Please select the eligibility criteria that correspond to the clinical trial below.
Title: Working Within an Integrated Learning Healthcare System to Improve Living Kidney Donation Knowledge Across the CKD Continuum for All Racial Groups
Brief Summary: Today, there are 25 million Americans with chronic kidney disease (CKD) and 660,000 patients in full kidney failure, the final CKD stage, known as end stage renal disease (ESRD). Over half of ESRD patients are Black, Hispanic, or Asian. ESRD patients must either receive regular dialysis treatments, by which waste is filtered from the blood by a machine, or a kidney transplant from a deceased or living donor. Five-year survival on dialysis is only 40%, compared to 74% with a deceased donor kidney transplant (DDKT) and 87% with a living donor kidney transplant (LDKT). Despite the known health benefits of DDKT and LDKT, 70% of ESRD patients remain on dialysis, especially ethnic/racial minorities.

An American Society of Transplantation (AST) Consensus Conference recently recommended that patients in all CKD stages should have the opportunity to learn about and decide which treatment option is right for them, particularly about LDKT. However, early education about LDKT and DDKT is inconsistent and often poor, with early stage CKD patients and ethnic/racial minorities even less likely to receive it.

Through previous HRSA grants, Dr. Waterman designed the Explore Transplant@Home (ET@Home) video-guided education program, and found that it significantly increased LDKT knowledge and informed decision-making for Black and White dialysis patients in Missouri when delivered by mail and supported through bimonthly postcards and texting. Now based at the University of California, Los Angeles (UCLA), she has partnered with Kaiser Permanente Southern California (KPSC), an integrated learning healthcare system providing insurance coverage and comprehensive care to 65,000 patients in CKD Stages 3, 4 and 5 (ESRD) (24% Hispanic, 52% White, 15% Black, and 9% Asian; 10% Spanish-speaking).


Options:
A: Inclusion Criteria:

* Sedentary (i.e., participating in moderate or vigorous physical activity two days per week or less for 30 minutes or less each day) women ages 18 to 65 who self-identify as Latina (or of a group defined as Hispanic/Latino by the Census Bureau) are eligible for participation

Exclusion Criteria:

* Exclusion criteria are history of coronary heart disease (history of myocardial infarction or symptoms of angina), diabetes, stroke, osteoarthritis, osteoporosis, orthopedic problems, or any other serious medical condition that would make physical activity unsafe. Other exclusion criteria will include individuals who report consuming three or more alcoholic drinks per day, current or planned pregnancy, planning to move from the area within the next six months, current suicidal ideation or psychosis, current clinical depression, hospitalization due to a psychiatric disorder in the past 3 years, BMI above 40, and/or taking medication that may impair physical activity tolerance or performance (e.g., beta blockers). Participants in the pilot study must also agree to be assigned to one of the two intervention conditions.
B: Inclusion Criteria:

1. Participant must be at least 18 years of age.
2. Participant must self-identify as African American, White, Hispanic, or Asian.
3. Participant must currently be classified as having CKD 3, 4 or 5.
4. Participant must be able to speak and read in English or Spanish.

Exclusion Criteria:

1. Participant is not classified as having CKD 3,4, or 5.
2. Participant cannot speak or read in English or Spanish.
C: Inclusion Criteria:

* All participants will be patients who receive their primary medical care at the Virginia Garcia Memorial Health Center (VGMHC)
* Self-identified as Spanish-speaking Latina or Hispanic
* Female
* Age 18 and older
* BMI greater than or equal to 27kg/m2
* Classified as diabetic or prediabetic in the electronic medical record by at least one of the following:

  * Fasting plasma glucose ≥ 100
  * 2-h post glucose level on the 75-g oral glucose tolerance test ≥ 140-199 mg/dL (7.8-11.0 mmol/L)
  * Hemoglobin HBA1c ≥ 5.7
  * Diagnosis of diabetes in patient's medical chart
  * Diagnosis of prediabetes in patient's medical chart
* Residing in the Portland metropolitan area, and having no plans to leave the area in the next 18 months.
* Willing and able to attend the 26-weekly group meetings and 6 monthly group meetings.
* Willing to accept random assignment to the active intervention or enhanced usual care control.
* Clearance by the patient's VGMHC primary care physician to participate in the intervention.

Exclusion Criteria:

* Treatment for cancer in the past two years (excluding non-melanoma skin cancers).
* Having conditions that require limitation of physical activity or that would be contraindicated for the DASH (Dietary Approaches to Stop Hypertension) diet patterns.
* Taking weight-loss medication currently or within the past 6 months.
* Current or recent (\< 12 months) pregnancy, breastfeeding, or planning pregnancy in the next 18 months.
D: Inclusion Criteria:

1. Parent or legal guardian of a singleton US-born infant ≤ 2 months of age
2. Parent or legal guardian age 18 or older
3. Parent or legal guardian self-identified as Latino/a
4. Parent or legal guardian foreign-born
5. Parental report of Spanish as their preferred healthcare language
6. Plan to select Medicaid/Priority Partners insurance for their child with the Johns Hopkins Bayview Medical Center Children's Medical Practice as the primary care site
7. Have a working cellular phone with text message capability and parent reports prior use of text messaging

Answer: B