoconferences Videoconferencing Work arm base coping mechanism cultural competence design dosage early onset experience health disparity indexing innovation literacy mHealth meetings patient oriented preference primary outcome programs screening secondary outcome shared decision making standard of care theories tool willingness

项目摘要

DESCRIPTION (provided by applicant): Chronic Kidney Disease is diagnosed in four times as many African Americans (AAs) as Whites and nearly twice as many AAs perish from the condition. Kidney transplantation offers the best outcomes for patients with End Stage Renal Disease (ESRD) but rates of procurement far outnumber cadaver organ availability, especially among AAs. A superior option is living donor kidney transplantation (LDKT). Since AAs comprise only 18.5% of LDKT recipients, innovative and culturally preferred strategies are needed to increase LDKT within the AA community. We hypothesize that a patient-centered, two tiered culturally sensitive education/motivation intervention targeting AA ESRD patients and potential donors (PDs) using mobile health (mHealth) technology will result in: 1) increased ESRD patients' willingness to ask for donation; 2) increased number of PDs who complete medical evaluation; and, 3) increased number of LDKTs. We will leverage mHealth technology as the delivery mechanism to maximize large scale dissemination potential. Guided by behavioral change and technology acceptability theories, the Live Organ Video Educated Donor [LOVED] program will be developed to address two domains. LOVED I will be tailored for AA ESRD patients and navigated by an AA LDKT recipient. LOVED II will be tailored for potential LDKT donors and navigated by an AA LDKT donor. iPad program delivery will include testimonial audio/video clips, home-work assignments, videoconferencing, chat room sessions, and text/emails. The proposed mixed methods research utilizes qualitative and quantitative studies in a 3 phase process of development that will involve: 1) Development of LOVED I and II technical content and delivery formats guided by behavioral and technological theories using 9 focus groups (8 per group) of AA LDKT recipients/donors, ESRD LDKT eligible patients, PDs who failed to complete screening and transplant healthcare provider team. 2) Conduct 3 month LOVED I and II proof of concept studies (LOVED I = 24 LDKT eligible patients; LOVED II = 24 PDs who did not complete screening) to assess program acceptability, feasibility, changes in self efficacy and attitudes. Also assessed will be % ESRD patients who identify PDs, % PDs who complete screening, % LDKTs and participants' perceptions of cultural competence of intervention including levels of trust, discrimination, shared decision making and literacy. 3) Conduct two 6 month 2-arm randomized control trials (LOVED I vs. standard of care, N=60; LOVED II vs. standard of care, N=80) to generate estimates needed for design of a large scale RCT.

描述（由申请人提供）：慢性肾脏病被诊断为四倍于白人的非洲裔美国人（AAs），几乎两倍于白人的AAs死于这种疾病。肾移植为终末期肾病（ESRD）患者提供了最佳结局，但采购率远远超过尸体器官可用性，特别是在AA中。一个上级选择是活体供肾移植（LDKT）。由于AA仅占LDKT接受者的18.5%，因此需要创新和文化上优先的战略来增加AA社区内的LDKT。我们假设，针对AA ESRD患者和使用移动的健康（mHealth）技术的潜在捐赠者（PD）的以患者为中心的两级文化敏感的教育/激励干预将导致：1）增加ESRD患者要求捐赠的意愿; 2）增加完成医学评估的PD数量; 3）增加LDKT数量。我们将利用移动医疗技术作为交付机制，以最大限度地发挥大规模传播的潜力。在行为变化和技术可接受性理论的指导下，活体器官视频教育捐赠者[LOVED]计划将开发用于解决两个领域。LOVED I将为AA ESRD患者量身定制，并由AA LDKT接受者导航。LOVED II将为潜在的LDKT供体量身定制，并由AA LDKT供体导航。iPad程序交付将包括证明音频/视频剪辑，家庭作业，视频会议，聊天室会议，和文本/电子邮件。拟议的混合方法研究在3个阶段的开发过程中利用定性和定量研究，将涉及：1）在行为和技术理论的指导下，使用AA LDKT受体/供体、ESRD LDKT合格患者、未能完成筛选的PD和移植医疗保健提供者团队的9个焦点小组（每组8人）开发LOVED I和II技术内容和交付形式。2)进行为期3个月的LOVED I和II概念验证研究（LOVED I = 24例符合LDKT条件的患者; LOVED II = 24例未完成筛选的PD），以评估项目的可接受性、可行性、自我效能和态度的变化。还将评估确定PD的ESRD患者%、完成筛查的PD %、LDKT %和参与者对干预的文化能力的看法，包括信任、歧视、共同决策和识字水平。3)进行两项6个月2组随机对照试验（LOVED I与标准治疗，N=60; LOVED II与标准治疗，N=80），以生成设计大规模RCT所需的估计值。