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: For potential kidney transplant recipients (all arms):

Inclusion Criteria:

* Adult (18 yrs or older)
* African American
* Duke Kidney and Pancreas Transplant patients with end stage kidney disease
* Currently on the deceased donor kidney waiting list from the Duke Kidney and Pancreas Transplant Program
* Give consent to participate

Exclusion Criteria:

* Previous kidney transplant (Revised Sept 2016: persons who have previously received a deceased donor kidney transplant, but who have not previously received a live donor kidney transplant)
* Cognitively impaired/Change in cognition
* Impaired hearing or speech
* Non-English speaking

For family members or friends of potential kidney transplant recipients (TALK and TALK PLUS arms):

Inclusion Criteria:

* 18 or older
* Come to SWI meeting with patient
* Give consent to participate

For potential live kidney donors (TALKS PLUS arm only)

Inclusion Criteria:

* 18 or older
* Contact the study
* Give consent to participate
B: Inclusion/Exclusion Criteria for Patients

Inclusion Criteria:

* Patients that visited a family physician
* Patients that are at least 16 years of age with a valid health card (eligibility criteria to register for organ donation in Ontario)

Inclusion/Exclusion Criteria for Family Physicians (Cluster level)

Inclusion Criteria:

- Working at a site that sees at least 100 patients per week

Exclusion Criteria:

- Working at multiple sites that cannot be separated in analyses
C: Inclusion Criteria:

Age 18 to 70 with stage IV or stage V (non-dialysis dependent) chronic kidney disease

Exclusion Criteria:

* No evidence of cancer within 2 years prior to recruitment date
* No evidence of stage IV congestive heart failure
* No evidence of end-stage liver disease
* No evidence of unstable coronary artery disease
* No evidence of pulmonary hypertension
* No evidence of severe peripheral vascular disease
* No history of HIV
* No chronic (debilitating) infections
* No prior kidney transplant
* No prior completion of transplant evaluation process
* No prior dialysis treatment
D: 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.

Answer: D