title: Your Path to Transplant: a randomized controlled trial of a tailored computer education intervention to increase living donor kidney transplant.
abstract: BACKGROUND
  Because of the deceased donor organ shortage, more kidney patients are considering whether to receive kidneys from family and friends, a process called living donor kidney transplantation (LDKT). Although Blacks and Hispanics are 3.4 and 1.5 times more likely, respectively, to develop end stage renal disease (ESRD) than Whites, they are less likely to receive LDKTs. To address this disparity, a new randomized controlled trial (RCT) will assess whether Black, Hispanic, and White transplant patients' knowledge, readiness to pursue LDKT, and receipt of LDKTs can be increased when they participate in the Your Path to Transplant (YPT) computer-tailored intervention.
  
  
  METHODS
  Nine hundred Black, Hispanic, and White ESRD patients presenting for transplant evaluation at University of California, Los Angeles Kidney and Pancreas Transplant Program (UCLA-KPTP) will be randomly assigned to one of two education conditions, YPT or Usual Care Control Education (UC). As they undergo transplant evaluation, patients in the YPT condition will receive individually-tailored telephonic coaching sessions, feedback reports, video and print transplant education resources, and assistance with reducing any known socioeconomic barriers to LDKT. Patients receiving UC will only receive transplant education provided by UCLA-KPTP. Changes in transplant knowledge, readiness, pros and cons, and self-efficacy to pursue LDKT will be assessed prior to presenting at the transplant center (baseline), during transplant evaluation, and 4- and 8-months post-baseline, while completion of transplant evaluation and receipt of LDKTs will be assessed at 18-months post-baseline. The RCT will determine, compared to UC, whether Black, Hispanic, and White patients receiving YPT increase in their readiness to pursue LDKT and transplant knowledge, and become more likely to complete transplant medical evaluation and pursue LDKT. It will also examine how known patient, family, and healthcare system barriers to LDKT act alone and in combination with YPT to affect patients' transplant decision-making and behavior. Statistical analyses will be performed under an intent-to-treat approach.
  
  
  CONCLUSIONS
  At the conclusion of the study, we will have assessed the effectiveness of an innovative and cost-effective YPT intervention that could be utilized to tailor LDKT discussion and education based on the needs of individual patients of different races in many healthcare settings.
  
  
  BACKGROUND
  ClinicalTrials.gov, number NCT02181114.
authors.affiliation: Division of Nephrology, David Geffen School of Medicine at the University of California, Los Angeles, 10940 Wilshire Blvd, Suite 1223, Los Angeles, CA 90024, USA. awaterman@mednet.ucla.edu.
authors.forename: Amy D
authors.initials: AD
authors.lastname: Waterman
authors.forename: Mark L
authors.initials: ML
authors.lastname: Robbins
authors.forename: Andrea L
authors.initials: AL
authors.lastname: Paiva
authors.forename: John D
authors.initials: JD
authors.lastname: Peipert
authors.forename: Crystal S
authors.initials: CS
authors.lastname: Kynard-Amerson
authors.forename: Christina J
authors.initials: CJ
authors.lastname: Goalby
authors.forename: LaShara A
authors.initials: LA
authors.lastname: Davis
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Thein
authors.forename: Emily A
authors.initials: EA
authors.lastname: Schenk
authors.forename: Kari A
authors.initials: KA
authors.lastname: Baldwin
authors.forename: Stacy L
authors.initials: SL
authors.lastname: Skelton
authors.forename: Nicole R
authors.initials: NR
authors.lastname: Amoyal
authors.forename: Leslie A
authors.initials: LA
authors.lastname: Brick
mesh_terms: D001296:Audiovisual Aids; D003194:Computer-Assisted Instruction / Q000379:methods; D003376:Counseling; D003657:Decision Making; D005006:Ethnicity / Q000523:psychology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007676:Kidney Failure, Chronic / Q000208:ethnology / Q000523:psychology* / Q000601:surgery; D016030:Kidney Transplantation / Q000523:psychology*; D019520:Living Donors; D015141:Los Angeles; D010174:Pamphlets; D010342:Patient Acceptance of Health Care; D010353:Patient Education as Topic; D018401:Sample Size; D012959:Socioeconomic Factors; D013689:Telephone