Patient Referral and Education Program prior to Renal Replacement Therapy (PREP RRT) - Resubmission 01

 描述（由申请人提供）：肾脏替代治疗前的患者转诊和教育计划（PREP RRT）肾脏替代治疗（RRT）前的患者教育可减少中心静脉导管的使用，改善自我护理透析（如腹膜透析）的可及性，并增加移植的可及性。这些方法中的每一种都已被证明可以降低终末期肾病（ESRD）患者的发病率和死亡率，并改善其生活质量。非裔美国人在透析开始前接受肾脏护理的可能性低于白色人。非裔美国人也不太可能有瘘透析，选择腹膜透析，并出现在肾移植等待名单。住院治疗可能意味着“错失了提供RRT教育和计划的机会”，以帮助患者根据自己的偏好做出明智的护理选择。许多患者在透析开始后三个月内住院。医院也可能捕获 与医疗系统没有良好联系的患者。此外，文化定制 通过病人叙述的健康教育信息已被发现是一种有效的手段，增加知识和激励非洲裔美国病人的行为改变。因此，我的目标是制定、实施和评价一项以患者为中心的RRT（PREP RRT）转诊和教育计划，该计划将面对面教育与针对晚期慢性肾脏病住院非洲裔美国患者的文化定制患者叙述视频相结合。为了有效地实现这些目标，我将通过课程和导师制发展定性研究，健康教育设计和行为干预方面的专业知识。我组建了一个指导和研究委员会，该委员会在减少健康差距、定性方法、医院干预、多媒体教育干预和慢性肾病方面具有专门知识。我还将完成健康研究，社会学和公共卫生相关的调查研究，定性分析和行为改变干预的伊利诺伊大学学院的部门的课程。通过该项目的成功实施，我们的目标是减少健康差距，降低终末期肾病患者的发病率、死亡率和卫生保健利用率。

 DESCRIPTION (provided by applicant): Patient Referral and Education Program prior to Renal Replacement Therapy (PREP RRT) Patient education prior to renal replacement therapy (RRT) leads to reduced central venous catheter use, improved access to self-care dialysis such as peritoneal dialysis, and increased access to transplantation. Each of these modalities has been shown to reduce morbidity and mortality and to improve quality of life for patients with end-stage renal disease (ESRD). African Americans are less likely than their White counterparts to receive nephrology care prior to dialysis initiation. African Americans are also less likely to hav a fistula for dialysis, to select peritoneal dialysis, and to appear on the renal transplant waitlit. Hospitalization may represent a "missed opportunity" to provide RRT education and 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 may also capture patients who are not otherwise well-linked to the medical system. In addition, culturally-tailoring of health education messages through patient narratives has been found to be an effective means of increasing knowledge and motivating behavior change in African American patients. Therefore, I aim to develop, implement, and evaluate a patient-centered referral and education program for RRT (PREP RRT) that incorporates in- person education with a video of culturally-tailored patient narratives for hospitalized African American patients with advanced chronic kidney disease. To effectively implement these goals, I will develop expertise in qualitative research, health education design and behavioral interventions through coursework and mentorship. I have assembled a mentorship and research committee with expertise in reducing health disparities, qualitative methods, hospital-based interventions, multi-media education interventions and chronic kidney disease. I also will complete coursework in the Departments of Health Studies, Sociology and at the University of Illinois School of Public Health related to Survey Research, Qualitative Analysis and Behavior Change Interventions. Through successful implementation of this project, we aim to reduce health disparities and to decrease morbidity, mortality and health care utilization in patients with ESRD.