title: Explore Transplant at Home: a randomized control trial of an educational intervention to increase transplant knowledge for Black and White socioeconomically disadvantaged dialysis patients.
abstract: BACKGROUND
  Compared to others, dialysis patients who are socioeconomically disadvantaged or Black are less likely to receive education about deceased donor kidney transplant (DDKT) and living donor kidney transplant (LDKT) before they reach transplant centers, often due to limited availability of transplant education within dialysis centers. Since these patients are often less knowledgeable or ready to pursue transplant, educational content must be simplified, made culturally sensitive, and presented gradually across multiple sessions to increase learning and honor where they are in their decision-making about transplant. The Explore Transplant at Home (ETH) program was developed to help patients learn more about DDKT and LDKT at home, with and without telephone conversations with an educator.
  
  
  METHODS
  In this randomized controlled trial (RCT), 540 low-income Black and White dialysis patients with household incomes at or below 250 % of the federal poverty line, some of whom receive financial assistance from the Missouri Kidney Program, will be randomly assigned to one of three education conditions: (1) standard-of-care transplant education provided by the dialysis center, (2) patient-guided ETH (ETH-PG), and (3) health educator-guided ETH (ETH-EG). Patients in the standard-of-care condition will only receive education provided in their dialysis centers. Those in the two ETH conditions will receive four video and print modules delivered over an 8 month period by mail, with the option of receiving supplementary text messages weekly. In addition, patients in the ETH-EG condition will participate in multiple telephonic educational sessions with a health educator. Changes in transplant knowledge, decisional balance, self-efficacy, and informed decision making will be captured with surveys administered before and after the ETH education.
  
  
  CONCLUSIONS
  At the conclusion of this RCT, we will have determined whether an education program administered to socioeconomically disadvantaged dialysis patients, over several months directly in their homes, can help more individuals learn about the options of DDKT and LDKT. We also will be able to examine the efficacy of different educational delivery approaches to further understand whether the addition of a telephone educator is necessary for increasing transplant knowledge.
  
  
  BACKGROUND
  ClinicalTrials.gov, NCT02268682.
authors: Division of Nephrology, David Geffen School of Medicine at University of California, Los Angeles, 10940 Wilshire Blvd, Suite 1223, Los Angeles, CA, 90024, USA. awaterman@mednet.ucla.edu.|Division of General Medical Sciences, Washington University School of Medicine, Campus Box 8005, 660 S. Euclid Ave., St. Louis, MO, 63110, USA. awaterman@mednet.ucla.edu.
authors: Amy D
authors: AD
authors: Waterman
authors: Division of Nephrology, David Geffen School of Medicine at University of California, Los Angeles, 10940 Wilshire Blvd, Suite 1223, Los Angeles, CA, 90024, USA. amcsorley@mednet.ucla.edu.
authors: Anna-Michelle M
authors: AM
authors: McSorley
authors: Division of Nephrology, David Geffen School of Medicine at University of California, Los Angeles, 10940 Wilshire Blvd, Suite 1223, Los Angeles, CA, 90024, USA. jpeipert@mednet.ucla.edu.|Division of General Medical Sciences, Washington University School of Medicine, Campus Box 8005, 660 S. Euclid Ave., St. Louis, MO, 63110, USA. jpeipert@mednet.ucla.edu.
authors: John D
authors: JD
authors: Peipert
authors: Division of Nephrology, David Geffen School of Medicine at University of California, Los Angeles, 10940 Wilshire Blvd, Suite 1223, Los Angeles, CA, 90024, USA. CGoalby@mednet.ucla.edu.|Division of General Medical Sciences, Washington University School of Medicine, Campus Box 8005, 660 S. Euclid Ave., St. Louis, MO, 63110, USA. CGoalby@mednet.ucla.edu.
authors: Christina J
authors: CJ
authors: Goalby
authors: Missouri Kidney Program, University of Missouri, Columbia, AP Green Building, Suite 111, 201 Business Loop-70 W, Columbia, MO, 65211, USA. peacelj@health.missouri.edu.
authors: Leanne J
authors: LJ
authors: Peace
authors: Missouri Kidney Program, University of Missouri, Columbia, AP Green Building, Suite 111, 201 Business Loop-70 W, Columbia, MO, 65211, USA. lutzp@health.missouri.edu.
authors: Patricia A
authors: PA
authors: Lutz
authors: Division of General Medical Sciences, Washington University School of Medicine, Campus Box 8005, 660 S. Euclid Ave., St. Louis, MO, 63110, USA. thein.jessica@gmail.com.
authors: Jessica L
authors: JL
authors: Thein
mesh_terms: D001741:Black or African American; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016030:Kidney Transplantation; D010353:Patient Education as Topic; D006435:Renal Dialysis; D012107:Research Design; D012959:Socioeconomic Factors; D035862:Vulnerable Populations; D044465:White People