TY - JOUR
T1 - Effectiveness of a culturally competent care intervention in reducing disparities in Hispanic live donor kidney transplantation
T2 - A hybrid trial
AU - Gordon, Elisa J.
AU - Uriarte, Jefferson J.
AU - Lee, Jungwha
AU - Kang, Raymong
AU - Shumate, Michelle
AU - Ruiz, Richard
AU - Mathur, Amit K.
AU - Ladner, Daniela P.
AU - Caicedo, Juan Carlos
N1 - Funding Information:
We thank the transplant stakeholders from both study sites for their engagement in this study. Special thanks go to Julieta Williams, Jazmin Beccera, Ashanti Smith, Brie Barnes, and Ann Cline, for their excellent research assistance. We are grateful for the guidance provided by Ronald Ackerman and Tara Lagu. REDCap is supported at Northwestern University Feinberg School of Medicine by the Northwestern University Clinical and Translational Science (NUCATS) Institute. Research reported in this publication was supported, in part, by the National Institutes of Health's National Center for Advancing Translational Sciences, Grant Number UL1TR001422. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. This work was supported in part by Health Resources and Services Administration contract 234‐2005‐370011C. The content is the responsibility of the authors alone and does not necessarily reflect the views or policies of the Department of Health and Human Services nor does mention of trade names, commercial products, or organizations imply endorsement by the US Government. NIDDK funded this research (1R01DK104876 to EJ Gordon and JC Caicedo, Co‐PIs).
Funding Information:
We thank the transplant stakeholders from both study sites for their engagement in this study. Special thanks go to Julieta Williams, Jazmin Beccera, Ashanti Smith, Brie Barnes, and Ann Cline, for their excellent research assistance. We are grateful for the guidance provided by Ronald Ackerman and Tara Lagu. REDCap is supported at Northwestern University Feinberg School of Medicine by the Northwestern University Clinical and Translational Science (NUCATS) Institute. Research reported in this publication was supported, in part, by the National Institutes of Health's National Center for Advancing Translational Sciences, Grant Number UL1TR001422. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. This work was supported in part by Health Resources and Services Administration contract 234-2005-370011C. The content is the responsibility of the authors alone and does not necessarily reflect the views or policies of the Department of Health and Human Services nor does mention of trade names, commercial products, or organizations imply endorsement by the US Government. NIDDK funded this research (1R01DK104876 to EJ Gordon and JC Caicedo, Co-PIs).
Publisher Copyright:
© 2021 The American Society of Transplantation and the American Society of Transplant Surgeons
PY - 2022/2
Y1 - 2022/2
N2 - Hispanic patients receive disproportionately fewer living donor kidney transplants (LDKTs) than non-Hispanic Whites (NHWs). The Northwestern Medicine Hispanic Kidney Transplant Program (HKTP), designed to increase Hispanic LDKTs, was evaluated as a nonrandomized, implementation-effectiveness hybrid trial of patients initiating transplant evaluation at two intervention and two similar control sites. Using a mixed method, observational design, we evaluated the fidelity of the HKTP implementation at the two intervention sites. We tested the impact of the HKTP intervention by evaluating the likelihood of receiving LDKT comparing pre-intervention (January 2011–December 2016) and postintervention (January 2017–March 2020), across ethnicity and centers. The HKTP study included 2063 recipients. Intervention Site A exhibited greater implementation fidelity than intervention Site B. For Hispanic recipients at Site A, the likelihood of receiving LDKTs was significantly higher at postintervention compared with pre-intervention (odds ratio [OR] = 3.17 95% confidence interval [1.04, 9.63]), but not at the paired control Site C (OR = 1.02 [0.61, 1.71]). For Hispanic recipients at Site B, the likelihood of receiving an LDKT did not differ between pre- and postintervention (OR = 0.88 [0.40, 1.94]). The LDKT rate was significantly lower for Hispanics at paired control Site D (OR = 0.45 [0.28, 0.90]). The intervention significantly improved LDKT rates for Hispanic patients at the intervention site that implemented the intervention with greater fidelity. Registration: ClinicalTrials.gov registered (retrospectively) on September 7, 2017 (NCT03276390).
AB - Hispanic patients receive disproportionately fewer living donor kidney transplants (LDKTs) than non-Hispanic Whites (NHWs). The Northwestern Medicine Hispanic Kidney Transplant Program (HKTP), designed to increase Hispanic LDKTs, was evaluated as a nonrandomized, implementation-effectiveness hybrid trial of patients initiating transplant evaluation at two intervention and two similar control sites. Using a mixed method, observational design, we evaluated the fidelity of the HKTP implementation at the two intervention sites. We tested the impact of the HKTP intervention by evaluating the likelihood of receiving LDKT comparing pre-intervention (January 2011–December 2016) and postintervention (January 2017–March 2020), across ethnicity and centers. The HKTP study included 2063 recipients. Intervention Site A exhibited greater implementation fidelity than intervention Site B. For Hispanic recipients at Site A, the likelihood of receiving LDKTs was significantly higher at postintervention compared with pre-intervention (odds ratio [OR] = 3.17 95% confidence interval [1.04, 9.63]), but not at the paired control Site C (OR = 1.02 [0.61, 1.71]). For Hispanic recipients at Site B, the likelihood of receiving an LDKT did not differ between pre- and postintervention (OR = 0.88 [0.40, 1.94]). The LDKT rate was significantly lower for Hispanics at paired control Site D (OR = 0.45 [0.28, 0.90]). The intervention significantly improved LDKT rates for Hispanic patients at the intervention site that implemented the intervention with greater fidelity. Registration: ClinicalTrials.gov registered (retrospectively) on September 7, 2017 (NCT03276390).
UR - http://www.scopus.com/inward/record.url?scp=85117107484&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85117107484&partnerID=8YFLogxK
U2 - 10.1111/ajt.16857
DO - 10.1111/ajt.16857
M3 - Article
C2 - 34559944
AN - SCOPUS:85117107484
SN - 1600-6135
VL - 22
SP - 474
EP - 488
JO - American Journal of Transplantation
JF - American Journal of Transplantation
IS - 2
ER -