title: A patient navigator and education program for increasing potential living donors: a comparative observational study.
abstract: Person-centered clinical environments may promote living donation for patients with end-stage renal disease (ESRD). We implemented an observational study design to explore whether a patient navigator (PN) program with person-centered education in nephrology practice settings could increase potential living donors (PLDs) and, subsequently, increase living transplantation.
  
  
  
  Patients referred to (N = 4621) and/or transplanted at (N = 950) our transplant center during 2007-2012 were eligible for inclusion. Two analytical study populations were derived from propensity score matched patient groups. Outcomes comprised total PLDs per candidate and living vs. deceased transplantation for recipients.
  
  
  
  Multivariable generalized estimating equations logistic regression showed that PN practice candidates were significantly more likely to have an initial inquiry PLD (odds ratio [OR] = 1.21, 95% confidence interval [CI] = 1.01-1.44) and a preliminary screening PLD (OR = 1.27, 95% CI = 1.05-1.54), while there were no significant differences observed in evaluated PLD (OR = 0.94, 95% CI = 0.61-1.45).
  
  
  
  Our results suggest that our person-centered PN program stimulated willingness to seek living transplantation and was associated with a trend toward increased LD.
authors.affiliation: Department of Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA.
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Marlow
authors.affiliation: Department of Healthcare Leadership and Management, College of Health Professions, Charleston, SC, USA.
authors.forename: Abby S
authors.initials: AS
authors.lastname: Kazley
authors.affiliation: Division of Transplant Surgery, College of Medicine, Medical University of South Carolina, Charleston, SC, USA.
authors.forename: Kenneth D
authors.initials: KD
authors.lastname: Chavin
authors.affiliation: Department of Healthcare Leadership and Management, College of Health Professions, Charleston, SC, USA.
authors.forename: Kit N
authors.initials: KN
authors.lastname: Simpson
authors.affiliation: Division of Bio-behavioral Medicine, Psychiatry and Behavioral Science, Medical University of South Carolina, Charleston, SC, USA.
authors.forename: Wendy
authors.initials: W
authors.lastname: Balliet
authors.affiliation: Division of Transplant Surgery, College of Medicine, Medical University of South Carolina, Charleston, SC, USA.
authors.forename: Prabhakar K
authors.initials: PK
authors.lastname: Baliga
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006266:Health Education / Q000706:statistics & numerical data*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D033181:Information Dissemination; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation; D019520:Living Donors / Q000193:education*; D008297:Male; D008875:Middle Aged; D062526:Patient Navigation; D011379:Prognosis; D011795:Surveys and Questionnaires
keywords: behavioral medicine; chronic renal insufficiency; kidney transplantation; patient education; patient-centered care