Cultural competency of a mobile, customized patient education tool for improving potential kidney transplant recipients’ knowledge and decision-making

Abstract

Abstract:Patients considering renal transplantation face an increasingly complex array of choices as a result of the revised kidney transplant allocation system. Decision aids have been shown to improve patient decision making through the provision of detailed, relevant, individualized clinical data. A mobile iOS based application (app) including animated patient education and individualized risk adjusted outcomes following kidney transplants with varying donor characteristics and DSA waiting times was piloted in 2 large US transplant programs with a diverse group of renal transplant candidates (N=81).The majority (86%) of patients felt that the app improved their knowledge and was culturally appropriate for their race/ethnicity (67%-85%). Patients scored significantly higher on transplant knowledge testing (9.1/20 to 13.8/20 p<0.001) after viewing the app, including patients with low health literacy (8.0 to 13.0 p<0.001). Overall knowledge of and interest in living and deceased donor kidney transplantation increased. This pilot project confirmed the benefit and cultural acceptability of this educational tool, and further refinement will explore how to better communicate the risks and benefits of non-standard donors.

Strategies for Increasing Knowledge, Communication, and Access to Living Donor Transplantation: an Evidence Review to Inform Patient Education

“…The patient-centered information allows candidates to consider the relative benefits of LDKT and various types of DDKT (e.g., low-moderate kidney donor profile index (KDPI), high KDPI, or an Increased Infection Risk donor). 30 …”

Development and preliminary evaluation of an animation (simplifyKDPI) to improve kidney transplant candidate understanding of the Kidney Donor Profile Index

“…A multi‐disciplinary group of transplant providers and researchers developed questionnaires—informed from previous surveys and written with simple language—to examine KDPI knowledge, self‐efficacy, and willingness. Research staff used the questionnaires to conduct cognitive interviews with 10 kidney transplant recipients or candidates to ensure that questions were interpreted as intended.…”

“…Web‐based education programs to assist persons with end‐stage renal disease (ESRD) when making healthcare decisions have been successful in areas such as increased‐risk donor kidneys, livers at risk for viral disease transmission, and living kidney donation and transplantation . To date, only one online educational approach, My Transplant Coach , informs ESRD patients about KDPI . Through a mobile application, patients receive information on expected post‐transplant survival with various levels of KDPI and Public Health Service increased‐risk organs.…”

“…9 To date, only one online educational approach, My Transplant Coach, informs ESRD patients about KDPI. 10 Through a mobile application, patients receive information on expected post-transplant survival with various levels of KDPI and Public Health Service increased-risk organs. Although this 3-minute mobile animation increased knowledge, no data are provided regarding knowledge changes among older people, a subgroup who may receive the greatest benefit from high KDPI kidneys.…”

Development and preliminary evaluation of ilearnKAS: An animated video about kidney allocation to support transplant decision‐making

“…The animated medium offers great opportunity to overcome barriers that poor literacy creates 17 by drawing attention to the materials or message as well as improving comprehension, 4,[18][19][20][21][22] recall of information, 18 the accuracy of risk estimates, 4 and satisfaction with information delivery. 18,19 In this paper, we (a) review the patient-engaged video development process, and (b) report preliminary evidence of its feasibility and acceptability based on pilot testing of the video with a purposive sample of AA and non-AA kidney transplant candidates.…”