title: Everybody needs a cheerleader to get a kidney transplant: a qualitative study of the patient barriers and facilitators to kidney transplantation in the Southeastern United States.
abstract: Kidney transplantation (KTx) disparity is a significant problem in the United States, particularly in the Southeastern region. In response to this phenomenon, the Southeastern Kidney Transplant Coalition was created in 2011 to increase the KTx rate, and to reduce disparities in access to transplantation in the Southeast, by identifying and reducing barriers in the transplant process.
  
  
  
  To determine perceived barriers and facilitators to KTx that dialysis patients in this region experience, we conducted three focus groups with 40 total patients in Georgia, North Carolina, and South Carolina.
  
  
  
  We identified two novel themes specific to Southeastern dialysis patients that describe the major barriers and facilitators to kidney transplantation: dialysis center approaches to patient education about KTx, and dialysis center advocacy and encouragement for KTx. In addition, themes related to barriers and facilitators of KTx were evident that were previously mentioned in the literature such as age, fear, knowing other patients with good or bad experiences with KTx, distrust of the KTx process equity, financial concerns and medical barriers.
  
  
  
  Dialysis providers are encouraged to enhance their delivery of information and active assistance to underserved patients related to KTx.
authors.affiliation: College of Social Work, University of South Carolina, 12 Hamilton, Columbia, SC, 29208, USA. browne@sc.edu.
authors.forename: Teri
authors.initials: T
authors.lastname: Browne
authors.affiliation: Southeastern Kidney Council, 1000 St. Albans Drive, Suite 270, Raleigh, NC, 27609, USA.
authors.forename: Ahinee
authors.initials: A
authors.lastname: Amamoo
authors.affiliation: School of Medicine, Emory University, 101 Woodruff Circle, 5105 WMB, Atlanta, GA, 30322, USA.
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Patzer
authors.affiliation: Southeastern Kidney Council, 1000 St. Albans Drive, Suite 270, Raleigh, NC, 27609, USA.
authors.forename: Jenna
authors.initials: J
authors.lastname: Krisher
authors.affiliation: National Kidney Foundation, 508 Hampton Street, Columbia, SC, 29201, USA.
authors.forename: Henry
authors.initials: H
authors.lastname: Well
authors.affiliation: School of Medicine, Emory University, 101 Woodruff Circle, 5105 WMB, Atlanta, GA, 30322, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Gander
authors.affiliation: School of Medicine, Emory University, 101 Woodruff Circle, 5105 WMB, Atlanta, GA, 30322, USA.
authors.forename: Stephen O
authors.initials: SO
authors.lastname: Pastan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005845:Georgia / Q000453:epidemiology; D006297:Health Services Accessibility / Q000592:standards*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D016030:Kidney Transplantation / Q000379:methods / Q000592:standards*; D008297:Male; D008875:Middle Aged; D009657:North Carolina / Q000453:epidemiology; D010353:Patient Education as Topic / Q000379:methods / Q000592:standards*; D006435:Renal Dialysis / Q000379:methods / Q000592:standards*; D013022:South Carolina / Q000453:epidemiology; D015144:Southeastern United States / Q000453:epidemiology; D055815:Young Adult