Division of Transplantation, Department of Surgery, University of Alabama Comprehensive Transplant Institute, Birmingham, AL, USA.
Division of Nephrology, Department of Medicine, University of Alabama Comprehensive Transplant Institute, Birmingham, AL, USA.
Prog Transplant. 2023 Dec;33(4):301-309. doi: 10.1177/15269248231212905. Epub 2023 Nov 7.
The Living Donor Navigator program is designed to mitigate disparities in living donor kidney transplantation, although geographic disparities in program participation were observed in the initial years of implementation. The purpose of this study was to understand participant perspectives regarding the use of a virtual option/alternative to expand program participation. Previous participants of the in-person navigator program were purposively sampled. Using the nominal group technique, a well-structured formative methodology to elicit participant perspectives, 2 meetings were conducted among transplant recipients and advocates (N = 13) to identify and prioritize responses to the question "What things would concern you about participating in a virtual and remote Living Donor Navigator program?" Mean participant age was 59.3 (9.3) years, and participants were 54% male and 62% white. Education levels varied from less than high school to master's degrees. Participants generated 70 unique responses, of which 36 (51.4%) received prioritization. The top 5 ranked responses of each nominal group technique meeting received approximately 50 percent (47.6% vs. 66.7%, respectively) of the total votes and described the potentially limited interpersonal connections, time conflicts, and differing content in a virtual navigator program compared to the in-person model. These data suggest that previous participants were concerned with upholding the original design of the program, thus, virtual living donor kidney transplantation programs should aim to maintain interpersonal connections and consistency of content to ensure adequate programmatic engagement. Future research will focus on program fidelity independent of delivery modality.
供者导航员计划旨在减少活体供肾移植中的差异,但在实施的最初几年中观察到了项目参与的地理差异。本研究的目的是了解参与者对使用虚拟选项/替代方案来扩大项目参与度的看法。 对参与现场导航员计划的前参与者进行了有针对性的抽样。使用名义小组技术,一种精心设计的形态学方法来引出参与者的观点,在 2 次会议中,在移植受者和倡导者中(N = 13)进行了会议,以确定并优先考虑对问题的回答“参加虚拟和远程活体供者导航员计划会让您担心什么?” 平均参与者年龄为 59.3(9.3)岁,参与者中 54%为男性,62%为白人。教育水平从低于高中学历到硕士学位不等。参与者提出了 70 个独特的回复,其中 36 个(51.4%)被优先考虑。每次名义小组技术会议的前 5 名排名回复分别获得了大约 50%(47.6%比 66.7%)的总票数,描述了虚拟导航员计划与面对面模式相比,潜在的有限人际联系、时间冲突和不同的内容。 这些数据表明,先前的参与者担心维持该计划的原始设计,因此,虚拟活体供肾移植计划应旨在保持人际联系和内容的一致性,以确保充分的计划参与。未来的研究将侧重于独立于传递方式的方案保真度。