Project Summary

This research project is in progress. PCORI will post the research findings on this page within 90 days after the results are final.

What is the research about?

Kidney disease affects 30 million Americans. Adults with kidney disease have few treatment options. They can get dialysis, which removes harmful materials from the blood. Or, eligible patients may choose to get a kidney transplant. Patients who get a kidney transplant live longer and healthier lives compared with patients who receive dialysis. Getting a kidney from a person who is alive is a live donor kidney transplant, or LDKT. These transplants usually last much longer than a kidney from someone who has died. For this reason, doctors urge patients to find a living donor, such as a family member or friend. Patients usually get information about the benefits of LDKT from their kidney doctors at transplant clinics.

Although an LDKT is the best option for patients with kidney disease, black patients are much less likely than white patients to get one. Reasons for this difference may include unwillingness to talk to family members and friends about donation, mistrust, and difficulty finding eligible donors. Healthcare providers may not address concerns that black patients and families have about kidney transplants. This study is comparing three approaches to improve black patients’ chances of getting an LDKT.

Who can this research help?

Doctors and clinic administrators can use findings from the study when considering ways to help black patients who would benefit from an LDKT.

What is the research team doing?

The research team is examining whether adding peer mentors to a program called House Calls improves black patients’ chances of getting an LDKT. The research team previously created the House Calls program to help patients with kidney disease learn about kidney transplants. The program sends a health educator to patients’ homes to teach patients and their friends and families about LDKT.

Although patients who get house calls are more likely to get an LDKT, the program hasn’t worked as well with black patients. To improve the help and guidance that patients receive, patient advisors suggested matching patients with a peer mentor who received an LDKT. Peer mentors are people who have had kidney failure and gotten an LDKT. They provide support and guidance to others considering transplant.

In this study, the research team is enrolling 374 black patients approved for kidney transplant at two medical centers in Boston, Massachusetts, and Charleston, South Carolina. The team is assigning patients by chance to receive one of three approaches for educating patients about LDKT:

  • Usual care: Patients get information about the benefits of LDKT from their kidney doctors, in the clinic.
  • House calls and usual care: Patients get usual care plus a 90-minute information session from a health educator in the patient’s home, with family and friends present.
  • House calls with peer mentorship and usual care: Patients get usual care, house calls, and emotional support and guidance from a peer mentor who received an LDKT for kidney failure.

The research team is tracking whether patients receive an LDKT within one year. The team is also looking at whether family or friends decide to be evaluated for donating a kidney. In addition, the team is asking about patients’ readiness to get an LDKT, concerns, quality of life, and knowledge about LDKT and other health topics.

Research methods at a glance

Design Elements Description
Design Randomized controlled trial
Population Black patients 21 years and older with end-stage renal disease (ESRD) who are eligible for a kidney transplant
Interventions/
Comparators
  • Usual care via clinic-based transplant education from kidney doctors
  • House calls and usual care
  • House calls, peer mentorship, and usual care
Outcomes

Primary: LDKT within 1 year

Secondary: live donor evaluations, number of donor evaluations

Timeframe 1-year follow-up for primary outcome

Project Information

James R. Rodrigue, PhD
Beth Israel Deaconess Medical Center
$1,789,920
Comparing the Effectiveness of House Calls and Peer Mentorship to Reduce Racial Disparities in Live Donor Kidney Transplantation

Key Dates

July 2017
July 2022
2017

Study Registration Information

Tags

Award Type
Health Conditions Health Conditions These are the broad terms we use to categorize our funded research studies; specific diseases or conditions are included within the appropriate larger category. Note: not all of our funded projects focus on a single disease or condition; some touch on multiple diseases or conditions, research methods, or broader health system interventions. Such projects won’t be listed by a primary disease/condition and so won’t appear if you use this filter tool to find them. View Glossary
Populations Populations PCORI is interested in research that seeks to better understand how different clinical and health system options work for different people. These populations are frequently studied in our portfolio or identified as being of interest by our stakeholders. View Glossary
Funding Opportunity Type
Intervention Strategy Intervention Strategies PCORI funds comparative clinical effectiveness research (CER) studies that compare two or more options or approaches to health care, or that compare different ways of delivering or receiving care. View Glossary
State State The state where the project originates, or where the primary institution or organization is located. View Glossary
Last updated: March 4, 2022