*Purpose: Decision support tools to improve racial disparities in access to kidney transplant need to be relevant and tailored to underserved racial groups.

*Methods: We conducted 2 focus groups with 20 African American (AA) kidney transplant candidates, and 2 groups with 16 members of their social support networks in Atlanta, Georgia. Coding and thematic synthesis was performed by 2 researchers.

*Results: Patients and their family members represented a wide range of education and household income. Half of the family members had attended the transplant evaluation with the patient, but only 2 of the family members reported that they understood enough about the transplant process. Patients and families commonly expressed that race impacts treatment options and outcomes but were uncertain and disagreed about the cause or nature of the effect. Many wanted to discuss these disparities with medical providers. Patients and families wanted to disseminate resources through their religious communities, and often attribute outcomes to a higher power which may obscure their own agency in the process. Finally, patients felt that education is hindered by provider bias and rigid provider-patient roles, and felt that they had a limited understanding of the factors that impact access to transplant and patient outcomes. Themes and representative quotes are illustrated in Figure 1.

*Conclusions: AA Patients and families expressed concerns specific to AA kidney transplant candidates. Interventions that address these unique needs may improve racial disparities in access and outcomes in kidney transplantation.

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