Enhancing Kidney Donation Through Live Organ Video Educated Donors (LOVED)

Medical University Of South Carolina, Charleston SC

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Abstract

DESCRIPTION (provided by applicant): Chronic Kidney Disease is diagnosed in four times as many African Americans (AAs) as Whites and nearly twice as many AAs perish from the condition. Kidney transplantation offers the best outcomes for patients with End Stage Renal Disease (ESRD) but rates of procurement far outnumber cadaver organ availability, especially among AAs. A superior option is living donor kidney transplantation (LDKT). Since AAs comprise only 18.5% of LDKT recipients, innovative and culturally preferred strategies are needed to increase LDKT within the AA community. We hypothesize that a patient-centered, two tiered culturally sensitive education/motivation intervention targeting AA ESRD patients and potential donors (PDs) using mobile health (mHealth) technology will result in: 1) increased ESRD patients' willingness to ask for donation; 2) increased number of PDs who complete medical evaluation; and, 3) increased number of LDKTs. We will leverage mHealth technology as the delivery mechanism to maximize large scale dissemination potential. Guided by behavioral change and technology acceptability theories, the Live Organ Video Educated Donor [LOVED] program will be developed to address two domains. LOVED I will be tailored for AA ESRD patients and navigated by an AA LDKT recipient. LOVED II will be tailored for potential LDKT donors and navigated by an AA LDKT donor. iPad program delivery will include testimonial audio/video clips, home-work assignments, videoconferencing, chat room sessions, and text/emails. The proposed mixed methods research utilizes qualitative and quantitative studies in a 3 phase process of development that will involve: 1) Development of LOVED I and II technical content and delivery formats guided by behavioral and technological theories using 9 focus groups (8 per group) of AA LDKT recipients/donors, ESRD LDKT eligible patients, PDs who failed to complete screening and transplant healthcare provider team. 2) Conduct 3 month LOVED I and II proof of concept studies (LOVED I = 24 LDKT eligible patients; LOVED II = 24 PDs who did not complete screening) to assess program acceptability, feasibility, changes in self efficacy and attitudes. Also assessed will be % ESRD patients who identify PDs, % PDs who complete screening, % LDKTs and participants' perceptions of cultural competence of intervention including levels of trust, discrimination, shared decision making and literacy. 3) Conduct two 6 month 2-arm randomized control trials (LOVED I vs. standard of care, N=60; LOVED II vs. standard of care, N=80) to generate estimates needed for design of a large scale RCT.