Sieverdes John C, Treiber Frank A, Mueller Martina, Nemeth Lynne S, Brunner-Jackson Brenda, Anderson Ashley, Baliga Prabhakar K
College of Nursing, Medical University of South Carolina, Charleston, SC.
College of Medicine, Medical University of South Carolina, Charleston, SC.
Transplant Direct. 2018 May 18;4(6):e357. doi: 10.1097/TXD.0000000000000799. eCollection 2018 Jun.
The purpose of the Living Organ Video Educated Donors (LOVED) program is to address living donor kidney transplantation (LDKT) disparities in African Americans who experience half the rates of LDKTs compared with whites in the United States.
LOVED is an iterative-designed, distance-based, navigator-led, mobile health educational program, developed via guidance from patients, Self-determination Theory and Social Cognitive Theory. The purpose of this study was to assess the feasibility of LOVED using a proof-of-concept design to increase African Americans' knowledge about the living donor process to improve their willingness to approach others about being a potential kidney donor. The 8-week LOVED program consisted of (1) a computer tablet-delivered education program, (2) group video chat sessions with an African American LDKT recipient navigator, and (3) additional communication between group members and the navigator.
Twenty-five participants completed the LOVED study. Poststudy focus groups were analyzed using inductive and deductive qualitative descriptive techniques and analysts found 6 themes reporting LOVED being highly acceptable with the program being overall empowering and helpful. The study had 0% attrition, 90.9% adherence to the education videos and 88% adherence to the video chat sessions. Surveys showed statistically significant improvements in LDKT knowledge, higher willingness to communicate to others about their need, lower donor concerns, and higher self-efficacy about LDKT.
Findings indicate that participation in LOVED can lead to improvements in predictors to increase the number of evaluations and LDKTs in African Americans; however, these findings need to be confirmed in adequately powered, randomized controlled trials. Using LOVED may reduce barriers to broadly address LDKT disparities. Findings from this study will inform the design of a future statewide randomized controlled trials.
活体器官视频教育捐赠者(LOVED)项目旨在解决非裔美国人活体供肾移植(LDKT)方面的差距,在美国,非裔美国人的LDKT发生率仅为白人的一半。
LOVED是一个经过反复设计、基于远程、由导航员主导的移动健康教育项目,是在患者、自我决定理论和社会认知理论的指导下开发的。本研究的目的是使用概念验证设计评估LOVED的可行性,以增加非裔美国人对活体捐赠过程的了解,提高他们向他人表达成为潜在肾脏捐赠者意愿的可能性。为期8周的LOVED项目包括:(1)通过电脑平板提供的教育项目;(2)与非裔美国LDKT受者导航员进行的小组视频聊天;(3)小组成员与导航员之间的额外交流。
25名参与者完成了LOVED研究。研究后的焦点小组使用归纳和演绎定性描述技术进行了分析,分析人员发现6个主题,表明LOVED非常受欢迎,该项目总体上具有赋权作用且很有帮助。该研究的损耗率为0%,教育视频的依从率为90.9%,视频聊天的依从率为88%。调查显示,在LDKT知识方面有统计学上的显著改善,向他人表达自身需求的意愿更高,捐赠方面的担忧更低,以及对LDKT的自我效能感更高。
研究结果表明,参与LOVED可以改善相关预测因素,从而增加非裔美国人的评估数量和LDKT数量;然而,这些结果需要在样本量充足的随机对照试验中得到证实。使用LOVED可能会减少广泛解决LDKT差距的障碍。本研究的结果将为未来全州范围内的随机对照试验的设计提供参考。