Frequency of In-Home Internet Use Among Prekidney and Postkidney Transplant Patients—Facilitators and Barriers to Use and Trends Over Time

Lockwood, Mark B.; Dunn-Lopez, Karen; Burke, Larisa A.; Becker, Yolanda T.; Saunders, Milda R.

doi:10.1097/txd.0000000000000735

Cited by 4 publications

(3 citation statements)

References 30 publications

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“…The entire process took approximately 1 hour per patient, with health utility assessments taking approximately 30 minutes on average. Barriers regarding home internet access may have increased the acceptability of utility assessment in the community dialysis clinic setting [ 27 ]. Many patients expressed pleasure at the opportunity to engage in a value-added activity while they were “captive” during their 3- to 4-hour dialysis session.…”

Section: Discussionmentioning

confidence: 99%

Implementing a Health Utility Assessment Platform to Acquire Health Utilities in a Hemodialysis Outpatient Setting: Feasibility Study

Adejare¹,

Duncan²,

Motz³

et al. 2022

JMIR Form Res

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Background Patients with end-stage kidney disease (ESKD) wait roughly 4 years for a kidney transplant. A potential way to reduce wait times is using hepatitis C virus (HCV)–viremic kidneys. Objective As preparation for developing a shared decision-making tool to assist patients with ESKD with the decision to accept an HCV-viremic kidney transplant, our initial goal was to assess the feasibility of using The Gambler II, a health utility assessment tool, in an ambulatory dialysis clinic setting. Our secondary goals were to collect health utilities for patients with ESKD and to explore whether the use of race-matched versus race-mismatched exemplars impacted the knowledge gained during the assessment process. Methods We used The Gambler II to elicit utilities for the following ESKD-related health states: hemodialysis, kidney transplant with HCV-unexposed kidney, and transplantation with HCV-viremic kidney. We created race exemplar video clips describing these health states and randomly assigned patients into the race-matched or race-mismatched video arms. We obtained utilities for these 3 health states from each patient, and we evaluated knowledge about ESKD and HCV-associated health conditions with pre- and postintervention knowledge assessments. Results A total of 63 patients with hemodialysis from 4 outpatient Dialysis Center Inc sites completed the study. Mean adjusted standard gamble utilities for hemodialysis, transplant with HCV-unexposed kidney, and transplantation with HCV-viremic kidney were 82.5, 89, and 75.5, respectively. General group knowledge assessment scores improved by 10 points (P<.05) following utility assessment process. The use of race-matched exemplars had little effect on the results of the knowledge assessment of patients. Conclusions Using The Gambler II to collect utilities for patients with ESKD in an ambulatory dialysis clinic setting proved feasible. In addition, educational information about health states provided as part of the utility assessment process tool improved patients’ knowledge and understanding about ESKD-related health states and implications of organ transplantation with HCV-viremic kidneys. A wide variation in patient health state utilities reinforces the importance of incorporating patients’ preferences into decisions regarding use of HCV-viremic kidneys for transplantation.

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Section: Discussionmentioning

confidence: 99%

Implementing a Health Utility Assessment Platform to Acquire Health Utilities in a Hemodialysis Outpatient Setting: Feasibility Study

Adejare¹,

Duncan²,

Motz³

et al. 2022

JMIR Form Res

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“…A recent Live Kidney Donation Consensus Conference recommended using the internet to improve delivery of information to kidney patients and their support networks. 6 Internet use among individuals with ESKD is high overall (over 90%) and across age, race, and income, 7 and online education has been met with general interest among patients with ESKD, 8 who recommend media that works quickly and is easy to use. 9 Over the last decade, web-based education about kidney transplantation informed by research has taken on a variety of formats to enable education across individual learning styles, including text, 8,10,11 images, 10,11 videos, 8,10,12 interactive modules, 10 risk calculators, 11,13 infographics, 10,11 drag and drop games, 10 and quizzes.…”

Section: Introductionmentioning

confidence: 99%

Formative Usability of the Kidneytime Online Live Donor Kidney Transplant Education Tool Among Transplant Candidates

et al. 2021

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Background Web-based education may be a powerful tool to support transplant candidates’ learning and communication about live donor kidney transplantation. Few educational interventions are web-based and have education sharing for living donor transplant as a primary goal. Methods Through user-centered design and iterative usability testing, we developed a web platform, called KidneyTIME, to support an educational intervention for adult transplant candidates. KidneyTIME delivers animated videos to improve candidate knowledge, motivation, and self-efficacy to pursue living donor transplantation and to promote outreach through video sharing. The animated-video educational content was previously produced by the researchers. We conducted a formative usability evaluation of the KidneyTIME web platform to enable users to find, view, and share the previously produced videos. A total of 30 kidney transplant candidates were involved in 4 rounds of testing at one transplant center, with amendments made after each round. Results Transplant candidates were predominantly White non-Hispanic; 47% had incomes <$30 000 and >43% had vision or motor impairment. Readability, navigation, and failure to find videos were the main usability issues identified. Substantial improvements were found in the usability of most functions after implementing certain features, such as enlarging text and buttons, enhancing contrast, and simplifying presentation. Participants reported that the intervention was user friendly and easy to navigate. Conclusion Considering feedback from a wide spectrum of users has improved the usability of KidneyTIME. A salient concern for End stage kidney disease populations is ensuring online accessibility despite vision and motor impairments.

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“…Outside of transplantation, mHealth has improved health care access, reduced costs, and increased self-management of chronic diseases in both observational studies and clinical trials [ 18 - 25 ]. Within the transplant community, single-center studies have examined the acceptability and effects of mHealth technologies among organ transplant recipients [ 26 - 30 ]. However, little is known about mHealth attitudes and perceptions among living donors, a distinct population that is generally healthier than the average US adult, without chronic conditions or regular interaction with the health system.…”

Section: Introductionmentioning

confidence: 99%

Assessing the Attitudes and Perceptions Regarding the Use of Mobile Health Technologies for Living Kidney Donor Follow-Up: Survey Study

Eno

Thomas

Ruck

et al. 2018

JMIR Mhealth Uhealth

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BackgroundIn 2013, the Organ Procurement and Transplantation Network began requiring transplant centers in the United States to collect and report postdonation living kidney donor follow-up data at 6 months, 1 year, and 2 years. Despite this requirement, <50% of transplant centers have been able to collect and report the required data. Previous work identified a number of barriers to living kidney donor follow-up, including logistical and administrative barriers for transplant centers and cost and functional barriers for donors. Novel smartphone-based mobile health (mHealth) technologies might reduce the burden of living kidney donor follow-up for centers and donors. However, the attitudes and perceptions toward the incorporation of mHealth into postdonation care among living kidney donors are unknown. Understanding donor attitudes and perceptions will be vital to the creation of a patient-oriented mHealth system to improve living donor follow-up in the United States.ObjectiveThe goal of this study was to assess living kidney donor attitudes and perceptions associated with the use of mHealth for follow-up.MethodsWe developed and administered a cross-sectional 14-question survey to 100 living kidney donors at our transplant center. All participants were part of an ongoing longitudinal study of long-term outcomes in living kidney donors. The survey included questions on smartphone use, current health maintenance behaviors, accessibility to health information, and attitudes toward using mHealth for living kidney donor follow-up.ResultsOf the 100 participants surveyed, 94 owned a smartphone (35 Android, 58 iPhone, 1 Blackberry), 37 had accessed their electronic medical record on their smartphone, and 38 had tracked their exercise and physical activity on their smartphone. While 77% (72/93) of participants who owned a smartphone and had asked a medical question in the last year placed the most trust with their doctors, nurses, or other health care professionals regarding answering a health-related question, 52% (48/93) most often accessed health information elsewhere. Overall, 79% (74/94) of smartphone-owning participants perceived accessing living kidney donor information and resources on their smartphone as useful. Additionally, 80% (75/94) perceived completing some living kidney donor follow-up via mHealth as useful. There were no significant differences in median age (60 vs 59 years; P=.65), median years since donation (10 vs 12 years; P=.45), gender (36/75, 36%, vs 37/75, 37%, male; P=.57), or race (70/75, 93%, vs 18/19, 95%, white; P=.34) between those who perceived mHealth as useful for living kidney donor follow-up and those who did not, respectively.ConclusionsOverall, smartphone ownership was high (94/100, 94.0%), and 79% (74/94) of surveyed smartphone-owning donors felt that it would be useful to complete their required follow-up with an mHealth tool, with no significant differences by age, sex, or race. These results suggest that patients would benefit from an mHealth tool to perform living donor follow-up.

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Frequency of In-Home Internet Use Among Prekidney and Postkidney Transplant Patients—Facilitators and Barriers to Use and Trends Over Time

Cited by 4 publications

References 30 publications

Implementing a Health Utility Assessment Platform to Acquire Health Utilities in a Hemodialysis Outpatient Setting: Feasibility Study

Implementing a Health Utility Assessment Platform to Acquire Health Utilities in a Hemodialysis Outpatient Setting: Feasibility Study

Formative Usability of the Kidneytime Online Live Donor Kidney Transplant Education Tool Among Transplant Candidates

Assessing the Attitudes and Perceptions Regarding the Use of Mobile Health Technologies for Living Kidney Donor Follow-Up: Survey Study

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