The TALKS study to improve communication, logistical, and financial barriers to live donor kidney transplantation in African Americans: Protocol of a randomized clinical trial

Tara S. Strigo, Patti L Ephraim, Iris Pounds, Felicia Hill-Briggs, Linda Darrell, Matthew Ellis, Debra Sudan, Hamid Rabb, Dorry Segev, Nae Yuh Wang, Mary Kaiser, Margaret Falkovic, Jill F. Lebov, Leigh Boulware

Research output: Contribution to journalArticle

Abstract

Background: Live donor kidney transplantation (LDKT), an optimal therapy for many patients with end-stage kidney disease, is underutilized, particularly by African Americans. Potential recipient difficulties initiating and sustaining conversations about LDKT, identifying willing and medically eligible donors, and potential donors' logistical and financial hurdles have been cited as potential contributors to race disparities in LDKT. Few interventions specifically targeting these factors have been tested. Methods/Design: We report the protocol of the Talking about Living Kidney Donation Support (TALKS) study, a study designed to evaluate the effectiveness of behavioral, educational and financial assistance interventions to improve access to LDKT among African Americans on the deceased donor kidney transplant recipient waiting list. We adapted a previously tested educational and social worker intervention shown to improve consideration and pursuit of LDKT among patients and their family members for its use among patients on the kidney transplant waiting list. We also developed a financial assistance intervention to help potential donors overcome logistical and financial challenges they might face during the pursuit of live kidney donation. We will evaluate the effectiveness of these interventions by conducting a randomized controlled trial in which patients on the deceased donor waiting list receive 1) usual care while on the transplant waiting list, 2) the educational and social worker intervention, or 3) the educational and social worker intervention plus the option of participating in the financial assistance program. The primary outcome of the randomized controlled trial will measure potential recipients' live kidney donor activation (a composite rate of live donor inquiries, completed new live donor evaluations, or live kidney donation) at 1 year. Discussion: The TALKS study will rigorously assess the effectiveness of promising interventions to reduce race disparities in LDKT. Trial registration: NCT02369354.

Original languageEnglish (US)
JournalBMC Nephrology
DOIs
StateAccepted/In press - Oct 9 2015

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African Americans
Kidney Transplantation
Randomized Controlled Trials
Communication
Tissue Donors
Kidney
Waiting Lists
Transplants
Chronic Kidney Failure

Keywords

  • African Americans
  • Disparities
  • Live donor kidney transplant
  • Live kidney donation
  • Randomized clinical trial

ASJC Scopus subject areas

  • Nephrology

Cite this

The TALKS study to improve communication, logistical, and financial barriers to live donor kidney transplantation in African Americans : Protocol of a randomized clinical trial. / Strigo, Tara S.; Ephraim, Patti L; Pounds, Iris; Hill-Briggs, Felicia; Darrell, Linda; Ellis, Matthew; Sudan, Debra; Rabb, Hamid; Segev, Dorry; Wang, Nae Yuh; Kaiser, Mary; Falkovic, Margaret; Lebov, Jill F.; Boulware, Leigh.

In: BMC Nephrology, 09.10.2015.

Research output: Contribution to journalArticle

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abstract = "Background: Live donor kidney transplantation (LDKT), an optimal therapy for many patients with end-stage kidney disease, is underutilized, particularly by African Americans. Potential recipient difficulties initiating and sustaining conversations about LDKT, identifying willing and medically eligible donors, and potential donors' logistical and financial hurdles have been cited as potential contributors to race disparities in LDKT. Few interventions specifically targeting these factors have been tested. Methods/Design: We report the protocol of the Talking about Living Kidney Donation Support (TALKS) study, a study designed to evaluate the effectiveness of behavioral, educational and financial assistance interventions to improve access to LDKT among African Americans on the deceased donor kidney transplant recipient waiting list. We adapted a previously tested educational and social worker intervention shown to improve consideration and pursuit of LDKT among patients and their family members for its use among patients on the kidney transplant waiting list. We also developed a financial assistance intervention to help potential donors overcome logistical and financial challenges they might face during the pursuit of live kidney donation. We will evaluate the effectiveness of these interventions by conducting a randomized controlled trial in which patients on the deceased donor waiting list receive 1) usual care while on the transplant waiting list, 2) the educational and social worker intervention, or 3) the educational and social worker intervention plus the option of participating in the financial assistance program. The primary outcome of the randomized controlled trial will measure potential recipients' live kidney donor activation (a composite rate of live donor inquiries, completed new live donor evaluations, or live kidney donation) at 1 year. Discussion: The TALKS study will rigorously assess the effectiveness of promising interventions to reduce race disparities in LDKT. Trial registration: NCT02369354.",
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T2 - Protocol of a randomized clinical trial

AU - Strigo, Tara S.

AU - Ephraim, Patti L

AU - Pounds, Iris

AU - Hill-Briggs, Felicia

AU - Darrell, Linda

AU - Ellis, Matthew

AU - Sudan, Debra

AU - Rabb, Hamid

AU - Segev, Dorry

AU - Wang, Nae Yuh

AU - Kaiser, Mary

AU - Falkovic, Margaret

AU - Lebov, Jill F.

AU - Boulware, Leigh

PY - 2015/10/9

Y1 - 2015/10/9

N2 - Background: Live donor kidney transplantation (LDKT), an optimal therapy for many patients with end-stage kidney disease, is underutilized, particularly by African Americans. Potential recipient difficulties initiating and sustaining conversations about LDKT, identifying willing and medically eligible donors, and potential donors' logistical and financial hurdles have been cited as potential contributors to race disparities in LDKT. Few interventions specifically targeting these factors have been tested. Methods/Design: We report the protocol of the Talking about Living Kidney Donation Support (TALKS) study, a study designed to evaluate the effectiveness of behavioral, educational and financial assistance interventions to improve access to LDKT among African Americans on the deceased donor kidney transplant recipient waiting list. We adapted a previously tested educational and social worker intervention shown to improve consideration and pursuit of LDKT among patients and their family members for its use among patients on the kidney transplant waiting list. We also developed a financial assistance intervention to help potential donors overcome logistical and financial challenges they might face during the pursuit of live kidney donation. We will evaluate the effectiveness of these interventions by conducting a randomized controlled trial in which patients on the deceased donor waiting list receive 1) usual care while on the transplant waiting list, 2) the educational and social worker intervention, or 3) the educational and social worker intervention plus the option of participating in the financial assistance program. The primary outcome of the randomized controlled trial will measure potential recipients' live kidney donor activation (a composite rate of live donor inquiries, completed new live donor evaluations, or live kidney donation) at 1 year. Discussion: The TALKS study will rigorously assess the effectiveness of promising interventions to reduce race disparities in LDKT. Trial registration: NCT02369354.

AB - Background: Live donor kidney transplantation (LDKT), an optimal therapy for many patients with end-stage kidney disease, is underutilized, particularly by African Americans. Potential recipient difficulties initiating and sustaining conversations about LDKT, identifying willing and medically eligible donors, and potential donors' logistical and financial hurdles have been cited as potential contributors to race disparities in LDKT. Few interventions specifically targeting these factors have been tested. Methods/Design: We report the protocol of the Talking about Living Kidney Donation Support (TALKS) study, a study designed to evaluate the effectiveness of behavioral, educational and financial assistance interventions to improve access to LDKT among African Americans on the deceased donor kidney transplant recipient waiting list. We adapted a previously tested educational and social worker intervention shown to improve consideration and pursuit of LDKT among patients and their family members for its use among patients on the kidney transplant waiting list. We also developed a financial assistance intervention to help potential donors overcome logistical and financial challenges they might face during the pursuit of live kidney donation. We will evaluate the effectiveness of these interventions by conducting a randomized controlled trial in which patients on the deceased donor waiting list receive 1) usual care while on the transplant waiting list, 2) the educational and social worker intervention, or 3) the educational and social worker intervention plus the option of participating in the financial assistance program. The primary outcome of the randomized controlled trial will measure potential recipients' live kidney donor activation (a composite rate of live donor inquiries, completed new live donor evaluations, or live kidney donation) at 1 year. Discussion: The TALKS study will rigorously assess the effectiveness of promising interventions to reduce race disparities in LDKT. Trial registration: NCT02369354.

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KW - Disparities

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KW - Live kidney donation

KW - Randomized clinical trial

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