Dialysis Providers’ Perceptions of Barriers to Transplant for Black and Low-Income Patients: A Mixed Methods Analysis Guided by the Socio-Ecological Model for Transplant

Anna Michelle M. McSorley; John D. Peipert; Cynthia Gonzalez; Keith C. Norris; Christina J. Goalby; Leanne J. Peace; Amy D. Waterman

doi:10.1002/wmh3.251

Dialysis Providers’ Perceptions of Barriers to Transplant for Black and Low-Income Patients: A Mixed Methods Analysis Guided by the Socio-Ecological Model for Transplant

Anna Michelle M. McSorley, John D. Peipert, Cynthia Gonzalez, Keith C. Norris, Christina J. Goalby, Leanne J. Peace, Amy D. Waterman^*

^*Corresponding author for this work

Medical Social Sciences

Research output: Contribution to journal › Article › peer-review

9 Scopus citations

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)
Pages (from-to)	399-417
Number of pages	19
Journal	World Medical and Health Policy
Volume	9
Issue number	4
DOIs	https://doi.org/10.1002/wmh3.251
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

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1002/wmh3.251

Cite this

McSorley, A. M. M., Peipert, J. D., Gonzalez, C., Norris, K. C., Goalby, C. J., Peace, L. J., & Waterman, A. D. (2017). Dialysis Providers’ Perceptions of Barriers to Transplant for Black and Low-Income Patients: A Mixed Methods Analysis Guided by the Socio-Ecological Model for Transplant. World Medical and Health Policy, 9(4), 399-417. https://doi.org/10.1002/wmh3.251

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title = "Dialysis Providers{\textquoteright} Perceptions of Barriers to Transplant for Black and Low-Income Patients: A Mixed Methods Analysis Guided by the Socio-Ecological Model for Transplant",

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{\textquoteright} 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.",

keywords = "Black, dialysis, disparities, education, kidney, low-income, socio-ecological model, transplant",

author = "McSorley, {Anna Michelle M.} and Peipert, {John D.} and Cynthia Gonzalez and Norris, {Keith C.} and Goalby, {Christina J.} and Peace, {Leanne J.} and Waterman, {Amy D.}",

note = "Funding Information: 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] Publisher Copyright: {\textcopyright} 2017 Policy Studies Organization",

year = "2017",

month = dec,

doi = "10.1002/wmh3.251",

language = "English (US)",

volume = "9",

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Dialysis Providers’ Perceptions of Barriers to Transplant for Black and Low-Income Patients: A Mixed Methods Analysis Guided by the Socio-Ecological Model for Transplant. / McSorley, Anna Michelle M.; Peipert, John D.; Gonzalez, Cynthia et al.
In: World Medical and Health Policy, Vol. 9, No. 4, 12.2017, p. 399-417.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Dialysis Providers’ Perceptions of Barriers to Transplant for Black and Low-Income Patients

T2 - A Mixed Methods Analysis Guided by the Socio-Ecological Model for Transplant

AU - McSorley, Anna Michelle M.

AU - Peipert, John D.

AU - Gonzalez, Cynthia

AU - Norris, Keith C.

AU - Goalby, Christina J.

AU - Peace, Leanne J.

AU - Waterman, Amy D.

N1 - Funding Information: 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] Publisher Copyright: © 2017 Policy Studies Organization

PY - 2017/12

Y1 - 2017/12

N2 - 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.

AB - 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.

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KW - dialysis

KW - disparities

KW - education

KW - kidney

KW - low-income

KW - socio-ecological model

KW - transplant

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JO - World Medical and Health Policy

JF - World Medical and Health Policy

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ER -

Dialysis Providers’ Perceptions of Barriers to Transplant for Black and Low-Income Patients: A Mixed Methods Analysis Guided by the Socio-Ecological Model for Transplant

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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