Abstract: TH-PO1118
NAVKIDS2 Trial: A Multi-Centre, Waitlisted, Mixed Methods, Randomized Controlled Trial of a Patient Navigator Intervention in Children with CKD
Session Information
- Late-Breaking Posters
November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Pediatric Nephrology
- 1900 Pediatric Nephrology
Author
- Wong, Germaine, The University of Sydney, Sydney, New South Wales, Australia
Group or Team Name
- NAVKIDS2 Trial Steering Committee
Background
Inequitable access to care is a major impediment to optimal health in children with chronic kidney disease (CKD). Patient navigators help patients and caregivers to navigate complex health systems, with the goal of improving accessibility to healthcare and community supports. However, the efficacy of patient navigation in improving the overall health of children with CKD is unknown.
Methods
In this multi-center, waitlisted, randomized control trial, we randomly assigned children with CKD (aged 0-16 years, of low socioeconomic backgrounds) (1:1) to receive immediate patient navigation (immediate) or wait for six months before receiving the intervention (waitlist). The primary outcome, assessed by intention to treat, was self-rated health (SRH) of the child at six months post-randomization. We analysed repeated measures of the primary outcome from baseline to six months post-randomisation using cumulative logit mixed effects models. Semi-structured interviews were analysed thematically to understand caregivers’ perspectives on the intervention.
Results
Of 398 children who were screened, 162 were enrolled (mean age (standard deviation): 8.8 (4.8) years, boys (64.8%)), with 80 and 82 assigned to the immediate and waitlist groups, respectively. There were no differences in the child’s SRH between the immediate and waitlist groups at baseline (p=0.92). There were also no cumulative differences in the child’s SRH between the immediate and waitlist groups over the 6 months period (p=0.70). Caregivers reported five themes: easing mental strain, facilitating care coordination, strengthening capacity to provide care, reinforcing care collaborations, alleviating family tensions.
Conclusion
In children with CKD, the child’s SRH did not differ significantly between the immediate and waitlist groups over time. However, caregivers may have gained skills and capacity related to care from the program.
Funding
- Government Support - Non-U.S.