*Purpose: The Talking About Live Kidney Donation (TALK) intervention uses an educational video and booklet to improve consideration and pursuit of LDKT in kidney failure patients. Our study tested the effect of the TALK intervention on increasing completion rates of KT evaluation and pursuit of LDKT.

*Methods: All patients undergoing a streamlined KT evaluation process (concierge-like approach, helping patients complete most testing within two weeks of initial appointment) at a single transplant center were eligible to participate. We recruited patients for a baseline interview prior to their first KT evaluation appointment. At the initial clinic appointment, we randomly assigned patients to receive TALK or not. The TALK group received a culturally sensitive educational booklet and video encouraging shared and informed consideration of LDKT to take home and were called after two weeks to address questions and encourage review of materials. We conducted a second interview (assessing intervention engagement and other outcomes) after patients completed or discontinued evaluation. As many patients fail to complete KT evaluations, we assessed for differences in KT evaluation completion rates between groups, in addition to assessing for differences in willingness to ask someone to be a living donor and identification of potential living donors.

*Results: Among 931 patients, 62.4% were male, mean age was 56.7 years, 44.8% were ≤ high school graduate, and most were either non-Hispanic White (70.9%) or Black (22%). Using a Fine-Gray proportional subdistribution hazards model for time to complete evaluation, and controlling for demographic and medical covariates, there was no difference in evaluation completion rates between TALK and no-TALK (SHR=1.12, CI=0.95-1.33, p=0.18). TALK group did not report greater willingness to ask someone to be a living donor, χ(1, 526)=0.32, p=.57, and they did not identify more potential living donors (M=.70, SD=1.17) than No-TALK group (M=.88, SD=1.31; t(472.42)=-1.61, p=.11). Despite most participants reporting the intervention materials to be helpful, this was not associated with number of potential living donors identified, r(126)= -.09, p=.308, and sharing materials with friends/family was also not associated with identification of more potential donors, t(139.46)=1.80, p=.07.

*Conclusions: Our findings suggest TALK education materials did not promote higher KT evaluation completion rates, greater willingness to pursue LDKT, or more identification of potential living donors. Those who found TALK materials helpful or shared materials with others also did not identify more potential living donors. Patients who are already undergoing an expedited KT evaluation may need additional or different support to encourage their willingness for and pursuit of LDKT, such as engagement from a social worker or a peer mentor.

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