Patients' perceptions of a culturally targeted Hispanic Kidney Transplant Program: A mixed methods study

Abstract

Disproportionately fewer waitlisted Hispanics receive living donor kidney transplants (LDKTs) compared to non‐Hispanic whites. Northwestern Medicine's® culturally targeted Hispanic Kidney Transplant Program (HKTP) is associated with a significant increase in LDKTs among Hispanics. This multisite study assessed potential kidney recipients' and donors' and/or family members' perceptions of the HKTP's cultural components through semi‐structured interviews and validated surveys. Qualitative thematic analysis and descriptive statistics were performed. Thirty‐six individuals participated (62% participation rate) comprising 21 potential recipients and 15 potential donors/family (mean age: 51 years, 50% female, 72% preferred Spanish). Participants felt confident about the educational information because a transplant physician delivered the education and viewed the group format as effective. Participants felt that education sessions addressed myths about transplantation shared by Hispanics. Primary use of Spanish enhanced participants' understanding of transplantation. While few knew about living donation before attending the HKTP, most were “more in favor of” kidney transplantation (97%) and living donation (97%) afterward. Few reported learning about the HKTP from outreach staff and suggested leveraging community leaders to promote HKTP awareness. Our findings suggest the HKTP's cultural components were viewed favorably and positively influenced perceptions of kidney transplantation and living donation, which may help reduce transplant disparities in Hispanics. (Clinicaltrial.gov registration # NCT03276390, date of registration: 9‐7‐17, retrospectively registered).

Low renal transplantation rates in children with end‐stage kidney disease: A study of barriers in a low‐resource setting

“…This should be given early in ESKD, along with information regarding fund‐raising so that prospective organ donors are not discouraged. Education about CKD and awareness of transplant : The late diagnosis and misperceptions of ESKD indicate that better awareness of CKD is needed in the community. Culturally acceptable awareness programmes conducted within the community have been shown to lead to a greater acceptance of the diagnosis and willingness for ESKD treatment among extended family members 37 . Peer interaction between ESKD families will enable a better understanding of dialysis, transplant, and living organ donation.…”

Impact of having potential living donors on ethnic/racial disparities in access to kidney transplantation

“…The PLDs' verbal expression of interest was reported by transplant candidates and/or their companions when meeting with the transplant surgeon during patient evaluation, as described elsewhere. 23 …”

“…Medical records of PLDs linked to candidates were also reviewed to assess the relationship between PLDs and candidates. The PLDs' verbal expression of interest was reported by transplant candidates and/or their companions when meeting with the transplant surgeon during patient evaluation, as described elsewhere 23 …”

Disparities in living donation

“…Language integration has also returned dividends for non-English speaking populations, specifically in Spanish speaking communities. The use of language-tailored interventions led to some of the great successes of the Hispanic Outreach program at Northwestern University [43]. In fact, identifying cultural barriers to implementation of culturally sensitive strategies has improved access to potential organ donors that may never had been evaluated in the absence of this cultural knowledge base [44 ▪ ,45,46].…”