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

项目摘要 活体供肾移植(LDKT)是治疗终末期肾病增多的最佳方法。 生命的长度和质量，然而它被极大地未得到利用，使成千上万的移植患者处于 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 以证据为基础的教育和外联工具，以克服实质性的信息障碍和帮助 从他们的社交网络中识别并招募活的捐赠者。长期目标是设计一种教育 这项战略旨在增加获得肾移植的机会，从而减少与肾脏疾病相关的发病率和死亡率。 此R01应用程序的目标是通过一种 基于网络的教育干预(KidneyTIME)以前由Co-Pis开发。虽然建议的 干预是循证的和有希望的，需要与对照相比进行有效性测试 在更大规模的评估之前的情况。我们的中心假设是，移植候选者最常 在向他们展示KidneyTIME教育时，让他们的社交网络参与有关LDKT的信息 干预。本研究将追求三个具体目标：(1)比较肾小球滤过率的影响 常规护理以改善移植患者LDKT知识、态度和外展行为，(2) 评估KidneyTIME与常规护理对潜在活体捐赠者询问捐献的影响，以及(3) 识别和比较KidneyTIME与常规护理对激活领悟社会支持的影响 在考虑LDKT时，在移植候选者中。对于第一个目标，经过验证的调查措施将评估 LDKT知识、关注度、就绪性、沟通自我效能感和外展行为 在暴露后2周、6个月和12个月。对于第二个目的，对在世捐赠者的估计查询 将获得基线后12个月的数据。对于第三个目标，多变量回归模型评估 同时，领悟到的社会支持将探索最佳的干预成分、剂量、调节剂、 和实时捐赠者询问的互动，以及嵌入的定性过程评估将用于 审查干预的可持续性、其所处的上下文范围，以及对 干预。提出的研究具有创新性，因为它改变了当前干预研究的范式 为了增加获得LDKT的机会，从主要依赖同步教育到移植候选人 转向一种异步学习方法，以促进对其他人进行关于LDKT的教育。建议数 研究在提供基于网络的教育方面具有重要意义，这是一种激活社交网络扩展的方法 这最终可能是增加获得LDKT的机会所必需的。我们预期的结果是知道如何 通过有关LDKT的教育有效地接触到候选人及其社交网络，以增加获得LDKT的机会。 这项拟议的研究与国家糖尿病、消化和肾脏疾病研究所有关。 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.