A Culturally Targeted Website for Hispanics/Latinos About Living Kidney Donation and Transplantation: A Randomized Controlled Trial of Increased Knowledge

作者:Gordon Elisa J*; Feinglass Joe; Carney Paula; Vera Karina; Olivero Maria; Black Anne; O'Connor Kate; MacLean Jessica; Nichols Shari; Sageshima Junichiro; Preczewski Luke; Caicedo Juan Carlos
来源:Transplantation, 2016, 100(5): 1149-1160.
DOI:10.1097/TP.0000000000000932

摘要

Background. Hispanics/Latinos receive disproportionately fewer living donor kidney transplantations (LDKTs) than non-Hispanic whites. We conducted a multisite, randomized controlled trial to evaluate the efficacy of exposure to a bilingual, culturally targeted website, Informate, for increasing Hispanics' knowledge about LDKT. Methods. Hispanic patients initiating transplant evaluation and their family/friends at 2 transplant centers were randomized to view Informate before attending routine transplant education sessions; usual care controls only attended education sessions. All participants completed a pretest; website participants also completed a posttest immediately after viewing Informate. All participants completed a 3-week telephone follow-up test. Random effects linear regression of 3-week knowledge scores tested the significance of website exposure after adjusting for clustering within families and controlling for pretest scores and covariates. Results. Two hundred-eighty-two individuals participated (81% patient participation rate). Website exposure was associated with a mean 21.7% same day knowledge score increase between pretest and posttest (P < 0.001). At 3 weeks, website participants' knowledge scores remained 22.6% above the pretest; control scores increased to 11.8% (P = 0.0001). Regression results found that website participants were associated with a 10.0% greater knowledge score at 3-week follow-up (P < 0.0001). Most website participants (92.6%) plan to return to Informate in the future. Conclusions. Our culturally targeted website increased participants' knowledge about LDKT above and beyond transplant education and should supplement transplant center education for Hispanics. When considered at the population level, Informate could have a great impact on knowledge gains in this underserved population disproportionately affected by kidney disease.