Acceptability of a Mobile-Health Living Kidney Donor Advocacy Program for Black Wait-Listed Patients
Abstract
:1. Introduction
2. Methods
2.1. Study Design
2.2. LOVED Intervention
2.3. Participants
2.4. Sample Size
2.5. Protocol
2.6. Measures
2.7. Data Analyses
2.7.1. Quantitative Analyses
2.7.2. Qualitative Analyses
3. Results
3.1. Sociodemographic Variables
3.2. Summary of Primary and Secondary Findings
3.3. Thematic Findings
3.3.1. Theme: Video Chat Sessions Provided Essential Support and Encouragement
3.3.2. Theme: Videos Motivated and Made Participants More Knowledgeable
3.3.3. Theme: Connectivity with Tablets Was Acceptable in Most Areas
3.3.4. Theme: Material Was Culturally Sensitive
3.3.5. Theme: Participation Was Overall a Positive Experience
3.3.6. Theme: More Willing to Ask for a Kidney Now
3.4. Participant Perspectives on the LOVED Navigators
“He kept it interesting. He always um bring some good to the table or give us like homework that we can have something to discuss when we come back together.”
“He kept us engaged, and he didn’t just allow you to sit back and not participate. Um he drew you in even when you didn’t want to answer, you had to say something.”
“The format was good because he uh, he been through the process I’m going through so any advice that he gave helped me cross that bridge in my process so…the way it was laid out, the way he gave it was good.”
3.5. Quantitative Findings with Qualitative Integration
“The staff have always been nice and helpful to me when I ask questions.”
“Everyone does a great job; everybody is patient and understanding with any question you have. Thank you for the program and [I] learned a lot.”
“My experience with [the facility’s] Transplant Team has been wonderful. However, there was a few times where there was miscommunication.”
The LOVED group specific questionnaire on trust demonstrated high mean scores for both 8-weeks (mean = 3.95 out of 4 [95% CI: 3.85, 4.05]) and at 6 months. Focus group comments also showed high levels of trust when speaking about their navigators, research staff, and medical staff.
“I have had two prior kidney transplants within a twelve-year period. The doctors and surgeons at [the facility] are very knowledgeable in their field. They perform hundreds of transplants per year. I trust them completely with my life.”
“He’s [speaking about their navigator] had that experience and he told us about stuff that he experienced. Which was great, because to hear somebody else talk about it, without them turning up their nose at you and saying, “oh, you have this”, and they don’t want to hear what you have or whatever, he wasn’t even like that. Not at all. He was great.”
“Me personally? I don’t have a problem with it [meaning discrimination]. But by the way things are looking, this is a disease that affects African Americans a lot, I mean because that basically who’s in this group.”
“For me it was helpful because I was blind to the fact. I thought because I’m a black man, that only a black person could donate a kidney to me, and I found out that’s not true.”
“The format was good because he been through the process I’m going through so any advice that he gave helped me cross that bridge in my process so…the way it was laid out, the way he gave it was good.”
“And I really learned that from him. Because I’m just like, “I’m tired, I’m ready to move forward in my life, I’m just tired of waiting.” So, you know, I learned that from him. That is the most valuable thing that I can get from the program.”
4. Discussion
4.1. Discussion of Themes
4.2. Comparisons to Other Studies
4.3. Limitations
4.4. Future Considerations
4.5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Overall program administration:
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Characteristics | LOVED (n = 24) | Usual Care (n = 24) | p-Value |
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Age, y [mean (SD)] | 50.9 (9.2) | 47.9 (10.0) | 0.29 |
Sex (Male), [n, %] | 12, 50.0% | 12, 50.0% | >0.99 |
Marital status, [n, %] Lives alone Married or living with significant other | 9, 37.5% 15, 62.5% | 13, 54.2% 11, 45.8% | 0.31 |
Educational attainment, [n, %] Less than high school High school diploma or GED College or Technical School | 4, 16.7% 5, 20.8% 15, 62.5% | 1, 4.3% 7, 30.4% 15, 65.2% | 0.85 a |
Employment status, [n, %] Working part or full time Retired Disabled or unemployed | 8, 33.3% 1, 4.2% 15, 62.5% | 4, 17.4% 2, 8.7% 17, 73.9% | 0.37 b |
Themes | Exemplar Quotes |
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Scale | LOVED Mean (SD) | 95% CI | Usual Care Mean (SD) | 95% CI | p-Value |
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Communication at 8 weeks | 3.93 (0.15) | 3.86, 3.99 | 3.78 (0.33) | 3.62, 3.93 | 0.07 * |
Communication at 6 months | 3.85 (0.31) | 3.71, 3.99 | 3.82 (0.28) | 3.68, 3.95 | 0.71 |
Trust at 8 weeks | 3.95 (0.22) | 3.85, 4.05 | - | - | - |
Trust at 6 months | 3.85 (0.31) | 3.70, 4.00 | - | - | - |
Discrimination at 8 weeks | 3.96 (0.13) | 3.89, 4.02 | 3.86 (0.36) | 3.71, 4.02 | 0.27 * |
Discrimination at 6 months | 3.96 (0.15) | 3.89, 4.02 | 3.78 (0.72) | 3.42, 4.14 | 0.32 * |
Decision Making at 8 weeks | 1.33 (0.67) | 1.01, 1.64 | - | - | - |
Decision Making at 6 months | 1.63 (1.03) | 1.16, 2.12 | - | - | - |
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Sieverdes, J.C.; Nemeth, L.S.; Mueller, M.; Rohan, V.; Baliga, P.K.; Treiber, F. Acceptability of a Mobile-Health Living Kidney Donor Advocacy Program for Black Wait-Listed Patients. Int. J. Environ. Res. Public Health 2021, 18, 8239. https://doi.org/10.3390/ijerph18168239
Sieverdes JC, Nemeth LS, Mueller M, Rohan V, Baliga PK, Treiber F. Acceptability of a Mobile-Health Living Kidney Donor Advocacy Program for Black Wait-Listed Patients. International Journal of Environmental Research and Public Health. 2021; 18(16):8239. https://doi.org/10.3390/ijerph18168239
Chicago/Turabian StyleSieverdes, John C., Lynne S. Nemeth, Martina Mueller, Vivik Rohan, Prabhakar K. Baliga, and Frank Treiber. 2021. "Acceptability of a Mobile-Health Living Kidney Donor Advocacy Program for Black Wait-Listed Patients" International Journal of Environmental Research and Public Health 18, no. 16: 8239. https://doi.org/10.3390/ijerph18168239