Abstract: TH-PO878
Healthcare System Intervention Changed Negative Perceptions of Healthcare in Kidney Transplant Candidates
Session Information
- Transplantation: Donation and Access
November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Velez-Bermudez, Miriam E., University of New Mexico Health Sciences Center, Albuquerque, New Mexico, United States
- Leyva, Yuridia, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, United States
- Loor, Jamie Marie, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, United States
- Dew, Mary Amanda, UPMC, Pittsburgh, Pennsylvania, United States
- Zhu, Yiliang, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, United States
- Unruh, Mark L., University of New Mexico Health Sciences Center, Albuquerque, New Mexico, United States
- Boulware, L. Ebony, Wake Forest University School of Medicine, Charlotte, North Carolina, United States
- Tevar, Amit D., UPMC, Pittsburgh, Pennsylvania, United States
- Myaskovsky, Larissa, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, United States
Background
The kidney transplant (KT) evaluation process is lengthy for patients but even longer for Black patients. One potential reason for these longer times is past negative experiences with healthcare contributing to mistrust toward healthcare systems. We examined whether engaging in a streamlined evaluation process at a transplant center reduced negative perceptions of the healthcare system among Black patients.
Methods
We recruited patients undergoing KT evaluation, and the intervention occurred during the evaluation period. We collected survey responses at T1 (before evaluation initiation) and T2 (following KT evaluation completion). Surveys assessed experience of discrimination in healthcare, perceived racism in healthcare, medical mistrust, and trust in physician. Regression analyses adjusted for baseline characteristics. We examined whether negative perceptions of healthcare changed from T1 to T2 among White and Black participants.
Results
The final sample included 883 participants (658 White, 225 Black). White participants consistently had lower scores for discrimination, racism, and mistrust but higher scores for trust in physician, compared to Black participants, across both time points (all p<.001). Interaction effects indicate that White participants experienced a significant reduction in discrimination, racism, and mistrust scores at T2, and Black participants experienced a significant reduction in discrimination, mistrust, and trust in physician scores at T2 (all p<.05). The difference in change-in-perception scores between Whites and Blacks was statistically significant for trust in physician (p = .012).
Conclusion
A coordinated healthcare system intervention reduced perceptions of discrimination, racism, and mistrust in patients undergoing KT evaluation, but results varied by race. Future work will ascertain whether perceptions of discrimination, racism, and mistrust are associated with faster time to KT waitlisting, treatment adherence, and quality of life post-transplant.
Funding
- NIDDK Support