Increasing Live Donor Kidney Transplantation Through Video-based Education and Mobile Communication

项目摘要 活体供肾移植（LDKT）是终末期肾病的最佳治疗方法， 生命的长度和质量，但它是大大利用不足，使成千上万的移植候选人在 过早死亡的不必要风险。有证据表明，移植候选人需要更好地获得 循证教育和推广工具，以克服他们的重大信息障碍， 从他们的社交网络中识别和招募活体捐赠者。长期目标是设计一种教育 因此，需要制定一项战略，以增加获得LDKT的机会，并在此过程中减少与肾脏疾病有关的发病率和死亡率。 R 01申请的目的是通过以下方式增加移植候选者对LDKT的接受性： 基于网络的教育干预（KidneyTIME）先前由Co-PI开发。虽然拟议 干预是有证据的和有希望的，它需要与对照相比进行有效性测试。 在进行大规模评估之前。我们的中心假设是，移植候选人通常 当向他们提供KidneyTIME教育时，让他们的社交网络了解LDKT的信息 干预本研究将追求3个具体目标：（1）确定KidneyTIME的效果， 对患者的护理，以改善移植候选人LDKT知识，态度和外展行为，（2） 评估KidneyTIME与肾脏护理相比对潜在活体捐献者询问捐献的影响，以及（3） 识别并比较KidneyTIME与肾脏护理对感知社会支持激活的影响 在考虑LDKT时，对于第一个目标，经过验证的调查措施将评估 LDKT知识，关注，准备，沟通自我效能和立即外展行为， 暴露后2周、6个月和12个月。对于第二个目标，估计活体捐赠者的查询， 12-将获得基线后的月数。对于第三个目标，多变量回归模型评估 感知社会支持同时将探索最佳干预成分，剂量，调节剂， 和互动，以及嵌入式定性过程评估将用于 检查干预的可持续性，在多大程度上它是在上下文中定位，以及潜在的完善， 干预这项研究的创新之处在于它改变了目前干预研究的范式 增加获得LDKT的机会，从主要依赖同步教育到移植候选人 采取异步学习方法，促进对其他人进行关于LDKT的教育。拟议 研究在提供基于网络的教育方面具有重要意义，这种教育可以激活社会网络外展， 这最终可能是增加获得LDKT的机会所必需的。我们期望的结果是知道如何 有效地向候选人及其社会网络提供有关LDKT的教育，以增加获得LDKT的机会。 这项拟议中的研究与国家糖尿病、消化和肾脏疾病研究所的研究有关。 使命是开展和资助肾脏疾病研究，以改善人们的健康和生活质量。

Project Summary Living-donor kidney transplantation (LDKT) is the optimal treatment for end-stage kidney disease to increase length and quality of life, yet it is vastly underutilized, putting thousands of transplant candidates at unnecessary risk for premature death. Evidence indicates that transplant candidates need better access to evidence-based education and outreach tools to overcome their substantial informational barriers and help identify and recruit live donors from their social networks. The long-term goal is to devise an educational strategy to increase access to LDKT and, in doing so, reduce kidney disease-related morbidity and mortality. The objective of this R01 application is to increase receptivity to LDKT among transplant candidates through a web-based educational intervention (KidneyTIME) previously developed by the Co-PIs. Although the proposed intervention is evidence-informed and promising, it needs to be effectiveness-tested compared with a control condition prior to larger-scale evaluation. Our central hypothesis is that transplant candidates will most often engage their social networks with information about LDKT when presented with the KidneyTIME educational intervention. The research study will pursue 3 specific aims: (1) determine the effects of KidneyTIME compared to Usual Care to improve transplant candidate LDKT knowledge, attitudes, and outreach behaviors, (2) evaluate the effects of KidneyTIME compared to Usual Care on potential live donor inquiries to donate, and (3) identify and compare the effects of KidneyTIME versus Usual Care on activation of perceived social support among transplant candidates when considering LDKT. For the first aim, validated survey measures will assess LDKT knowledge, concerns, readiness, communication self-efficacy, and outreach behaviors immediately and at 2-weeks, 6-months, and 12-months post-exposure. For the second aim, estimates of living donor inquiries at 12-months post-baseline will be obtained. For the third aim, multivariate regression models that assess perceived social support simultaneously will explore optimal intervention components, dosage, moderators, and interactions on live donor inquiries, and an embedded qualitative process evaluation will be used to examine intervention sustainability, extent to which it is contextually situated, and potential refinements to the intervention. The proposed research is innovative in that it shifts the current paradigm of intervention research to increase access to LDKT from a primary reliance on synchronous education to transplant candidates towards an asynchronous learning approach that facilitates education of others about LDKT. The proposed research is significant in providing web-based education that activates social network outreach—an approach that ultimately may be necessary to increase access to LDKT. Our expected outcome is knowledge of how to effectively reach candidates and their social network with education about LDKT to increase access to LDKT. The proposed research is relevant to the National Institute of Diabetes and Digestive and Kidney Diseases’ mission to conduct and fund research on kidney diseases to improve people’s health and quality of life.