*Purpose: Web-based education may be a powerful tool to support kidney patients’ learning about living kidney donation (LKD); however, websites that are not user-friendly can be less effective and less appealing. This study aims to identify optimal design adaptation of a prototype educational website to inform the development of a future web-based educational intervention.

*Methods: We conducted a usability evaluation of a prototype educational website. Phase 1 consisted of a stakeholder assessment for pre-modification. Phase 2 consisted of user-centered testing with 30 kidney patients. Patients were asked to “think aloud” when using the website. They then completed a semi-structured interview on their perceptions of working with the website and its usability. The sessions were observed and audio-recorded. Descriptive statistics and qualitative analysis were used to assess patients’ experiences with the website and to uncover usability problems. Rapid-cycle design was employed between the research team and the website developer through 4 meetings over a 2-month period, during which revisions were reviewed in usability testing sessions. The result was a series of designs culminating in a final prototype.

*Results: We identified kidney patients’ needs for a simple and accessible tool to learn about LKD. We identified usability problems within two overarching themes: 1) page design and 2) navigation. The final prototype resolved usability problems through adaptation of page layout, text readability, scrolling, clutter, page-to-page consistency, error messaging, and link clickability. Throughout the design process, poor vision and low tech literacy represented key challenges; however, even these patients were able to learn the website quickly. Overall, patients found the website easy to use and reported willingness to use the website in the future.

*Conclusions: A user-informed and iteratively refined website may be acceptable to kidney patients to increase their access to education on LDK. This study identified design features to inform the next prototype of our web-based educational intervention. Results may be generalizable to low literacy patients.

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