Can Improved Spanish-Language Kidney Transplant Education Reduce Barriers to Educating Hispanics?

Abstract

Purpose: Compared to Whites, Hispanics are less likely to receive education about kidney transplant (KTX) and more likely to remain on dialysis. This study determined: (1) the degree to which language is a barrier to KTX education in dialysis centers, (2) the number of Spanish-speaking (S-S) dialysis patients without access to a S-S educator, and (3) the impact of newly available Spanish-language education on the number of S-S patients being educated. Methods: From 2011-2013, 1514 dialysis educators from 1038 acute, chronic dialysis centers in 18 states were surveyed about the number of S-S patients in their caseload, whether they spoke Spanish fluently, and the likelihood of 21 potential barriers being present when educating about transplant. During a quality improvement initiative, educators received copies of a Spanish-language guided video program, “Considere Un Trasplante” to disseminate to their S-S patients. We examined the frequency of education-related barriers for all providers. For a subgroup of dialysis centers with ≥ 1 S-S patient (S-S DCs; n=493), we determined the total number of S-S patients, whether there was a S-S educator present, whether they planned to educate ≥ 1 or ≥ 5 of their S-S patients, and how many S-S patients they educated 6 months later. Results: The top two most-likely education-related barriers were language barriers (51% likely) and competing work priorities (51%). In S-S DCs, 85% (n=417) of the educators, serving 6668 S-S patients total, reported that they did not speak Spanish fluently. Even after receiving Spanish-language resources, centers without a S-S educator had significantly fewer plans to educate and lower actual education of S-S patients six months later (Table).Table: No Caption available.Conclusion: If a dialysis educator does not speak Spanish, only having access to educational materials translated into Spanish may not be sufficient for overcoming disparities in access to transplant education for Hispanics.