Living donor transplant education for African American patients with end-stage renal disease

Abstract

Context: Despite numerous benefits of live donor kidney transplant (LDKT), patient-level barriers often prevent African Americans from considering LDKT. Educational interventions designed to address patient-level barriers may increase willingness among African American patients with end-stage renal disease to explore LDKT as a treatment option.

Objective: To assess the effectiveness of a culturally sensitive educational intervention called Living ACTS (About Choices in Transplantation and Sharing) that was designed to address patient-level barriers to LDKT among African American patients with end-stage renal disease.

Design/participants: Patients were randomized to intervention (n = 136) or control (n = 132) groups. They completed baseline measures and then viewed either the Living ACTS or control video. Both groups then completed an immediate follow-up measure and a 6-month assessment administered via telephone.

Main outcome measures: Self-reported knowledge about LDKT, willingness to talk to the patient's family about LDKT, and perceived benefits of LDKT were measured at 3 time points.

Results: At 6-month follow-up, intervention participants demonstrated a significantly greater increase in knowledge of LDKT than control participants (F2,229=3.08, P= .05). Intervention participants expressed greater willingness to talk to patients' families about LDKT than did control participants from baseline through 6-month follow-up (F1,230 = 7.11, P= .008). Finally, at immediate follow-up, intervention participants reported greater endorsement of the benefits of LDKT than did control participants (F2,223 = 14.27, P< .001); however, this effect had disappeared by the 6-month follow-up.

Conclusions: Living ACTS is effective at increasing and maintaining knowledge about LDKT among African American patients with end-stage renal disease who are considering transplant.