A Randomized Controlled Trial of a Pretransplant Educational Intervention in Kidney Patients

Abstract

Kidney TransplantationBackground. Poor patient knowledge about transplantation is a significant problem following kidney transplant. A video-based educational intervention was developed to supplement standard education provided by transplant teams. Methods. A multicenter randomized controlled trial tested the intervention delivered to patients undergoing assessment or waitlisted for kidney transplant. Adult participants were randomized to the control (standard education) or the intervention group, consisting of electronic access to the videos (or digital video disks if no internet) plus standard education. Differences between groups in changes in transplant knowledge (measured by the Kidney Transplant Understanding Tool), education satisfaction, self-efficacy, and quality of life (secondary outcomes) were evaluated by a preintervention and postintervention survey. Video viewing habits were tracked and described for patients in the intervention group. Results. One hundred sixty-two patients were enrolled, with 132 completing both questionnaires (n = 64 intervention and n = 68 control), with similar enrollment from 3 Canadian sites. Video viewing statistics in the complete cases indicated that 78% (50/64) watched the videos, with 70% (45/64) viewing them electronically, while 8% (5/64) received digital video disks and self-reported participation. Baseline knowledge scores in the intent-to-treat population were 55.4 ± 6.5 and 55.7 ± 7.1 in the intervention and control, respectively. The mean knowledge change in the intervention (2.1 ± 3.6) was significantly higher than in the control group (0.8 ± 3.4, P < 0.02). In the per-protocol analysis (patients with objective evidence of watching at least 80% of the videos), the knowledge improvements were 3.4 ± 3.8. Video group participants reported higher satisfaction with education (P < 0.02) and expressed positive comments in open-ended feedback. Conclusions. Electronic video education in the pretransplant setting improved knowledge and satisfaction.

Preliminary feasibility of animated video education designed to empower patients’ referral to kidney transplantation

“…Although our findings of gains in several transplant‐pursuit indicators are promising, they require validation compared to a control group. In a recent randomized controlled trial conducted at 3 Canadian sites, animation mixed with live action yielded significant knowledge increases, but did not impact self‐efficacy, quality of life, or medication beliefs relative to usual care among transplant candidates 24 . The authors attributed this to a “one‐size fits all” video delivery strategy and suggested tailoring and a multicomponent intervention approach to improve these outcomes.…”

“…elements, which reduces cognitive load and enhances information processing, as suggested by Mayer's cognitive theory of multimedia learning. 23 Other studies have also reported significant knowledge increases using standalone animation 13 or blended animation and live action 24 in transplantation and other health contexts. 25 Our report's 21% knowledge gain with a r = .54 effect size is considered large and promising and is similar to a meta-analysis of standalone animated video education in different healthcare contexts that found a small to medium effect size (Cohen's d = .38) across 20 studies.…”

“…In a recent randomized controlled trial conducted at 3 Canadian sites, animation mixed with live action yielded significant knowledge increases, but did not impact self-efficacy, quality of life, or medication beliefs relative to usual care among transplant candidates. 24 The authors attributed this to a "one-size fits all" video delivery strategy and suggested tailoring and a multicomponent intervention approach to improve these outcomes. Feedback from the participants in our study suggest that optimal video delivery strategy may involve completion of core content in a specific order to ensure that users access relevant topics.…”

Validation of the Chinese version of the kidney transplant understanding tool in Chinese patients

“…The Cronbach's alpha of the tool is 0.79 to 0.88, and the intragroup correlation coefficient is 0.76 to 0.94, which has good reliability. At present, it is applied in the United States (Bruns et al, 2021 ), South Korea (Kang & Jeong, 2020 ), North American countries (Mansell et al, 2019 ), Canada (Mansell et al, 2021 ) and Iran (Ganjali et al, 2019 ).…”

A Mixed Methods Assessment of Home-Based Video Pretransplant Lung Education

“…Recently, our interdisciplinary team collaborated with Lung Saskatchewan and patient stakeholders to develop a 6-part video series that describes the lung transplant process. The English videos, which were adapted from previous work [3][4][5] according to best practice for education for patients pursuing transplants, 6 are intended to supplement the first education session provided by the transplant respirologist. This initial meeting includes basic information about the transplant process (eg, what a lung transplant is, the process involved, potential risks and benefits, and what the expectations are before and after the transplant).…”