The ASCENT (Allocation System Changes for Equity in Kidney Transplantation) Study: A Randomized Effectiveness-Implementation Study to Improve Kidney Transplant Waitlisting and Reduce Racial Disparity

被引：15

作者：

Patzer, Rachel E. ^{[1
,4
,5
]}

Smith, Kayla ^{[1
]}

Basu, Mohua ^{[1
]}

Gander, Jennifer ^{[1
]}

Mohan, Sumit ^{[2
,3
]}

Escoffery, Cam ^{[4
]}

Plantinga, Laura ^{[6
]}

Melanson, Taylor ^{[7
]}

Kalloo, Sean ^{[2
,3
]}

Green, Gary ^{[8
]}

Berlin, Alex ^{[9
]}

Renville, Gary ^{[10
]}

Browne, Teri ^{[11
]}

Turgeon, Nicole ^{[1
]}

Caponi, Susan ^{[12
]}

Zhang, Rebecca ^{[13
]}

Pastan, Stephen ^{[6
]}

机构：

[1] Emory Univ, Sch Med, Dept Surg, Div Transplantat, Atlanta, GA 30322 USA

[2] Columbia Univ, Coll Phys & Surg, Div Nephrol, Dept Med, New York, NY USA

[3] Columbia Univ, Dept Epidemiol, Mailman Sch Publ Hlth, New York, NY USA

[4] Emory Univ, Sch Med, Rollins Sch Publ Hlth, Dept Epidemiol, Atlanta, GA USA

[5] Emory Univ, Rollins Sch Publ Hlth, Dept Behav Sci & Hlth Educ, Sch Med, Atlanta, GA USA

[6] Emory Univ, Sch Med, Dept Med, Div Renal Med, Atlanta, GA USA

[7] Emory Sch Med, Rollins Sch Publ Hlth, Dept Hlth Policy Management, Atlanta, GA USA

[8] Amer Assoc Kidney Patients, Tampa, FL USA

[9] Southeastern Kidney Transplant Coalit, Atlanta, GA USA

[10] Natl Kidney Fdn, Atlanta, GA USA

[11] Univ South Carolina, Coll Social Work, Columbia, SC USA

[12] US ESRD Network 2, Lake Success, NY USA

[13] Emory Univ, Sch Med, Dept Biostat, Rollins Sch Publ Hlth, Atlanta, GA USA

来源：

KIDNEY INTERNATIONAL REPORTS | 2017年 / 2卷 / 03期

关键词：

education; ESRD Networks; Kidney Allocation System; kidney transplantation; multicomponent intervention; waitlisting; PUBLIC-HEALTH IMPACT; RE-AIM FRAMEWORK; INTERVENTIONS; COMPLETION; DIALYSIS; FEEDBACK; RACE;

D O I：

10.1016/j.ekir.2017.02.002

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Introduction: The United Network for Organ Sharing (UNOS) implemented a new Kidney Allocation System (KAS) in December 2014 that is expected to substantially reduce racial disparities in kidney transplantation among waitlisted patients. However, not all dialysis facility clinical providers and end-stage renal disease (ESRD) patients are aware of how the policy change could improve access to transplantation. Methods: We describe the ASCENT (Allocation System Changes for Equity in Kidney Transplantation) study, a randomized, controlled effectiveness-implementation study designed to test the effectiveness of a multicomponent intervention to improve access to the early steps of kidney transplantation among dialysis facilities across the United States. The multicomponent intervention consists of an educational webinar for dialysis medical directors, an educational video for patients and an educational video for dialysis staff, and a dialysis facility-specific transplantation performance feedback report. Materials will be developed by a multidisciplinary dissemination advisory board and will undergo formative testing in dialysis facilities across the United States. Results: This study is estimated to enroll w600 US dialysis facilities with low waitlisting in all 18 ESRD networks. The co-primary outcomes include change in waitlisting and waitlist disparity at 1 year; secondary outcomes include changes in facility medical director knowledge about KAS, staff training regarding KAS, patient education regarding transplantation, and the intent of the medical director to refer patients for transplantation evaluation. Discussion: The results from the ASCENT study will demonstrate the feasibility and effectiveness of a multicomponent intervention designed to increase access to the deceased donor kidney waitlist and to reduce racial disparities in waitlisting.

引用

页码：433 / 441

页数：9

共 24 条

[11] LONGITUDINAL DATA-ANALYSIS USING GENERALIZED LINEAR-MODELS
LIANG, KY
ZEGER, SL
[J]. BIOMETRIKA, 1986, 73 (01) : 13 - 22
[12] Achieving the goal: results from the Fistula First Breakthrough Initiative
Lynch, Janet R.
Mohan, Sumit
McClellan, William M.
[J]. CURRENT OPINION IN NEPHROLOGY AND HYPERTENSION, 2011, 20 (06) : 583 - 592
[13] Early Changes in Kidney Distribution under the New Allocation System
Massie, Allan B.
Luo, Xun
Lonze, Bonnie E.
Desai, Niraj M.
Bingaman, Adam W.
Cooper, Matthew
Segev, Dorry L.
[J]. JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2016, 27 (08): : 2495 - 2501
[14] A randomized evaluation of two health care quality improvement program (HCQIP) interventions to improve the adequacy of hemodialysis care of ESRD patients: Feedback alone versus intensive intervention
McClellan, WM
Hodgin, E
Pastan, S
McAdams, L
Soucie, M
[J]. JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2004, 15 (03): : 754 - 760
[15] Organ Procurement and Transplantation Network, 2014, ORG PROC TRANSPL NET
[16] The RaDIANT community study protocol: community-based participatory research for reducing disparities in access to kidney transplantation
Patzer, Rachel E.
Gander, Jennifer
Sauls, Leighann
Amamoo, M. Ahinee
Krisher, Jenna
Mulloy, Laura L.
Gibney, Eric
Browne, Teri
Plantinga, Laura
Pastan, Stephen O.
[J]. BMC NEPHROLOGY, 2014, 15
[17] Influence of race, ethnicity and socioeconomic status on kidney disease
Patzer, Rachel E.
McClellan, William M.
[J]. NATURE REVIEWS NEPHROLOGY, 2012, 8 (09) : 533 - 541
[18] Neighborhood Poverty and Racial Disparities in Kidney Transplant Waitlisting
Patzer, Rachel E.
Amaral, Sandra
Wasse, Haimanot
Volkova, Nataliya
Kleinbaum, David
McClellan, William M.
[J]. JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2009, 20 (06): : 1333 - 1340
[19] Patzer RE, 2016, J AM SOC NEPHROL
[20] Rogers E.M., 2003, Diffusion of Innovations, V5th ed.

← 1 2 3 →