Designing a Patient-Centered Interdisciplinary Intervention to Promote Equitable Access to Kidney Transplantation across Health Systems: The STEPS Study

Teri Browne¹, Clarissa J Diamantidis², Jamie A Green³, Patti L Ephraim⁴, Julisa Tindall⁵, Ashley Cabacungan⁶, Tariq Shafi⁷, George L Jackson⁸, Emily L Obermiller⁹, Ranee Chatterjee¹⁰, Tyffany Locklear¹¹, Sherri Swan-Nesbit¹², Jennie Riley¹³, Lauren Brubaker¹⁴, Autumn Bayoumi¹⁵, Karen Szczepanik-Riley¹⁶, Pradeep K Vaitla¹⁷, Lynette Gray¹⁸, Terri Lynchard¹⁹, Evangeline D Snell²⁰, Tara S Strigo²¹, L Ebony Boulware²²

Affiliations

¹ Teri Browne, PhD, MSW, is dean and professor, College of Social Work, University of South Carolina, 1512 Pendleton Street, Columbia, SC 29208, USA.
² Clarissa J. Diamantidis, MD, MHS, is professor of medicine, general internal medicine, nephrology, and epidemiology and prevention; and interim director, Maya Angelou Research Center for Healthy Communities, School of Medicine, Wake Forest University, Winston-Salem, NC, USA.
³ Jamie A. Green, MD, MS, is associate professor, Department of Population Health Sciences, and codirector, Center for Kidney Health Research, Geisinger College of Health Sciences, Danville, PA, USA.
⁴ Patti L. Ephraim, MPH, is director of clinical research and prevention programs, Feinstein Institute for Medical Research, Manhasset, NY, USA.
⁵ Julisa Tindall, MSW, LISW-CP, is PhD student, College of Social Work, University of South Carolina, Columbia, SC, USA.
⁶ Ashley Cabacungan, BS, is program manager II, Maya Angelou Research Center for Healthy Communities, School of Medicine, Wake Forest University, Winston-Salem, NC, USA.
⁷ Tariq Shafi, MD, MHS, is director, Division of Nephrology, Baylor Scott & White Health, Temple, TX, USA.
⁸ George L. Jackson, PhD, MHA, is professor, Department of Health Economics, Systems, and Policy, and director, Advancing Implementation & Improvement Science Program, Peter O'Donnell Jr. School of Public Health; professor, Division of General Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA; and research health scientist, Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, NC, USA.
⁹ Emily L. Obermiller, BS, MEd, is clinical protocol and grant writer, Clinical and Translational Science Institute, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
¹⁰ Ranee Chatterjee, MD, MPH, is associate professor and vice chief of research, Division of General Internal Medicine, Department of Medicine, and director, Primary Care Research Consortium, Duke University; and primary care doctor, Duke Primary Care South Durham, Durham, NC, USA.
¹¹ Tyffany Locklear, MMCi, BS, BA, is research program leader, Duke General Internal Medicine, and clinical research coordinator, Department of Medicine, Duke University School of Medicine, Durham, NC, USA.
¹² Sherri Swan-Nesbit, MSN, is lead nurse research coordinator, Duke University Medical Center, , Durham, NC, USA.
¹³ Jennie Riley is research interventionist, Department of Population Health Sciences, School of Medicine, Duke University, Durham, NC, USA.
¹⁴ Lauren Brubaker, MPH, is research project manager II, Center for Kidney Health Research, , Danville, PA, USA.
¹⁵ Autumn Bayoumi, LSW, is social worker, Geisinger Medical Center, Danville, PA, USA.
¹⁶ Karen Szczepanik-Riley, BSN, RN, is transplant nurse coordinator, Geisinger Medical Center, Danville, PA, USA.
¹⁷ Pradeep K. Vaitla, MD, is associate professor of medicine, medical director of kidney and pancreas transplantation, and program director for the nephrology fellowship, School of Medicine, Department of Medicine.
¹⁸ Lynette Gray, RN, is transplant nurse coordinator, University of Mississippi Medical Center, Jackson, MS, USA.
¹⁹ Terri Lynchard, MSW, LCSW, is social worker, University of Mississippi Medical Center, Jackson, MS, USA.
²⁰ Evangeline D. Snell, MSW, LCSWA, is clinical social worker and research interventionist, Duke University Hospital, Durham, NC, USA.
²¹ Tara S. Strigo, MPH, is program director IV, School of Medicine, Wake Forest University, Winston-Salem, NC, USA.
²² L. Ebony Boulware, MD, MPH, is dean, School of Medicine, Wake Forest University, and chief science officer, Advocate Health, Winston-Salem, NC, USA.

PMID: 40591642
PMCID: PMC12277683 (available on 2026-07-01)
DOI: 10.1093/hsw/hlaf028

Designing a Patient-Centered Interdisciplinary Intervention to Promote Equitable Access to Kidney Transplantation across Health Systems: The STEPS Study

Teri Browne et al. Health Soc Work. 2025.

. 2025 Aug 1;50(3):219-227.

doi: 10.1093/hsw/hlaf028.

Authors

Affiliations

¹ Teri Browne, PhD, MSW, is dean and professor, College of Social Work, University of South Carolina, 1512 Pendleton Street, Columbia, SC 29208, USA.
² Clarissa J. Diamantidis, MD, MHS, is professor of medicine, general internal medicine, nephrology, and epidemiology and prevention; and interim director, Maya Angelou Research Center for Healthy Communities, School of Medicine, Wake Forest University, Winston-Salem, NC, USA.
³ Jamie A. Green, MD, MS, is associate professor, Department of Population Health Sciences, and codirector, Center for Kidney Health Research, Geisinger College of Health Sciences, Danville, PA, USA.
⁴ Patti L. Ephraim, MPH, is director of clinical research and prevention programs, Feinstein Institute for Medical Research, Manhasset, NY, USA.
⁵ Julisa Tindall, MSW, LISW-CP, is PhD student, College of Social Work, University of South Carolina, Columbia, SC, USA.
⁶ Ashley Cabacungan, BS, is program manager II, Maya Angelou Research Center for Healthy Communities, School of Medicine, Wake Forest University, Winston-Salem, NC, USA.
⁷ Tariq Shafi, MD, MHS, is director, Division of Nephrology, Baylor Scott & White Health, Temple, TX, USA.
⁸ George L. Jackson, PhD, MHA, is professor, Department of Health Economics, Systems, and Policy, and director, Advancing Implementation & Improvement Science Program, Peter O'Donnell Jr. School of Public Health; professor, Division of General Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA; and research health scientist, Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, NC, USA.
⁹ Emily L. Obermiller, BS, MEd, is clinical protocol and grant writer, Clinical and Translational Science Institute, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
¹⁰ Ranee Chatterjee, MD, MPH, is associate professor and vice chief of research, Division of General Internal Medicine, Department of Medicine, and director, Primary Care Research Consortium, Duke University; and primary care doctor, Duke Primary Care South Durham, Durham, NC, USA.
¹¹ Tyffany Locklear, MMCi, BS, BA, is research program leader, Duke General Internal Medicine, and clinical research coordinator, Department of Medicine, Duke University School of Medicine, Durham, NC, USA.
¹² Sherri Swan-Nesbit, MSN, is lead nurse research coordinator, Duke University Medical Center, , Durham, NC, USA.
¹³ Jennie Riley is research interventionist, Department of Population Health Sciences, School of Medicine, Duke University, Durham, NC, USA.
¹⁴ Lauren Brubaker, MPH, is research project manager II, Center for Kidney Health Research, , Danville, PA, USA.
¹⁵ Autumn Bayoumi, LSW, is social worker, Geisinger Medical Center, Danville, PA, USA.
¹⁶ Karen Szczepanik-Riley, BSN, RN, is transplant nurse coordinator, Geisinger Medical Center, Danville, PA, USA.
¹⁷ Pradeep K. Vaitla, MD, is associate professor of medicine, medical director of kidney and pancreas transplantation, and program director for the nephrology fellowship, School of Medicine, Department of Medicine.
¹⁸ Lynette Gray, RN, is transplant nurse coordinator, University of Mississippi Medical Center, Jackson, MS, USA.
¹⁹ Terri Lynchard, MSW, LCSW, is social worker, University of Mississippi Medical Center, Jackson, MS, USA.
²⁰ Evangeline D. Snell, MSW, LCSWA, is clinical social worker and research interventionist, Duke University Hospital, Durham, NC, USA.
²¹ Tara S. Strigo, MPH, is program director IV, School of Medicine, Wake Forest University, Winston-Salem, NC, USA.
²² L. Ebony Boulware, MD, MPH, is dean, School of Medicine, Wake Forest University, and chief science officer, Advocate Health, Winston-Salem, NC, USA.

PMID: 40591642
PMCID: PMC12277683 (available on 2026-07-01)
DOI: 10.1093/hsw/hlaf028

Abstract

In the United States, health inequities persist in the management of chronic kidney disease and end-stage kidney disease, including unequal access to kidney transplantation. These disparities are deeply rooted in complex social and structural determinants of health, including socioeconomic status, race, geographic location, and healthcare access. Addressing these inequities necessitates a patient-centered interdisciplinary approach to improve outcomes and promote transplant access equity. This article describes the conceptualization and design of the System Interventions to Achieve Early and Equitable Transplants (STEPS) intervention. The STEPS intervention was developed by patients, family members, professional and community stakeholders, social workers, nurses, physicians, and other health professionals to address multifactorial barriers to kidney transplantation in three large health systems in Mississippi, North Carolina, and Pennsylvania. By addressing transplant barriers through collaborative interdisciplinary interventions provided by social workers and transplant nurses, STEPS aims to empower individuals and promote systemic changes in healthcare delivery and access to kidney transplants. This intervention can be used as a model for other interdisciplinary approaches to address social and structural determinants of health to improve access to care and promote health equity.

Keywords: disparities; interdisciplinary intervention; kidney disease; social determinants of health; transplantation.

PubMed Disclaimer

References

1. Association of Cancer Care Centers. (n.d.). Just ASK! Increasing diversity in cancer clinical research. Retrieved August 13, 2024, from https://courses.accc-cancer.org/products/just-ask-increasing-diversity-i...
1. Beaumont J. L., Kawakita S., Peipert J. D., Waterman A. D. (2018). Understanding race and gender disparities in living donor kidney transplant readiness, actions, knowledge, and socioeconomic barriers prior to transplant evaluation. Transplantation, 102, Article S307. 10.1097/01.tp.0000543024.01197.3e - DOI
1. Billioux A., Verlander K., Anthony S., Alley D. (2017). Standardized screening for health-related social needs in clinical settings: The Accountable Health Communities screening tool [Discussion paper]. National Academy of Medicine Perspectives. 10.31478/201705b - DOI
1. Boulware L. E., Hill-Briggs F., Kraus E. S., Melancon J. K., Falcone B., Ephraim P. L., Jaar B. G., Giminez L., Choie M., Senga M., Kolotos M., LaPricia Lewis-Boyer B. A., Cook C., Lihht L., DePasquale N., Noletto T., Powe N. R. (2013). Effectiveness of educational and social worker interventions to activate patients’ discussion and pursuit of preemptive living donor kidney transplantation: A randomized controlled trial. American Journal of Kidney Diseases, 61, 476–486. 10.1053/j.ajkd.2012.08.039 - DOI - PMC - PubMed
1. Boulware L. E., Hill-Briggs F., Kraus E. S., Melancon J. K., Senga M., Evans K. E., Troll M. U., Ephraim P., Jaar B. G., Myers D. I., McGuire R., Falcone B., Bonhage B., Powe N. R. (2011). Identifying and addressing barriers to African American and non-African American families’ discussions about preemptive living related kidney transplantation. Progress in Transplantation, 21, 97–104. 10.1177/152692481102100203 - DOI - PubMed

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

Grants and funding

LinkOut - more resources

Full Text Sources
- Silverchair Information Systems
Medical
- MedlinePlus Health Information

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Designing a Patient-Centered Interdisciplinary Intervention to Promote Equitable Access to Kidney Transplantation across Health Systems: The STEPS Study

Affiliations

Designing a Patient-Centered Interdisciplinary Intervention to Promote Equitable Access to Kidney Transplantation across Health Systems: The STEPS Study

Authors

Affiliations

Abstract

References

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical