Project living ACTS: Living donor transplant education for African American end-stage renal disease patients

African Americans (AAs) are overrepresented among those in need of a kidney transplant. Transplantation continues to be the therapy of choice for many AAs with End-Stage Renal Disease. Living donor transplant (LDT) offers numerous advantages over deceased donor transplantation; however, research consistently finds that AAs face significant barriers to LDT stemming from a lack of knowledge of LDT as a viable treatment option, distrust of the health care system, and lack of willingness to discuss LDT with family members. There is a need for culturally-sensitive interventions that addresses such patient-level barriers.

Living ACTS (About Choices in Transplantation and Sharing) is a theory-based self-education intervention consisting of a DVD and educational booklet. Using a pre-post experimental research design, participants (N=296) received either Living ACTS or standardly available materials. Main outcomes explored knowledge of LDT, willingness to discuss LDT with family, and perceived benefit of LDT at both immediate and 6-month follow-up.

At immediate follow-up, intervention participants demonstrated greater knowledge of LDT as a treatment option (ß=.16, p<.01) and reported greater perceived benefit of LDT (ß =.26, p<.001) than control participants. At 6-month follow-up, intervention participants reported greater willingness to talk to family about LDT (ß =.12, p<.05) than control participants.

Living ACTS was successful at improving knowledge and perceived benefit of LDT in the short term. These improvements may have provided a mechanism for increasing willingness to talk to family about LDT over the subsequent 6 months during which time participants may have opportunities to experience family conversations about LDT.