Please select the eligibility criteria that correspond to the clinical trial below.
Title: Improving Low-Income End Stage Renal Disease Patients' Transplant Knowledge: A Case Management Trial
Brief Summary: Kidney transplantation, especially living donor kidney transplant (LDKT), offers patients in end-stage renal disease (ESRD) 3 to 17 additional years of life and improved quality-of-life compared to remaining on dialysis. Unfortunately, LDKT education in dialysis centers occurs inconsistently, especially for minorities and those who are socioeconomically disadvantaged.

To ensure more informed transplant decision-making, through a previous HRSA grant, Dr. Waterman designed the Explore Transplant (ET) education program based on the Transtheoretical Model of Behavioral Change. Through a previous trial, an earlier version of ET, delivered face-to-face with patients while they were undergoing dialysis, was shown to increase patients' DDKT and LDKT knowledge. However, additional research exploring dialysis providers' ability to integrate ET into their care revealed that multiple patient, provider, and system barriers limited the degree to which transplant education could be improved.

Thus, a more comprehensive case-management program to educate patients through external organizations may be needed to supplement ongoing transplant education within dialysis centers. For this grant, the investigators propose to test the effectiveness of another replicable solution for disseminating ET education on a broad scale: Partnering with a large health insurance organization to deliver video-guided transplant education supported by telephone and mail. The Missouri Kidney Program (MoKP) is a state-wide organization whose mission is to serve and educate kidney patients, particularly those who are economically disadvantaged. Since MoKP subsidizes the costs of dialysis medication for low-income ESRD patients, they operate as an insurance company would with respect to their 1200-patient member group. With 900 dialysis patients currently being managed by the MoKP, the investigators will conduct an eight-month, group randomized controlled trial (GRCT) where 540 patients will be randomized to receive: (1) no additional education other than from their dialysis center; (2) a video-guided, four-part Explore Transplant (ET) program delivered via the internet or mail; or (3) a video-guided ET program with discussion facilitated by a telephone case manager.


Options:
A: Inclusion Criteria:

Each subject must meet the following inclusion criteria to be enrolled:

1. Participant must be 18-74 years of age.
2. Participant must self-identify as African American or White.
3. Participant must currently be on dialysis.
4. Participant must have a household income at or below 250% of the federal poverty level.
5. Participant must be able to speak and read in English.

Exclusion Criteria:

Subjects that meet any of the following exclusion criteria are not to be enrolled:

1. Participant has a visual and/or hearing impairment that would preclude him/her from watching and reading educational study material.
2. Participant has had a previous kidney transplant
3. Participant has previously been told that they are not a candidate for transplant.
B: Inclusion Criteria:

* Patients showing new or recurrent symptoms of uterine fibroids (e.g. heavy menstrual bleeding, pelvic pressure or pain, etc.) who are seeking treatment.
* Assigned female sex at birth
* At least 18 years of age
* Speak English or Spanish
* Have the ability to complete short surveys online independently or assisted by a caregiver.

The investigators will also include health care professionals who will provide care to women with symptomatic uterine fibroids during the project duration at participating sites.

Exclusion Criteria:

* Patients who are under 18
* Patients not assigned female sex at birth
* Women who are postmenopausal because they will have different treatment options than the ones presented in this study's intervention.
C: Inclusion Criteria

1. Over the age of 60
2. The ability to provide informed consent
3. The ability to communicate in English
4. And one of the following:

   1. An established diagnosis of metastatic cancer or
   2. An established diagnosis of advanced heart failure (NYHA class III/IV heart failure) or
   3. An established diagnosis of chronic obstructive lung disease with an FEV1 \< 50% or
   4. Two hospitalizations within the last 6 months or
   5. An advanced illness or multiple comorbidities that are not otherwise specified with an overall prognosis of one year or less confirmed with the attending physician on service. Exclusion Criterion

1. Subject scores 6 or less on the Short Portable Mental Status Questionnaire, which is indicative of cognitive impairment.
D: Inclusion Criteria:

* \>18 years old
* English or Spanish speaking
* Presence of coronary disease, or a caregiver/relative of one with coronary disease

Exclusion Criteria:

* non-English or non-Spanish speaking
* dementia

Answer: A