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Dialysis Facility Provider Transplant Knowledge after a Randomized Multilevel Intervention to Increase Kidney Transplant Referral and Evaluation in the Southeast

K. Maroney1, R. Hamoda1, L. McPherson1, A. Cruz2, S. Pastan1, L. Plantinga1, S. Paul1, M. Ellis3, D. DuBay4, A. Reeves-Daniel5, R. Detwiler6, E. Hartmann7, H. Jones8, B. Thrasher9, C. Zayas10, L. Mulloy10, S. Wright11, R. Patzer1

1Emory University, Atlanta, GA, 2IPRO Network of the South Atlantic, Raleigh, NC, 3Duke University, Durham, NC, 4Medical University of South Carolina, Charleston, SC, 5Wake Forest Health Transplant Center, Winston-Salem, NC, 6UNC Center for Transplantation, Chapel Hill, NC, 7Piedmont Transplant Institute, Atlanta, GA, 8Vidant Medical Center Transplant Services, Greenville, NC, 9Carolinas Transplant Center, Charlotte, NC, 10Augusta University, Augusta, GA, 11IPRO Network of the South Atlantic, Morrisville, NC

Meeting: 2019 American Transplant Congress

Abstract number: 613

Keywords: Kidney, Kidney transplantation, Multicenter studies, Resource utilization

Session Information

Session Name: Concurrent Session: Non-Organ Specific: Disparities and Access to Healthcare II

Session Type: Concurrent Session

Date: Tuesday, June 4, 2019

Session Time: 4:30pm-6:00pm

 Presentation Time: 4:30pm-4:42pm

Location: Room 208

*Purpose: Dialysis facility provider kidney transplantation (KTx) knowledge influences patient transplant access. The Reducing Disparities in Access to kidNey Transplantation (RaDIANT) Regional Study is a multicomponent intervention aimed to educate dialysis patients and staff on KTx to improve access to KTx referral and evaluation in the Southeast (Georgia, North Carolina, South Carolina). We describe the effect of the RaDIANT Regional intervention on KTx knowledge among dialysis facility providers.

*Methods: From January – September 2018, we 1:1 randomized 440 dialysis facilities to receive the RaDIANT multicomponent intervention or standard improvement materials. Dialysis providers at all facilities completed baseline and follow-up surveys containing a validated 15-item Knowledge Assessment of Renal Transplantation (KART) scale measuring KTx knowledge. KART items were weighted (correct=2, incorrect=1, unsure=0) and converted to a T score (min: 10.9, max: 75.5). We use generalized linear models and difference-in-difference analysis to examine the effect of the RaDIANT intervention on KART scores pre- and post-intervention.

*Results: The 440 participating facilities were 90.2% for-profit, with a mean of 13.5 ± 7.1 staff and 68.1 ± 40.1 patients per facility; facility characteristics did not meaningfully differ by group. Overall, KART scores increased by an average of 2.2 points (±9.2) post-intervention (Figure 1). Intervention providers had significantly higher KART score increases post-intervention as compared to control facility providers (3.4 vs. 0.9, p=0.0069). The effect size was moderately small (Cohen’s d=0.29).

*Conclusions: The RaDIANT Regional multicomponent intervention is effective in improving dialysis facility provider KTx knowledge in the Southeast. Future work will examine if this increase in provider knowledge is associated with improved access to KTx.

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To cite this abstract in AMA style:

Maroney K, Hamoda R, McPherson L, Cruz A, Pastan S, Plantinga L, Paul S, Ellis M, DuBay D, Reeves-Daniel A, Detwiler R, Hartmann E, Jones H, Thrasher B, Zayas C, Mulloy L, Wright S, Patzer R. Dialysis Facility Provider Transplant Knowledge after a Randomized Multilevel Intervention to Increase Kidney Transplant Referral and Evaluation in the Southeast [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/dialysis-facility-provider-transplant-knowledge-after-a-randomized-multilevel-intervention-to-increase-kidney-transplant-referral-and-evaluation-in-the-southeast/. Accessed May 29, 2025.

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