Communicating about Choices in Transplantation: An Educational Intervention

交流移植的选择：教育干预

• 批准号: 8282151
• 负责人: Heather Marie Gardiner
• 金额: $ 5万
• 依托单位: VIRGINIA COMMONWEALTH UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-03-01 至 2014-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8282151
• 关键词: Communicating; about; Choices; Transplantation; Educational

DESCRIPTION (provided by applicant): There are currently over 111,000 Americans awaiting a solid organ transplant, approximately 89,000 of which are in need of a transplantable kidney. As compared to sustained dialysis or deceased donor transplantation (DDT), live donor transplantation (LDT) is associated with better patient and graft survival. Although transplant centers routinely provide basic education on transplantation to newly listed candidates, a major barrier to kidney transplant candidates' pursuit of LDT is lack of communication about the topic with family members and friends (e.g., social networks). This study proposes to develop and pilot test an educational intervention, communicating about Choices in Transplantation (COACH), designed to increase kidney transplant candidates' knowledge of DDT and LDT as well as their confidence and ability discussing these transplant options, specifically LDT, within their social networks. A Community Advisory Board (CAB) will be convened to assist in the final design and implementation of the culturally-sensitive COACH Program that will teach transplant candidates the communication skills needed to discuss LDT and DDT with members of their social networks. The efficacy of the COACH Program will be evaluated using an experimental design. Specifically, a randomized, controlled trial will provide preliminary data on the effects f the program on candidates' LDT/DDT knowledge, communication competence, self-efficacy, intent to discuss their transplant options with family and friends, and self-reported discussion of LDT/DDT. Individuals (n=158) listed as candidates for kidney transplantation at two mid-Atlantic transplant centers will be invited to participate. Consenting candidates will be randomized to one of two study arms: 1) standard education provided by the transplant center; or, 2) standard education provided by the center coupled with the COACH Program. The application has the following specific aims: Aim 1. Develop a culturally-relevant communication intervention to improve kidney transplant candidates' understanding of the process, benefits and risks associated with LDT and DDT and to enhance candidates' relational and communication competence, self-efficacy, communication apprehension, and communication-related barriers to holding discussions about transplantation; Aim2. Conduct a pilot test of the program to evaluate its impact on transplant candidates' knowledge of LDT and DDT, relational and communication competence, self-efficacy, communication-related barriers, intent to discuss transplantation with family and friends, and self-reported discussion of the two transplant options. PUBLIC HEALTH RELEVANCE: Live donor transplantation (LDT) is the preferred treatment option for the nearly 89,000 candidates awaiting kidney transplants. Many transplant candidates, however, will not receive a live donor transplant due to a reluctance to communicate about LDT with members of their social networks (e.g., family and friends). This research proposes to pilot an intervention to increase kidney transplant candidates' knowledge of both LDT and deceased-donor transplantation as well as candidates' communication about these treatment options.

描述（由申请人提供）：目前有超过 111,000 名美国人正在等待实体器官移植，其中大约 89,000 人需要可移植的肾脏。与持续透析或死者供体移植（DDT）相比，活体供体移植（LDT）与更好的患者和移植物存活相关。尽管移植中心通常会向新列入的候选者提供有关移植的基础教育，但肾移植候选者追求 LDT 的一个主要障碍是缺乏与家人和朋友（例如社交网络）就该主题进行的沟通。本研究建议开发并试点测试一种教育干预措施，交流移植选择 (COACH)，旨在提高肾移植候选者对 DDT 和 LDT 的了解，以及他们在自己的范围内讨论这些移植选择（特别是 LDT）的信心和能力。社交网络。将召集一个社区咨询委员会 (CAB)，协助文化敏感的 COACH 计划的最终设计和实施，该计划将向移植候选人传授与社交网络成员讨论 LDT 和 DDT 所需的沟通技巧。 COACH 计划的功效将通过实验设计进行评估。 具体来说，一项随机对照试验将提供初步数据，说明该计划对候选人 LDT/DDT 知识、沟通能力、自我效能、与家人和朋友讨论移植选择的意愿以及自我报告的讨论的影响。 LDT/滴滴涕。被列为大西洋中部两个移植中心肾移植候选者的个人 (n=158) 将受邀参加。同意的候选人将被随机分配到两个研究组之一：1）移植中心提供的标准教育；或者，2) 由中心提供的标准教育以及 COACH 计划。该应用程序有以下具体目标： 目标 1. 制定与文化相关的沟通干预措施，以提高肾移植候选人对 LDT 和 DDT 相关过程、益处和风险的理解，并提高候选人的关系和沟通能力、自我效能、沟通忧虑以及进行有关移植讨论的沟通相关障碍；目标2。对该计划进行试点测试，以评估其对移植候选者的 LDT 和 DDT 知识、关系和沟通能力、自我效能、沟通相关障碍、与家人和朋友讨论移植的意愿以及自我报告的讨论的影响两种移植选择。 公共卫生相关性：活体供体移植 (LDT) 是近 89,000 名等待肾移植的候选者的首选治疗选择。然而，许多移植候选者不会接受活体供体移植，因为他们不愿意与社交网络成员（例如家人和朋友）交流 LDT。本研究提议试点一项干预措施，以提高肾移植候选者对 LDT 和已故捐赠者移植的了解，以及候选者对这些治疗方案的沟通。