Intensive Patient Referral and Education Program prior to Renal Replacement Therapy (iPREP RRT)

肾脏替代治疗前强化患者转诊和教育计划 (iPREP RRT)

基本信息

批准号：
10265591
负责人：
MILDA Renne SAUNDERS
金额：
$ 32.4万
依托单位：
UNIVERSITY OF CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-09-20 至 2024-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10265591
关键词：
Acute African American Ambulatory Care Behavior Blood Pressure Caring Chronic Kidney Failure Clinic Communities Complement Consent Coupled Diabetes Mellitus Dialysis procedure Disease Outcome Disease Progression Education Educational Intervention End stage renal failure Evaluation Exercise Face Guidelines Hemodialysis High Prevalence Home Hemodialysis Hospitalization Hospitals Hypertension Inpatients Intervention Knowledge Life Style Link Maintenance Medical Modality Morbidity - disease rate Nephrology Outpatients Patient Education Patients Peritoneal Dialysis Persons Pharmaceutical Preparations Preparation Prevalence Primary Health Care Quality of life Renal Replacement Therapy Resources Self Care Self Efficacy Self Management Site Sodium-Restricted Diet System Telephone Testing Text Messaging Therapeutic Intervention Time Transplantation Visit Work base behavior change blood pressure regulation comorbidity comparative efficacy cost disparity reduction education planning effective intervention effectiveness testing evidence base experience follow-up health disparity health seeking behavior improved innovation kidney disease education literacy mortality multimodality outpatient programs patient population post intervention preference prevent programs randomized trial recruit skills social culture theories therapy development treatment as usual trial design

项目摘要

PROJECT ABSTRACT African Americans with chronic kidney disease (CKD) experience disparities in the quality of their medical care, self-care and preparation for end stage renal disease (ESRD). Patient education can help African-American patients with advanced CKD decide to engage in self-care to delay progression to ESRD and about renal replacement therapy (RRT) treatment options. Hospitalization represents a “missed opportunity” to provide CKD education and ESRD 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 also captures patients who are not otherwise well-linked to the medical system. In prior work our team developed and implemented PREP RRT, a culturally-tailored, multi-modality patient education intervention for hospitalized African American patients with advanced CKD using a racially concordant in-person educator and literacy- sensitive education materials. Our intervention was feasible and effective in increasing patient knowledge but was not intensive enough to change behavior. Thus, we used adapted an 12- week effective outpatient patient education program to complement our in-patient pilot program to increase patient knowledge, improve self- care behavior and strengthen linkage to care. In this proposal, we will conduct a randomized trial to test the effectiveness of the intensive PREP RRT intervention for hospitalized African American patients with advanced CKD with both a hospital-based intervention and a 12 week community-based intervention. We seek to increase patient knowledge, self-efficacy, self-management behavior, health seeking behavior, RRT planning and blood pressure control. We have assembled a strong team with skills in CKD health disparities, hospital- based and community-based interventions, randomized trial design, culturally-tailored patient-education, and theory-based intervention development. After successful completion of our aims, we will have developed an effective intervention that will reduce disparities by improving patient's CKD- related knowledge, behavior and care. We will also have the ability to disseminate the intervention across settings and to adapt the intervention for other patient populations.

项目摘要患有慢性肾脏疾病（CKD）的非裔美国人在医疗质量方面经历了分布，自我保健和终阶段肾脏疾病（ESRD）的准备。患者教育可以帮助非裔美国人高级CKD的患者决定进行自我保健，以延迟到ESRD和肾脏的进展替代疗法（RRT）治疗方案。住院是一个提供的“错过的机会” CKD教育和ESRD计划帮助患者做出有关与之一致的护理的明智选择他们的偏好。许多患者在透析计划的三个月内住院。医院也是捕获没有其他与医疗系统相关的患者。在先前的工作中，我们的团队开发了并实施了Prep RRT，这是一种经过文化的，多种模式的患者教育干预措施非裔美国人患有晚期CKD的患者使用种族一致的面对面教育者和扫盲 - 敏感的教育材料。我们的干预是可行的，可有效地增加患者知识，但它不足以改变行为。那就是我们使用了一个改编的12周有效门诊患者教育计划以补充我们的住院试验计划，以提高患者知识，改善自我护理行为并加强与护理的联系。在此提案中，我们将进行一项随机试验，以测试对住院的非裔美国人患者的强化准备RRT干预的有效性 CKD既有基于医院的干预措施和12周的社区干预措施。我们寻求提高患者知识，自我有效，自我管理行为，寻求健康行为，RRT计划和血压控制。我们已经组建了一个强大的团队，具备CKD健康分配技能，医院的技能 - 基于和社区的干预措施，随机试验设计，经过文化定制的患者教育以及基于理论的干预发展。成功完成目标后，我们将开发一个有效的干预措施将通过改善患者的CKD相关知识，行为和关心。我们还将有能力在各个环境中传播干预措施并调整干预措施对于其他患者人群。