title: Measuring and explaining racial and ethnic differences in willingness to donate live kidneys in the United States.
abstract: BACKGROUND
  Reasons for US racial-ethnic minority ESRD patients' reported difficulties identifying live kidney donors are poorly understood.
  
  
  METHODS
  We conducted a national study to develop scales measuring willingness to donate live kidneys among US adults (scores ranged from 0 [not willing] to 10 [extremely willing]), and we tested whether racial-ethnic differences exist in willingness to donate. We also examined whether clinical, sociodemographic, and attitudinal factors mediated potential racial-ethnic differences in willingness.
  
  
  RESULTS
  Among 845 participants, the majority were extremely willing to donate to relatives (77%) while fewer than half were extremely willing to donate to non-relatives (18%). In multivariable linear regression analyses, willingness to donate varied by race-ethnicity and recipient relationship to the donor. African Americans were less willing to donate to relatives than whites (β: -0.48; 95% CI [Confidence Interval]: -0.94 to -0.17; p = 0.04), but these differences were eliminated after accounting for socioeconomic factors, medical trust, and concerns about burial after death. There were no differences in willingness to donate between Hispanics and whites.
  
  
  CONCLUSIONS
  African Americans' burial concerns, medical trust, and socioeconomic factors explained differences in their willingness to donate to relatives, suggesting efforts to address these barriers may enhance rates of live kidney donation in this group.
authors.affiliation: Division of General Internal Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA; Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
authors.forename: Tanjala S
authors.initials: TS
authors.lastname: Purnell
authors.forename: Neil R
authors.initials: NR
authors.lastname: Powe
authors.forename: Misty U
authors.initials: MU
authors.lastname: Troll
authors.forename: Nae-Yuh
authors.initials: NY
authors.lastname: Wang
authors.forename: Carlton
authors.initials: C
authors.lastname: Haywood
authors.forename: Thomas A
authors.initials: TA
authors.lastname: LaVeist
authors.forename: L Ebony
authors.initials: LE
authors.lastname: Boulware
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology*; D000368:Aged; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006630:Hispanic or Latino / Q000523:psychology*; D006801:Humans; D016030:Kidney Transplantation / Q000523:psychology*; D019520:Living Donors / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D044469:Racial Groups; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014481:United States; D044465:White People / Q000523:psychology*; D055815:Young Adult
keywords: live donor kidney transplantation; live kidney donation; minority donation; racial-ethnic disparities; willingness to donate live kidneys
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