A Randomized Trial and Reduce to Disparity in Live Donor Kidney Transplantation

随机试验并减少活体肾移植的差异

• 批准号: 8121444
• 负责人: James R Rodrigue
• 金额: $ 23.09万
• 依托单位: BETH ISRAEL DEACONESS MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-08-01 至 2013-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8121444
• 关键词: Address; Adherence; Adult; Affect; African; African American; Area; Awareness; Characteristics; Chronic Kidney Failure; Clinic; Clinical effectiveness; Communities; Data; Diabetes Mellitus; Dialysis procedure; Education; Educational Intervention; Educational Materials; Effectiveness; End stage renal failure; Enrollment; Environment; Evaluation; Extended Family; Family; Family member; Friends; Funding; Glomerulonephritis; Goals; Group Homes; Home environment; Hypertension; Incidence; Individual; Intervention; Kidney Transplantation; Knowledge; Life; Living Donors; Medical; Methodology; Minority; Morbidity - disease rate; Nature; Organ Donations; Outcome; Outcome Study; Participant; Patient Education; Patients; Polycystic Kidney Diseases; Population; Protocols documentation; Randomized; Randomized Clinical Trials; Relative (related person); Research; Research Personnel; Study Section; Testing; Time; Transplantation; United States Health Resources and Services Administration; Waiting Lists; Work; base; design; evidence base; experience; health disparity; improved; innovation; intervention program; male; meetings; mortality; multidisciplinary; novel; patient population; primary outcome; programs; randomized trial; satisfaction; secondary outcome; standard care; willingness

DESCRIPTION (provided by applicant): African Americans comprise a higher percentage of the waiting list for kidney transplantation than would be expected based on population parameters, they wait longer for kidney transplantation, and they are far less likely to receive live donor kidney transplantation (LDKT). While educational efforts have helped to expand awareness about the need for and benefits of LDKT among African Americans with ESRD, there have been very few attempts to systematically examine strategies for increasing LDKT in this patient population. The long-term goal of this research program is to improve education provided to African Americans and, thereby, increase rates of LDKT. The objective of this application is to determine the relative effectiveness of three strategies for increasing LDKT rates in African Americans. The central hypothesis is that a home-based intervention that involves the patient and significant others yields higher LDKT rates in an African American population relative to educational interventions delivered in the transplant center. Guided by strong preliminary data, this hypothesis will be tested by pursuing two specific aims: 1) Determine the clinical effectiveness of three separate LDKT educational approaches with African American patients; and 2) Determine the sociodemographic, medical, and donation-specific variables that are most strongly associated with pursuing LDKT. One hundred eighty African American adults with end-stage renal disease (ESRD) will be urn randomized to receive one of three educational interventions: home-based (HB), group-based (GB), or standard care (SC). The HB (in the home) and GB (in the transplant center) interventions will provide education to patients and their immediate and extended family members, significant others, and friends. The SC intervention (in the transplant center) mirrors what is currently done at this transplant center and will provide education to individual patients only. The primary outcome is the proportion of patients who receive LDKT. Secondary outcomes include live donor inquiries, live donor evaluations, number of potential live donors educated, and LDKT knowledge, concerns, and willingness. Recruitment rates, attrition rates, reasons for nonparticipation and attrition, protocol adherence, and participant satisfaction ratings will be gathered. The proposed research is innovative because it evaluates the relative effectiveness of three educational strategies designed to increase LDKT rates in African Americans. Findings from this study have the potential to close this racial disparity gap by identifying evidence-based educational strategies that can be used by kidney transplant centers to increase LDKT rates in African Americans. This proposal directly addresses three of the priority areas of HealthyPeople2010 (4-1, 4-5, 4-6).

描述（由申请人提供）： 非裔美国人在肾脏移植的等待名单中比根据人口参数所预期的要等待更长的等待肾脏移植，他们等待肾脏移植的时间更长，而且他们接受现场供体肾脏肾脏移植（LDKT）的可能性要小得多。尽管教育努力有助于扩大对具有ESRD的非洲裔美国人对LDKT的需求和利益的认识，但很少有尝试系统地研究该患者人群中LDKT的策略。该研究计划的长期目标是改善向非裔美国人提供的教育，从而提高LDKT的速度。该应用的目的是确定提高非裔美国人LDKT率的三种策略的相对有效性。中心假设是，涉及患者和重要其他人的家庭干预措施相对于移植中心提供的教育干预措施，在非洲裔美国人群中产生的LDKT率更高。在强大的初步数据的指导下，将通过追求两个具体目标来检验该假设：1）确定与非裔美国人患者的三种独立LDKT教育方法的临床有效性； 2）确定与追求LDKT最密切相关的社会人口统计学，医学和捐赠特定变量。将随机分配有终末期肾脏疾病（ESRD）的一百八十名非裔美国人成年人接受三种教育干预措施之一：基于家庭的（HB），基于组（GB）或标准护理（SC）。 HB（在家里）和GB（在移植中心）的干预措施将为患者及其直接和大家人，重要的其他人和朋友提供教育。 SC干预（在移植中心）反映了该移植中心目前所做的事情，并将仅向单个患者提供教育。主要结果是接受LDKT的患者的比例。次要结果包括现场捐助者查询，现场捐助者评估，受过教育的潜在活捐赠者的数量以及LDKT知识，关注和意愿。招聘率，流失率，非参与和损耗的原因，协议依从性和参与者满意度等级将被收集。拟议的研究具有创新性，因为它评估了三种旨在提高非裔美国人LDKT率的教育策略的相对有效性。这项研究的发现有可能通过识别基于证据的教育策略来缩小这一种族差异差距，这些策略可以被肾脏移植中心使用以提高非洲裔美国人的LDKT率。该提案直接解决了HealthypeOple2010的三个优先领域（4-1、4-5、4-6）。

项目成果

Patient-reported immunosuppression nonadherence 6 to 24 months after liver transplant: association with pretransplant psychosocial factors and perceptions of health status change.

• DOI: 10.7182/pit2013501
• 发表时间: 2013-12
• 期刊: Progress in transplantation (Aliso Viejo, Calif.)
• 作者: Rodrigue JR;Nelson DR;Hanto DW;Reed AI;Curry MP
• 通讯作者: Curry MP

Development and validation of a questionnaire to assess fear of kidney failure following living donation.

制定并验证一份调查问卷，以评估活体捐赠后对肾衰竭的恐惧。

• DOI: 10.1111/tri.12299
• 发表时间: 2014
• 期刊: Transplant international : official journal of the European Society for Organ Transplantation
• 作者: Rodrigue,JamesR;Fleishman,Aaron;Vishnevsky,Tanya;Whiting,James;Vella,JohnP;Garrison,Krista;Moore,Deonna;Kayler,Liise;Baliga,Prabhakar;Chavin,KennethD;Karp,Seth;Mandelbrot,DidierA
• 通讯作者: Mandelbrot,DidierA

Living Donor Kidney Transplantation: Improving Efficiencies in Live Kidney Donor Evaluation--Recommendations from a Consensus Conference.

活体肾捐赠者移植：提高活体肾捐赠者评估的效率——来自共识会议的建议。

• DOI: 10.2215/cjn.01040115
• 发表时间: 2015
• 期刊: Clinical journal of the American Society of Nephrology : CJASN
• 作者: Moore,DeonnaR;Serur,David;Rudow,DianneLaPointe;Rodrigue,JamesR;Hays,Rebecca;Cooper,Matthew;AmericanSocietyofTransplantation
• 通讯作者: AmericanSocietyofTransplantation

Reimbursement for living kidney donor follow-up care: how often does donor insurance pay?

活体肾脏捐赠者后续护理的报销：捐赠者保险多久支付一次？

• DOI: 10.1097/tp.0b013e31826cc9a1
• 发表时间: 2012
• 期刊: Transplantation
• 影响因子: 6.2
• 作者: Kher,Ajay;Rodrigue,James;Ajaimy,Maria;Wasilewski,Marcy;Ladin,Keren;Mandelbrot,Didier
• 通讯作者: Mandelbrot,Didier

Making house calls increases living donor inquiries and evaluations for blacks on the kidney transplant waiting list.

• DOI: 10.1097/tp.0000000000000165
• 发表时间: 2014-11-15
• 期刊: Transplantation
• 影响因子: 6.2
• 作者: Rodrigue JR;Paek MJ;Egbuna O;Waterman AD;Schold JD;Pavlakis M;Mandelbrot DA
• 通讯作者: Mandelbrot DA