Process evaluation of the RaDIANT community study: a dialysis facility-level intervention to increase referral for kidney transplantation
Abstract Background The Reducing Disparities in Access to kidNey Transplantation Community Study (RaDIANT) was an End-Stage Renal Disease (ESRD) Network 6-developed, dialysis facility-level randomized trial testing the effectiveness of a 1-year multicomponent education and quality improvement interv...
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2018-01-01
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Online Access: | http://link.springer.com/article/10.1186/s12882-017-0807-z |
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Article |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Reem E. Hamoda Jennifer C. Gander Laura J. McPherson Kimberly J. Arriola Loren Cobb Stephen O. Pastan Laura Plantinga Teri Browne Erica Hartmann Laura Mulloy Carlos Zayas Jenna Krisher Rachel E. Patzer |
spellingShingle |
Reem E. Hamoda Jennifer C. Gander Laura J. McPherson Kimberly J. Arriola Loren Cobb Stephen O. Pastan Laura Plantinga Teri Browne Erica Hartmann Laura Mulloy Carlos Zayas Jenna Krisher Rachel E. Patzer Process evaluation of the RaDIANT community study: a dialysis facility-level intervention to increase referral for kidney transplantation BMC Nephrology Kidney transplantation Dialysis facility Randomized trial Education Staff Community-based participatory research |
author_facet |
Reem E. Hamoda Jennifer C. Gander Laura J. McPherson Kimberly J. Arriola Loren Cobb Stephen O. Pastan Laura Plantinga Teri Browne Erica Hartmann Laura Mulloy Carlos Zayas Jenna Krisher Rachel E. Patzer |
author_sort |
Reem E. Hamoda |
title |
Process evaluation of the RaDIANT community study: a dialysis facility-level intervention to increase referral for kidney transplantation |
title_short |
Process evaluation of the RaDIANT community study: a dialysis facility-level intervention to increase referral for kidney transplantation |
title_full |
Process evaluation of the RaDIANT community study: a dialysis facility-level intervention to increase referral for kidney transplantation |
title_fullStr |
Process evaluation of the RaDIANT community study: a dialysis facility-level intervention to increase referral for kidney transplantation |
title_full_unstemmed |
Process evaluation of the RaDIANT community study: a dialysis facility-level intervention to increase referral for kidney transplantation |
title_sort |
process evaluation of the radiant community study: a dialysis facility-level intervention to increase referral for kidney transplantation |
publisher |
BMC |
series |
BMC Nephrology |
issn |
1471-2369 |
publishDate |
2018-01-01 |
description |
Abstract Background The Reducing Disparities in Access to kidNey Transplantation Community Study (RaDIANT) was an End-Stage Renal Disease (ESRD) Network 6-developed, dialysis facility-level randomized trial testing the effectiveness of a 1-year multicomponent education and quality improvement intervention in increasing referral for kidney transplant evaluation among selected Georgia dialysis facilities. Methods To assess implementation of the RaDIANT intervention, we conducted a process evaluation at the conclusion of the intervention period (January–December 2014). We administered a 20-item survey to the staff involved with transplant education in 67 dialysis facilities randomized to participate in intervention activities. Survey items assessed facility participation in the intervention (fidelity and reach), helpfulness and willingness to continue intervention activities (sustainability), suggestions for improving intervention components (sustainability), and factors that may have influenced participation and study outcomes (context). We defined high fidelity to the intervention as completing 11 or more activities, and high participation in an activity as having at least 75% participation across intervention facilities. Results Staff from 65 of the 67 dialysis facilities completed the questionnaire, and more than half (50.8%) reported high adherence (fidelity) to RaDIANT intervention requirements. Nearly two-thirds (63.1%) of facilities reported that RaDIANT intervention activities were helpful or very helpful, with 90.8% of facilities willing to continue at least one intervention component beyond the study period. Intervention components with high participation emphasized staff and patient-level education, including in-service staff orientations, patient and family education programs, and patient educational materials. Suggested improvements for intervention activities emphasized addressing financial barriers to transplantation, with financial education materials perceived as most helpful among RaDIANT educational materials. Variation in facility-level fidelity of the RADIANT intervention did not significantly influence the mean difference in proportion of patients referred pre- (2013) and post-intervention (2014). Conclusions We found high fidelity to the RaDIANT multicomponent intervention at the majority of intervention facilities, with sustainability of select intervention components at intervention facilities and feasibility for dissemination across ESRD Networks. Future modification of the intervention should emphasize financial education regarding kidney transplantation and amend intervention components that facilities perceive as time-intensive or non-sustainable. Trial registration Clinicaltrials.gov number NCT02092727 . Registered 13 Mar 2014 (retrospectively registered). |
topic |
Kidney transplantation Dialysis facility Randomized trial Education Staff Community-based participatory research |
url |
http://link.springer.com/article/10.1186/s12882-017-0807-z |
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doaj-64671381032e4c36b3d584f8e9970be22020-11-25T00:51:48ZengBMCBMC Nephrology1471-23692018-01-0119111010.1186/s12882-017-0807-zProcess evaluation of the RaDIANT community study: a dialysis facility-level intervention to increase referral for kidney transplantationReem E. Hamoda0Jennifer C. Gander1Laura J. McPherson2Kimberly J. Arriola3Loren Cobb4Stephen O. Pastan5Laura Plantinga6Teri Browne7Erica Hartmann8Laura Mulloy9Carlos Zayas10Jenna Krisher11Rachel E. Patzer12Department of Surgery, Division of Transplantation, Emory University School of MedicineDepartment of Surgery, Division of Transplantation, Emory University School of MedicineDepartment of Surgery, Division of Transplantation, Emory University School of MedicineDepartment of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory UniversityDepartment of Biology, Spelman CollegeDepartment of Medicine, Division of Renal Medicine, Emory University School of MedicineDepartment of Epidemiology, Rollins School of Public Health, Emory UniversityCollege of Social Work, University of South CarolinaPiedmont Transplant InstituteDivision of Nephrology, Hypertension, and Transplant, Augusta UniversityDivision of Nephrology, Hypertension, and Transplant, Augusta UniversitySoutheastern Kidney Transplant Coalition, End Stage Renal Disease Network 6Department of Surgery, Division of Transplantation, Emory University School of MedicineAbstract Background The Reducing Disparities in Access to kidNey Transplantation Community Study (RaDIANT) was an End-Stage Renal Disease (ESRD) Network 6-developed, dialysis facility-level randomized trial testing the effectiveness of a 1-year multicomponent education and quality improvement intervention in increasing referral for kidney transplant evaluation among selected Georgia dialysis facilities. Methods To assess implementation of the RaDIANT intervention, we conducted a process evaluation at the conclusion of the intervention period (January–December 2014). We administered a 20-item survey to the staff involved with transplant education in 67 dialysis facilities randomized to participate in intervention activities. Survey items assessed facility participation in the intervention (fidelity and reach), helpfulness and willingness to continue intervention activities (sustainability), suggestions for improving intervention components (sustainability), and factors that may have influenced participation and study outcomes (context). We defined high fidelity to the intervention as completing 11 or more activities, and high participation in an activity as having at least 75% participation across intervention facilities. Results Staff from 65 of the 67 dialysis facilities completed the questionnaire, and more than half (50.8%) reported high adherence (fidelity) to RaDIANT intervention requirements. Nearly two-thirds (63.1%) of facilities reported that RaDIANT intervention activities were helpful or very helpful, with 90.8% of facilities willing to continue at least one intervention component beyond the study period. Intervention components with high participation emphasized staff and patient-level education, including in-service staff orientations, patient and family education programs, and patient educational materials. Suggested improvements for intervention activities emphasized addressing financial barriers to transplantation, with financial education materials perceived as most helpful among RaDIANT educational materials. Variation in facility-level fidelity of the RADIANT intervention did not significantly influence the mean difference in proportion of patients referred pre- (2013) and post-intervention (2014). Conclusions We found high fidelity to the RaDIANT multicomponent intervention at the majority of intervention facilities, with sustainability of select intervention components at intervention facilities and feasibility for dissemination across ESRD Networks. Future modification of the intervention should emphasize financial education regarding kidney transplantation and amend intervention components that facilities perceive as time-intensive or non-sustainable. Trial registration Clinicaltrials.gov number NCT02092727 . Registered 13 Mar 2014 (retrospectively registered).http://link.springer.com/article/10.1186/s12882-017-0807-zKidney transplantationDialysis facilityRandomized trialEducationStaffCommunity-based participatory research |