Process evaluation of the RaDIANT community study: A dialysis facility-level intervention to increase referral for kidney transplantation

Reem E. Hamoda, Jennifer C. Gander, Laura J. McPherson, Kimberly J. Arriola, Loren Cobb, Stephen O. Pastan, Laura Plantinga, Teri Browne, Erica Hartmann, Laura L Mulloy, Carlos F Zayas Montalvo, Jenna Krisher, Rachel E. Patzer

Research output: Contribution to journalArticle

1 Citation (Scopus)

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).

Original languageEnglish (US)
Article number13
JournalBMC Nephrology
Volume19
Issue number1
DOIs
StatePublished - Jan 15 2018

Fingerprint

Kidney Transplantation
Dialysis
Referral and Consultation
Education
Patient Education
Chronic Kidney Failure
Transplants
Mars
Quality Improvement
Transplantation
Outcome Assessment (Health Care)
Kidney
Surveys and Questionnaires

Keywords

  • Community-based participatory research
  • Dialysis facility
  • Education
  • Kidney transplantation
  • Process evaluation
  • Randomized trial
  • Staff

ASJC Scopus subject areas

  • Nephrology

Cite this

Hamoda, R. E., Gander, J. C., McPherson, L. J., Arriola, K. J., Cobb, L., Pastan, S. O., ... Patzer, R. E. (2018). Process evaluation of the RaDIANT community study: A dialysis facility-level intervention to increase referral for kidney transplantation. BMC Nephrology, 19(1), [13]. https://doi.org/10.1186/s12882-017-0807-z

Process evaluation of the RaDIANT community study : A dialysis facility-level intervention to increase referral for kidney transplantation. / Hamoda, Reem E.; Gander, Jennifer C.; McPherson, Laura J.; Arriola, Kimberly J.; Cobb, Loren; Pastan, Stephen O.; Plantinga, Laura; Browne, Teri; Hartmann, Erica; Mulloy, Laura L; Zayas Montalvo, Carlos F; Krisher, Jenna; Patzer, Rachel E.

In: BMC Nephrology, Vol. 19, No. 1, 13, 15.01.2018.

Research output: Contribution to journalArticle

Hamoda, RE, Gander, JC, McPherson, LJ, Arriola, KJ, Cobb, L, Pastan, SO, Plantinga, L, Browne, T, Hartmann, E, Mulloy, LL, Zayas Montalvo, CF, Krisher, J & Patzer, RE 2018, 'Process evaluation of the RaDIANT community study: A dialysis facility-level intervention to increase referral for kidney transplantation', BMC Nephrology, vol. 19, no. 1, 13. https://doi.org/10.1186/s12882-017-0807-z
Hamoda, Reem E. ; Gander, Jennifer C. ; McPherson, Laura J. ; Arriola, Kimberly J. ; Cobb, Loren ; Pastan, Stephen O. ; Plantinga, Laura ; Browne, Teri ; Hartmann, Erica ; Mulloy, Laura L ; Zayas Montalvo, Carlos F ; Krisher, Jenna ; Patzer, Rachel E. / Process evaluation of the RaDIANT community study : A dialysis facility-level intervention to increase referral for kidney transplantation. In: BMC Nephrology. 2018 ; Vol. 19, No. 1.
@article{f32a7332421e490eb86832acfd474e9a,
title = "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 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).",
keywords = "Community-based participatory research, Dialysis facility, Education, Kidney transplantation, Process evaluation, Randomized trial, Staff",
author = "Hamoda, {Reem E.} and Gander, {Jennifer C.} and McPherson, {Laura J.} and Arriola, {Kimberly J.} and Loren Cobb and Pastan, {Stephen O.} and Laura Plantinga and Teri Browne and Erica Hartmann and Mulloy, {Laura L} and {Zayas Montalvo}, {Carlos F} and Jenna Krisher and Patzer, {Rachel E.}",
year = "2018",
month = "1",
day = "15",
doi = "10.1186/s12882-017-0807-z",
language = "English (US)",
volume = "19",
journal = "BMC Nephrology",
issn = "1471-2369",
publisher = "BioMed Central",
number = "1",

}

TY - JOUR

T1 - Process evaluation of the RaDIANT community study

T2 - A dialysis facility-level intervention to increase referral for kidney transplantation

AU - Hamoda, Reem E.

AU - Gander, Jennifer C.

AU - McPherson, Laura J.

AU - Arriola, Kimberly J.

AU - Cobb, Loren

AU - Pastan, Stephen O.

AU - Plantinga, Laura

AU - Browne, Teri

AU - Hartmann, Erica

AU - Mulloy, Laura L

AU - Zayas Montalvo, Carlos F

AU - Krisher, Jenna

AU - Patzer, Rachel E.

PY - 2018/1/15

Y1 - 2018/1/15

N2 - 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).

AB - 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).

KW - Community-based participatory research

KW - Dialysis facility

KW - Education

KW - Kidney transplantation

KW - Process evaluation

KW - Randomized trial

KW - Staff

UR - http://www.scopus.com/inward/record.url?scp=85040764251&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85040764251&partnerID=8YFLogxK

U2 - 10.1186/s12882-017-0807-z

DO - 10.1186/s12882-017-0807-z

M3 - Article

C2 - 29334900

AN - SCOPUS:85040764251

VL - 19

JO - BMC Nephrology

JF - BMC Nephrology

SN - 1471-2369

IS - 1

M1 - 13

ER -