Abstract
Although mandates require all dialysis patients be informed about transplant, Black and low-income patients remain less likely to receive transplant education, and significant racial and socioeconomic disparities in access to transplant persist. This mixed methods study, utilizing surveys and focus groups, examined 48 dialysis providers’ perceptions of transplant barriers for Black and low-income patients. Focus group transcripts were coded for common themes, which were organized by level of the Socio-Ecological Model for Transplant (SEMT). On surveys, over 50 percent of providers reported having insufficient time to provide transplant education. In focus groups, providers perceived that Black and low-income patients experience greater barriers to transplant. These perceptions, as well as limited time and resources, could enable subtle biases against comprehensive transplant education for these patient groups to emerge. Raising awareness among providers about existing biases and supplementing transplant education within dialysis centers may improve the consistency of education and access to transplant.
Original language | English (US) |
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Pages (from-to) | 399-417 |
Number of pages | 19 |
Journal | World Medical and Health Policy |
Volume | 9 |
Issue number | 4 |
DOIs | |
State | Published - Dec 2017 |
Funding
We thank Jessica L. Thein for her support in coordinating study activities, AuBre R. Parnicky for her support with literature reviews, and Rana Nath for his help with manuscript formatting. This study was funded by a Health Resources and Services Administration Grant, R39OT26843 (Waterman), a University of California, Los Angeles Clinical and Translation Science Institute Award UL1TR000124 (Waterman), a National Institutes of Health Training Grant T32-DK-07789 (Gonzalez), and a National Institute on Minority Health and Health Disparities Grant 5S21MD000103 (Gonzalez). This manuscript was prepared in memory of Patricia A. Lutz. All authors read and approved the final manuscript, and all authors made intellectual contributions to the design of the study. AMM, JDP, CG, and ADW prepared the manuscript. KCN, CJG, and LJP revised the manuscript. Conflicts of Interest: None declared. Corresponding author: Amy D. Waterman, [email protected]
Keywords
- Black
- dialysis
- disparities
- education
- kidney
- low-income
- socio-ecological model
- transplant
ASJC Scopus subject areas
- Health Policy