Culturally Sensitive Behavioral Interventions to Enhance Living Kidney Donation / Living Kidney Transplantation
Condition: Chronic Kidney Disease
MeSH terms: Kidney Diseases; Renal Insufficiency, Chronic
Study type: Interventional

Summary: 
      Title: Culturally tailored behavioral interventions to enhance living kidney donation/living
      kidney transplantation Applicants: Johns Hopkins Medical Institutions, National Kidney
      Foundation of Maryland Principal Investigator: Neil R. Powe, MD, MPH, MBA Address: 2024 E.
      Monument Street, Suite 2-600, Baltimore, MD, 21205 Phone: 410-955-6953; Email:
      npowe@jhmi.edu; Fax: 410-955-0476 Rates of kidney donation have been largely stagnant for the
      past 10 years, resulting in large imbalances in numbers of persons on transplant waiting
      lists and the number of persons receiving kidney transplants. Slow improvement in donation
      and transplantation rates are exacerbated by ethnic/racial disparities in kidney transplants,
      in which minorities, particularly African Americans, are far less likely to receive deceased
      kidney transplants. Although living related kidney donation (LD) offers patients an
      opportunity to bypass many barriers contributing to disparities in kidney transplantation
      (e.g. waiting lists and immunological incompatibility issues), African Americans remain less
      likely to receive living related kidney transplants (LRT), further exacerbating disparities
      in transplant rates. Recent research demonstrates many ethnic minorities desire kidney
      transplantation, but rates of patient-physician and patient-family discussions regarding
      LD/LRT are suboptimal. Compared to Whites, African Americans have also been shown to have
      disproportionately greater rates of culture-specific concerns (such as mistrust in health
      care) that could impede them from seeking important medical therapies. It is unknown whether
      culturally tailored behavioral interventions to enhance patient/family decision-making
      regarding LD/LRT before the onset of end stage renal disease could improve rates of LD/LRT or
      could narrow racial disparities in the receipt of transplantation. The primary goal of this
      proposal is a) to use focus group methodology to develop culturally tailored educational
      materials for patients/families considering LD/LRT and b) to perform a randomized controlled
      trial to test the effectiveness of a culturally tailored social-worker led intervention
      (using established behavioral problem-solving therapeutic techniques) in enhancing rates of
      family communication, donor evaluations, and transplantation. The substantial experience of
      our consortium, including the National Kidney Foundation of Maryland and the Johns Hopkins
      Medical Institutions (Welch Center and the Medical Surgical Transplant Services in the School
      of Medicine), in the evaluation/ implementation of donor/recipient educational programs as
      well as the conduct of behavioral, epidemiologic and interventional studies related to
      donor/recipient health and psychology provides a strong foundation for the conduct of this
      study.
    


Intervention name(s): TALK PLUS; TALK Standard; Usual Care
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): Participants receive and educational video and booklet about living kidney donation and meet with a social worker; Participants receive and educational video and booklet about living kidney donation; Participants receive their usual care
Allocation: Randomized
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Health Services Research
Keywords: kidney; transplant; donation