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The RaDIANT community study protocol: community-based participatory research for reducing disparities in access to kidney transplantation.

Patzer RE, Gander J, Sauls L, Amamoo MA, Krisher J, Mulloy LL, Gibney E, Browne T, Plantinga L, Pastan SO, Southeastern Kidney Transplant Coaliti - BMC Nephrol (2014)

Bottom Line: The Southeastern United States has the lowest kidney transplant rates in the nation, and racial disparities in kidney transplant access are concentrated in this region.The Southeastern Kidney Transplant Coalition (SEKTC) of Georgia, North Carolina, and South Carolina is an academic and community partnership that was formed with the mission to improve access to kidney transplantation and reduce disparities among African American (AA) end stage renal disease (ESRD) patients in the Southeastern United States.The primary outcome is change in facility-level referral for kidney transplantation from baseline to 12 months; the secondary outcome is reduction in racial disparity in transplant referral.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Division of Transplantation, Emory University School of Medicine, Atlanta, GA, USA. rpatzer@emory.edu.

ABSTRACT

Background: The Southeastern United States has the lowest kidney transplant rates in the nation, and racial disparities in kidney transplant access are concentrated in this region. The Southeastern Kidney Transplant Coalition (SEKTC) of Georgia, North Carolina, and South Carolina is an academic and community partnership that was formed with the mission to improve access to kidney transplantation and reduce disparities among African American (AA) end stage renal disease (ESRD) patients in the Southeastern United States.

Methods/design: We describe the community-based participatory research (CBPR) process utilized in planning the Reducing Disparities In Access to kidNey Transplantation (RaDIANT) Community Study, a trial developed by the SEKTC to reduce health disparities in access to kidney transplantation among AA ESRD patients in Georgia, the state with the lowest kidney transplant rates in the nation. The SEKTC Coalition conducted a needs assessment of the ESRD population in the Southeast and used results to develop a multicomponent, dialysis facility-randomized, quality improvement intervention to improve transplant access among dialysis facilities in GA. A total of 134 dialysis facilities are randomized to receive either: (1) standard of care or "usual" transplant education, or (2) the multicomponent intervention consisting of transplant education and engagement activities targeting dialysis facility leadership, staff, and patients within dialysis facilities. The primary outcome is change in facility-level referral for kidney transplantation from baseline to 12 months; the secondary outcome is reduction in racial disparity in transplant referral.

Discussion: The RaDIANT Community Study aims to improve equity in access to kidney transplantation for ESRD patients in the Southeast.

Trial registration: Clinicaltrials.gov number NCT02092727.

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Related in: MedlinePlus

RaDIANT community study flow diagram for dialysis facility selection.
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Fig1: RaDIANT community study flow diagram for dialysis facility selection.

Mentions: All dialysis facilities within GA were considered for randomization of the intervention (n = 283). To ensure that each facility had a large enough population to detect a change in the main effect of disparity reduction, facilities with a 2012 population of <25 patients (18-69 years of age) were excluded from the potential pool of facilities (n = 11). The remaining facilities were selected in a step-wise selection process: 1) The presence of a racial disparity in transplant referral (n = 75), or 2) crude annual referral in the lowest 50th percentile (referral <0.06; n = 59) for the state. The presence of a racial disparity was based on a difference of the proportion of AA ESRD patients referred and the proportion of white ESRD patients referred. The remaining facilities selected had a calculated crude referral in the lower 50th percentile. The final pool of 134 facilities were randomized by generating a random number to either the intervention (n = 67) or control (n = 67) group (Figure 1). Dialysis facilities in the intervention group are not blinded to intervention activities; however, facilities selected as controls are blinded. Researchers are not blinded to dialysis facility allocation.Figure 1


The RaDIANT community study protocol: community-based participatory research for reducing disparities in access to kidney transplantation.

Patzer RE, Gander J, Sauls L, Amamoo MA, Krisher J, Mulloy LL, Gibney E, Browne T, Plantinga L, Pastan SO, Southeastern Kidney Transplant Coaliti - BMC Nephrol (2014)

RaDIANT community study flow diagram for dialysis facility selection.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4230631&req=5

Fig1: RaDIANT community study flow diagram for dialysis facility selection.
Mentions: All dialysis facilities within GA were considered for randomization of the intervention (n = 283). To ensure that each facility had a large enough population to detect a change in the main effect of disparity reduction, facilities with a 2012 population of <25 patients (18-69 years of age) were excluded from the potential pool of facilities (n = 11). The remaining facilities were selected in a step-wise selection process: 1) The presence of a racial disparity in transplant referral (n = 75), or 2) crude annual referral in the lowest 50th percentile (referral <0.06; n = 59) for the state. The presence of a racial disparity was based on a difference of the proportion of AA ESRD patients referred and the proportion of white ESRD patients referred. The remaining facilities selected had a calculated crude referral in the lower 50th percentile. The final pool of 134 facilities were randomized by generating a random number to either the intervention (n = 67) or control (n = 67) group (Figure 1). Dialysis facilities in the intervention group are not blinded to intervention activities; however, facilities selected as controls are blinded. Researchers are not blinded to dialysis facility allocation.Figure 1

Bottom Line: The Southeastern United States has the lowest kidney transplant rates in the nation, and racial disparities in kidney transplant access are concentrated in this region.The Southeastern Kidney Transplant Coalition (SEKTC) of Georgia, North Carolina, and South Carolina is an academic and community partnership that was formed with the mission to improve access to kidney transplantation and reduce disparities among African American (AA) end stage renal disease (ESRD) patients in the Southeastern United States.The primary outcome is change in facility-level referral for kidney transplantation from baseline to 12 months; the secondary outcome is reduction in racial disparity in transplant referral.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Division of Transplantation, Emory University School of Medicine, Atlanta, GA, USA. rpatzer@emory.edu.

ABSTRACT

Background: The Southeastern United States has the lowest kidney transplant rates in the nation, and racial disparities in kidney transplant access are concentrated in this region. The Southeastern Kidney Transplant Coalition (SEKTC) of Georgia, North Carolina, and South Carolina is an academic and community partnership that was formed with the mission to improve access to kidney transplantation and reduce disparities among African American (AA) end stage renal disease (ESRD) patients in the Southeastern United States.

Methods/design: We describe the community-based participatory research (CBPR) process utilized in planning the Reducing Disparities In Access to kidNey Transplantation (RaDIANT) Community Study, a trial developed by the SEKTC to reduce health disparities in access to kidney transplantation among AA ESRD patients in Georgia, the state with the lowest kidney transplant rates in the nation. The SEKTC Coalition conducted a needs assessment of the ESRD population in the Southeast and used results to develop a multicomponent, dialysis facility-randomized, quality improvement intervention to improve transplant access among dialysis facilities in GA. A total of 134 dialysis facilities are randomized to receive either: (1) standard of care or "usual" transplant education, or (2) the multicomponent intervention consisting of transplant education and engagement activities targeting dialysis facility leadership, staff, and patients within dialysis facilities. The primary outcome is change in facility-level referral for kidney transplantation from baseline to 12 months; the secondary outcome is reduction in racial disparity in transplant referral.

Discussion: The RaDIANT Community Study aims to improve equity in access to kidney transplantation for ESRD patients in the Southeast.

Trial registration: Clinicaltrials.gov number NCT02092727.

Show MeSH
Related in: MedlinePlus