*Purpose: Live Donor and Deceased Donor Kidney Transplantation (LDKT and DDKT) confer meaningful survival, and quality of life benefits to patients with End Stage Renal Disease (ESRD), in comparison to dialysis. Research reveals disparities in access to kidney transplant as a treatment option, particularly among racial minorities. ESRD patients report feeling unprepared to hold discussions about transplantation with their social networks, which the literature reveals are prerequisites for successfully pursuing LDKT or DDKT. This study describes the baseline communication patterns of kidney transplant candidates enrolled in the randomized controlled trial, Communicating About Choices in Transplantation (COACH).

*Methods: Semi-structured phone interviews (N=252) assessed participants’ communication patterns, including their perceived communication competence and self-efficacy, perceived difficulties discussing transplantation, and actual kidney transplant discussions. Summary statistics were used to describe the participant sample. Categorical and dichotomous variables are presented as frequency counts and percentages; continuous variables are summarized as means and standard deviations.

*Results: Participants were, on average, 51.1 years of age, primarily African-American (69.1%), male (51.2%), with incomes under $39,999 (62.1%). Preliminary analyses revealed that candidates utilized an average of 12.6 (SD: 4.5) of 21 communication skills and reported mean self-efficacy score of 1148.8 (SD: 251.9) on a scale from 0 to 1500. Participants rated

2.6 (SD: 2.7) out of ten communication tasks as difficult, and on a scale from 7 to 49, had a mean communication attitudes score of 39.1 (SD: 7.6). At baseline, the majority (93.6%) of participants reported holding prior transplant conversations, and most participants (81.5%) intended to continue, however, just one-third (33.5%) of the sample initiated these transplant conversations.

*Conclusions: These findings indicate a need to develop patients’ communication skills to effectively lead transplant-related discussions and request living kidney donation with individuals in their social networks. In particular, interventions that include role play or other activities to foster patients’ communication self-efficacy, or confidence communicating about transplantation, are needed.

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