Hispanics receive disproportionately fewer live donor kidney transplants than non-Hispanic whites. Increasing Hispanics' knowledge and changing attitudes about live kidney donation may reduce these disparities.
Objective
To evaluate the effectiveness of culturally and linguistically competent educational sessions delivered through Northwestern University's Hispanic Transplant Program.
Design
Baseline and postsession questionnaires were used to evaluate changes in patients' and family members' knowledge and attitudes toward live kidney donation and program satisfaction. Knowledge items related to live kidney donation were scaled, and changes in scores were evaluated via a paired t test. Multiple regression analysis of follow-up knowledge scores controlled for baseline scores was used to estimate the effects of patients' and families' sociodemographic characteristics. Changes in attitude items, including comfort with exploring live kidney donation, were analyzed with χ2 tests.
Results
One-hundred thirteen patients and family members completed surveys before and after an education session. Respondents' knowledge about live kidney donation and transplant increased significantly (P < .001) between baseline and after the session. Patients' attitudes toward live kidney donation became more favorable (P < .02), as did family members' attitudes toward being a donor (P < .001) after participating in the program. All respondents reported high levels of satisfaction with the program and preferences for culturally congruent care.
Conclusions
The educational sessions provided by the Hispanic Transplant Program effectively addressed commonly shared Hispanic concerns about live kidney donation. Culturally congruent education increased Hispanic patients' and family members' knowledge and improved attitudes about live donor kidney transplants.
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References
1.
MatasAJBartlettSTLeichtmanABDelmonicoFL. Morbidity and mortality after living kidney donation, 1999–2001: Survey of United States transplant centers. Am J Transplant.2003;3(7):830–834.
HallYNChoiAIXuPO'HareAMChertowGM. Racial ethnic differences in rates and determinants of deceased donor kidney transplantation. J Am Soc Nephrol.2011;22(4):743–751.
4.
US Renal Data System. USRDS 2011 Annual Data Report: Atlas of Chronic Kidney Disease and End-Stage Renal Disease in the United States.National Institutes of Health. Bethesda, MD, 2011. http://www.usrds.org/adr.htm. Accessed July 25, 2012.
US Census Bureau. Projections of the Resident Population by Race, Hispanic Origin and Nativity: Middle Series, 2006–2010.Washington, DC: US Government Printing Office; 2006.
7.
SiegelJTAlvaroEMLacACranoWDDominickA. Intentions of becoming a living organ donor among Hispanics: A theory-based approach exploring differences between living and nonliving organ donation. J Health Commun.2008;13(1):80–99.
8.
AlvaroEMSiegelJTTurcotteDLishaNCranoWDDominickA. Living kidney donation among Hispanics: A qualitative examination of barriers and opportunities. Prog Transplant.2008;18(4):243–250.
9.
DominguezJMGonzalezZAMorales-OteroLATorresASantiago-DelphinEA. Knowledge and attitude about organ donation in a Hispanic population. Prog Transplant.1991;23(2):1804–1806.
10.
KasiskeBLLondonWEllisonMD. Race and socioeconomic factors influencing early placement on the kidney transplant waiting list. J Am Soc Nephrol.1998;9(11):2142–2147.
11.
Committee on Increasing Rates of Organ Donation, ChildressJFLivermanC, eds. Organ Donation: Opportunities for Action.Washington, DC: The National Academies; 2006.
12.
Martinez-AlarconLRiosAConesaC. Attitude of kidney patients on the transplant waiting list toward related-living donation. A reason for the scarce development of living donation in Spain. Clin Transpl.2006;20(6):719–724.
13.
Martinez-AlarconLRiosAConesaC. Attitude toward living related donation off patients on the waiting list for a deceased donor solid organ transplant. Transplant Proc.2005;37(9):3614–3617.
MorganSEMillerJK. Beyond the organ donor card: The effect of knowledge, attitudes, and values on willingness to communicate about organ donation to family members. Health Commun.2002;14(1):121–134.
16.
CiancioGBurkeGWGomezC. Organ donation among Hispanics: A single-center experience. Transplant Proc.1997;29(8):3745.
17.
US Department of Health and Human Services, OPHS, Office of Minority Health. National Standards for Culturally and Linguistically Appropriate Services in Health Care Final Report.Washington, DC: Department of Health and Human Services; 2001.
18.
LeiningerM. Culture Care Diversity and Universality: A Theory of Nursing.New York, NY: National League for Nursing; 1991.
19.
JenkinsJHKarnoM. The meaning of “expressed emotion”: Theoretical issues raised by cross-cultural research. Am J Psychiatr.1992;149(1):9–21.
20.
RodrigueJRCornellDLKaplanBHowardRJ. A randomized trial of a home-based educational approach to increase live donor kidney transplantation: Effects in blacks and whites. Am J Kidney Dis.2008;51(4):663–670.
21.
CallendearCOHallMBBranchD. An assessment of the effectiveness of the Mottep model for increasing donation rates and preventing the need for transplantation—adult findings: Program years 1998 and 1999. Semin Nephrol.2001;21(4):419–428.
22.
ChristakisDAZimmermanFJRivaraFPEbelB. Improving pediatric prevention via the internet: A randomized, controlled trial. Pediatrics.2006;118(3):1157–1166.
23.
RodrigueJRCornellDLLinJKKaplanBHowardRJ. Increasing live donor kidney transplantation: A randomized controlled trial of a home-based educational intervention. Am J Transplant.2007;7(2):394–401.
24.
AlvaroEMJonesSPRoblesASSiegelJ. Hispanic organ donation: Impact of a Spanish-language organ donation campaign. J Nat Med Assoc.2006;98(1):28–35.
25.
AlvaroEMSiegelJTCranoWDDominickA. A mass mediated intervention on Hispanic live kidney organ donation. J Health Commun.2010;15(4):374–387.
26.
SemanskyRMAltschulDSommerfeldDHoughRWillgingCE. Capacity for delivering culturally competent mental health services in New Mexico: Results of a statewide agency survey. Adm Policy Ment Health.2009;36(5):289–307.
GalantiGA. The Hispanic family and male-female relationships: An overview. J Transcult Nurs.2003;14(3):180–185.
29.
da SilvaGC. Awareness of Hispanic cultural issues in the health care setting. Child Health Care.1984;13(1):4–10.
30.
Gonzalez-SwaffordMJGutierrezMG. Ethno-medical beliefs and practices of Mexican-Americans. Nurse Pract.1983;8(10): 29–34.
31.
SchmidleyD. The Foreign-Born Population in the United States: March 2002. Current Population Reports, P20–539.Washington, DC: US Census Bureau; 2003.
32.
KarlinerLSNapoles-SpringerAMSchillingerDBibbins-DomingoKPérez-StableEJ. Identification of limited English proficient patients in clinical care. J Gen Intern Med.2008;23(10):1555–1560.
33.
LennerlingAForsbergAMeyerKNybergG. Motives for becoming a living kidney donor. Nephrol Dial Transplant.2004;19(6):1600–1605.
SchiefeleUCsikszentmihalyiM. Motivation and ability as factors in mathematics experience and achievement. J Res Math Educ.1995;26(2):163–181.
37.
MierNOryMGMedinaAA. Anatomy of culturally sensitive interventions promoting nutrition and exercise in Hispanics: A critical examination of existing literature. Health Promot Pract.2010;11(4):541–554.
38.
RogersAT. Exploring health beliefs and care-seeking behaviors of older USA-dwelling Mexicans and Mexican-Americans. Ethn Health.2010;15(6):581–599.
39.
CostantinoGMalgadyRGPrimaveraLH. Congruence between culturally competent treatment and cultural needs of older Latinos. J Consult Clin Psychol.2009;77(5):941–949.
40.
WhittemoreR. Culturally competent interventions for Hispanic adults with type 2 diabetes: A systematic review. J Transcult Nurs.2007;18(2):157–166.
41.
ZehPSandhuHKCannabyAMSturtJA. The impact of culturally competent diabetes care interventions for improving diabetes-related outcomes in ethnic minority groups: A systematic review. Diabet Med.2012;29(10):1237–1252.
42.
CabelleroAETenzerP. Building cultural competency for improved diabetes care: Latino Americans and diabetes. J Fam Pract.2007;56(9suppl Building):S7–S13.
43.
JacobsEASadowskiLSRathouzPJ. The impact of an enhanced interpreter service intervention on hospital costs and patient satisfaction. J Gen Intern Med.2007;22(suppl 2):306–311.
44.
KeithDAshbyVBPortFKLeichtmanAB. Insurance type and minority status associated with large disparities in prelisting dialysis among candidates for kidney transplantation. Clin J Am Soc Nephrol.2008;3(2):463–470.
45.
EscofferyCMcCormickLBatemanK. Development and process evaluation of a web-based smoking cessation program for college smokers: Innovative tool for education. Patient Educ Couns.2004;53(2):217–225.
46.
GordonEJCaicedoJCLadnerDPReddyEAbecassisMM. Transplant center provision of education and culturally and linguistically competent care: A national study. Am J Transplant.2010;10(12):2701–2707.
47.
ChinMHClarkeARNoconRS. A roadmap and best practices for organizations to reduce racial and ethnic disparities in health care. J Gen Intern Med.2012;27(8):992–1000.
