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Comparing the effectiveness of house calls and peer mentorship to reduce racial disparities in live donor kidney transplantation
Investigator (PI): Rodrigue, James R
Performing Organization (PO): (Current): Beth Israel Deaconess Medical Center, Transplant Institute / (617) 632-9700
Supporting Agency (SA): Patient-Centered Outcomes Research Institute (PCORI)
Initial Year: 2018
Final Year: 2022
Record Source/Award ID: PCORI/AD-1609-36589
Funding: Total Award Amount: $1,789,919
Award Type: Contract
Award Information: PCORI: More information and project results (when completed)
Abstract: Adults with kidney failure have two treatment options for survival dialysis (a machine that filters harmful wastes, salt, and excess fluid from the blood) or a kidney transplant. For those who are eligible, a kidney transplant allows patients to live longer and healthier lives compared to dialysis. Patients are encouraged to find a living donor for their kidney transplant because that kidney usually lasts much longer than a kidney from someone who has died. While a live donor kidney transplant (LDKT) is the best option, minorities (especially blacks) are much less likely than whites to receive a LDKT. There are many possible reasons for this racial disparity, including the difficulty patients have asking others to consider being a living donor. One educational approach (Transplant "House Calls"), developed by our team, has been shown to increase the rate of LDKTs in adults with kidney failure by sending a health educator to the patient's home to provide transplant and living donation information to the patient and to members of his/her social network. However, the House Calls program has not been as effective with black patients, compared to white patients. Our patient stakeholders suggested that this may be because House Calls have not included peer mentors, someone who has been through the LDKT process. We are proposing a study that will compare three strategies for helping black patients increase their chances of a LDKT: usual care, House Calls, and House Calls + Peer Mentorship. In most kidney transplant programs in the United States, patients receive information about the benefits of LDKT from their kidney doctors in the transplant clinic (usual care). House Calls involve delivering a 90-minute educational session in the patient's home, with family and friends present. Peer Mentorship matches patients with a peer mentor (someone who had kidney failure and received a LDKT) to provide emotional support and guidance throughout the transplant process. Our study will determine whether the Peer Mentorship program improves the House Calls intervention for black patients with kidney failure awaiting a transplant. Racial disparities persist in access to the best treatment for kidney failure (i.e., LDKT) and this study will determine if these two approaches combined can increase the likelihood of black patients receiving a LDKT. We have consulted with our patient advisory group and the National Kidney Foundation in the development and design of this study. Indeed, the idea to combine House Calls and Peer Mentorship started with discussions we have had with patients who participated in our past studies. The National Kidney Foundation developed a peer mentoring program and their guidance will be instrumental in helping us throughout the study. Our patient advisory group also will help us to refine our study protocol, identify effective recruitment strategies, interpret our findings, and make sure that other patients and organizations learn from our study.
MeSH Terms:
  • African Americans
  • Comparative Effectiveness Research
  • Ethnic Groups
  • Foundations
  • Health Status Disparities
  • * Healthcare Disparities
  • * House Calls
  • Humans
  • Kidney Transplantation /*methods
  • /psychology
  • Living Donors
  • * Mentors
  • Minority Groups
  • Patient Education as Topic /methods
  • Patient Participation
  • * Peer Group
  • Renal Insufficiency /*ethnology
  • /psychology /*surgery
  • United States
Country: United States
State: Massachusetts
Zip Code: 02215
UI: 20181369
CTgovId: NCT03354910
Project Status: Ongoing
Record History: ('2018: Start date changed from 2017 to 2018 and project extended to 2022.',)