Identifying Social Barriers to Health Literacy in ESRD Patients Undergoing Kidney Transplant Evaluation.
1Dept of Surgery, University of Iowa, Iowa City, IA
2Dept of Social Work, University of Iowa, Iowa City, IA
3Dept of Internal Medicine, University of Iowa, Iowa City, IA.
Meeting: 2016 American Transplant Congress
Abstract number: B61
Keywords: Economics, Kidney transplantation, Multivariate analysis, Public policy
Session Information
Date: Sunday, June 12, 2016
Session Name: Poster Session B: Disparities in Access and Outcomes
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
Background: Low health literacy is associated with increased hospitalizations and mortality. ESRD patients have reduced health literacy as ESRD disproportionately affects the elderly and individuals with less education and socioeconomic resources. CMS mandates transplant centers to provide education for kidney transplant (KT) patients but there is limited data on transplant education effectiveness in ESRD patients.
Objective: To evaluate KT education at a moderate volume transplant center.
Methods: The KT Knowledge Test (KT2) was developed, validated, and distributed to 470 ESRD patients. The KT2 survey covers 3 categories: ESRD/dialysis, transplant, and living donation. Unbalanced ANOVA models identified univariate and multivariate predictors of health literacy. Three patient focus groups were also held to provide qualitative, patient-centered feedback on KT education.
Results: Survey response rate was 30.2% (141/470). Respondents correctly answered 74.0% of ESRD and 64.4% of Living Donor, compared to only 44.1% of Transplant questions. Transplant had the highest percentage of 'Don't Know' (43.7%) responses. Univariate predictors of correct responses were age, marital status, education, income, number of evaluations, prior transplant, waitlist status, diabetes, and heart disease. On multivariate analysis, only education, income, number of evaluations, and prior transplant remained significant predictors. Patient feedback from the focus groups strongly correlated with the KT2 survey findings.
Conclusion: Mixed methods research identified several social barriers to KT education in ESRD patients, including lower education level and income. New educational methods for KT patients in these high-risk populations have been implemented and future work will study the impact on the effectiveness of transplant education.
| Table 1. | ||||
| Overall | ESRD | Transplant | Living Donation | |
| Correct | 59.4% | 74.0% | 44.1% | 64.4% |
| Incorrect | 9.4% | 5.1% | 11.8% | 10.3% |
| Don’t Know | 30.8% | 20.5% | 43.7% | 25.0% |
| Missing | 0.4% | 0.4% | 0.4% | 0.3% |
| Table 2 | |
| Predictor | p-value |
| Age | NS |
| Marital Status | NS |
| Education Level | 0.23 |
| Household Income | 0.39 |
| Number of Doctors | NS |
| Number of Evaluations | 0.18 |
| Prior Transplant | 0.006 |
| Waitlist Status | NS |
| Diabetes | NS |
| Heart Disease | NS |
CITATION INFORMATION: Leick K, Jones J, Witte S, Hunsicker L, Stewart Z. Identifying Social Barriers to Health Literacy in ESRD Patients Undergoing Kidney Transplant Evaluation. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Leick K, Jones J, Witte S, Hunsicker L, Stewart Z. Identifying Social Barriers to Health Literacy in ESRD Patients Undergoing Kidney Transplant Evaluation. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/identifying-social-barriers-to-health-literacy-in-esrd-patients-undergoing-kidney-transplant-evaluation/. Accessed January 21, 2021.« Back to 2016 American Transplant Congress