Renal transplant Equity through Partnership And Structural Transformation (REPAST)

通过伙伴关系和结构转型实现肾移植公平 (REPAST)

基本信息

  • 批准号:
    10743661
  • 负责人:
  • 金额:
    $ 85.91万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
    2023
  • 资助国家:
    美国
  • 起止时间:
    2023-09-01 至 2028-06-30
  • 项目状态:
    未结题

项目摘要

Abstract Kidney transplantation (KTx) is considered the preferred treatment for patients with end-stage kidney disease. Despite recent changes to the kidney allocation Black and Hispanic individuals are less likely to receive KTx, a multi-step process requiring patient referral, patient medical/surgical/psychosocial evaluation, and patient waitlisting. As there are no standardized acceptable metrics for psychosocial evaluations, each of steps is impacted by provider and patient bias and thwarted by social determinants often overlooked and structural racism continues to drive of racial and ethnic disparities in KTx. We have identified barriers and facilitators to evaluation and waitlisting for KTx, including provider bias, high unmet social determinants of health and symptom burden in patients on hemodialysis. To address the impact of structure racism on KTx, we now propose a multi-level intervention in full partnership with an Executive Stakeholder Board and Workgroups comprised of patients, clinicians, caregivers, advocates, and system leaders for dialysis organizations and transplant centers. This work will be built on 2 decades of community-engaged research and trials to improve health in diverse populations. We will work with the Board to develop an intervention based on past work by our team and others, supplemented by formative interview with patients, caregivers, and clinicians. To increase rates of patients receiving KTx evaluation, patient navigators who have chronic kidney disease and waitlisted for kidney transplant or are transplant recipients themselves will guide patients through the transplant evaluation process. This will include conducting a social needs screen and addressing barriers uncovered, including facilitating appointments to address unmet needs such as food insecurity and transportation, control of symptoms and mental health challenges. To increase rates of waitlisting among those evaluated, we will identify stigmatizing language from KTx providers; notes and provide an anti-bias initiative including structural changes to evaluation and education for KTx nephrologists. We will evaluate the impact of this multifactorial intervention in a clinical trial among 320 adults with an eGFR <20ml/min/1.73m2 or on in-center hemodialysis with a primary outcome of transplant waitlisting. Together, we will also develop a blueprint of how to conduct this work, so that it can be used nationally to reduce inequities and inform policies, systems and practices. Our Board will serve as a durable resource for future kidney equity work.
摘要

项目成果

期刊论文数量(0)
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Lili Chan其他文献

Lili Chan的其他文献

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{{ truncateString('Lili Chan', 18)}}的其他基金

Improving risk prediction of adverse outcomes in hemodialysis patients by incorporating non-traditional risk factors
通过纳入非传统风险因素改善血液透析患者不良结果的风险预测
  • 批准号:
    10327321
  • 财政年份:
    2021
  • 资助金额:
    $ 85.91万
  • 项目类别:
Improving risk prediction of adverse outcomes in hemodialysis patients by incorporating non-traditional risk factors
通过纳入非传统风险因素改善血液透析患者不良结果的风险预测
  • 批准号:
    10530671
  • 财政年份:
    2021
  • 资助金额:
    $ 85.91万
  • 项目类别:

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