The RaDIANT community study protocol: community-based participatory research for reducing disparities in access to kidney transplantation.

Rachel E Patzer,Teri Browne,Jennifer Gander,Laura L Mulloy,Stephen O Pastan,Jenna Krisher,Laura Plantinga,M Ahinee Amamoo,Eric Gibney,Leighann Sauls

doi:10.1186/1471-2369-15-171

Abstract

BackgroundThe Southeastern United States has the lowest kidney transplant rates in the nation, and racial disparities in kidney transplant access are concentrated in this region. The Southeastern Kidney Transplant Coalition (SEKTC) of Georgia, North Carolina, and South Carolina is an academic and community partnership that was formed with the mission to improve access to kidney transplantation and reduce disparities among African American (AA) end stage renal disease (ESRD) patients in the Southeastern United States.Methods/DesignWe describe the community-based participatory research (CBPR) process utilized in planning the Reducing Disparities In Access to kidNey Transplantation (RaDIANT) Community Study, a trial developed by the SEKTC to reduce health disparities in access to kidney transplantation among AA ESRD patients in Georgia, the state with the lowest kidney transplant rates in the nation. The SEKTC Coalition conducted a needs assessment of the ESRD population in the Southeast and used results to develop a multicomponent, dialysis facility-randomized, quality improvement intervention to improve transplant access among dialysis facilities in GA. A total of 134 dialysis facilities are randomized to receive either: (1) standard of care or “usual” transplant education, or (2) the multicomponent intervention consisting of transplant education and engagement activities targeting dialysis facility leadership, staff, and patients within dialysis facilities. The primary outcome is change in facility-level referral for kidney transplantation from baseline to 12 months; the secondary outcome is reduction in racial disparity in transplant referral.DiscussionThe RaDIANT Community Study aims to improve equity in access to kidney transplantation for ESRD patients in the Southeast.Trial registrationClinicaltrials.gov number NCT02092727.

Highlights

The Southeastern United States has the lowest kidney transplant rates in the nation, and racial disparities in kidney transplant access are concentrated in this region
Coalition members formed subgroup committees to address these gaps and, throughout the following 18 months, performed qualitative and quantitative research to improve our understanding of the challenges within the transplantation process in the Southeast. Detailed results from this population needs assessment [43,44,45,46] are described elsewhere, but we describe these results in brief below since these results influenced the development of multi-component intervention activities for the Reducing Disparities In Access to kidNey Transplantation (RaDIANT) Community Study
In this paper, we described the formation of an academic– community partnership; the development of a multicomponent, quality improvement intervention based on results of a community needs assessment; and the selection of dialysis facilities for the RaDIANT Community Study

Summary

Introduction

The Southeastern United States has the lowest kidney transplant rates in the nation, and racial disparities in kidney transplant access are concentrated in this region. The Southeastern Kidney Transplant Coalition (SEKTC) of Georgia, North Carolina, and South Carolina is an academic and community partnership that was formed with the mission to improve access to kidney transplantation and reduce disparities among African American (AA) end stage renal disease (ESRD) patients in the Southeastern United States. Our Southeastern Kidney Transplant Coalition (SEKTC) was formed in 2010 with the help of ESRD Network 6 (Southeastern Kidney Council) with a mission of improving equity in access to kidney transplantation for ESRD patients in the Southeast, Georgia (GA), North Carolina (NC), and South Carolina (SC) This group consists of voluntary stakeholders in the ESRD community, including ESRD patients, dialysis facilities, transplant centers, social workers, organ procurement organizations, healthcare providers, academic researchers, patient advocacy groups within the tri-state region, and ESRD Network 6 staff

Objectives

Methods

Findings

Conclusion