Kidney Week

Abstract: TH-PO859

MoVE TRIAL Protocol: MotiVational Strategies to Empower African American Patients to Improve Dialysis Adherence

Session Information

• Race, Ethnicity, and Gender in Kidney Health and Care
  October 24, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Diversity and Equity in Kidney Health

• 900 Diversity and Equity in Kidney Health

Authors

• Medepalli, Anita, Mercer University, Macon, Georgia, United States

Anita Medepalli

• Wallace, Marylou, Vanderbilt University Medical Center, Nashville, Tennessee, United States

Marylou Wallace, MPH

• St. Julien, Zuri Naeem, University of Missouri-St Louis, St Louis, Missouri, United States

Zuri Naeem St. Julien

• Forbess, Julianna, Vanderbilt University Medical Center, Nashville, Tennessee, United States

Julianna Forbess

• Prigmore, Heather Leanne, Vanderbilt University Medical Center, Nashville, Tennessee, United States

Heather Leanne Prigmore, MPH

• Greevy, Robert, Vanderbilt University Medical Center, Nashville, Tennessee, United States

Robert Greevy, PhD

• Schrauben, Sarah J., University of Pennsylvania, Philadelphia, Pennsylvania, United States

Sarah J. Schrauben, MD, MS

• Nair, Devika, Vanderbilt University Medical Center, Nashville, Tennessee, United States

Devika Nair, MD, MS, FASN

• Fissell, Rachel B., Vanderbilt University Medical Center, Nashville, Tennessee, United States

Rachel B. Fissell, MD, MS

• Lewis, Julia, Vanderbilt University Medical Center, Nashville, Tennessee, United States

Julia Lewis, MD, FASN

• Cavanaugh, Kerri L., Vanderbilt University Medical Center, Nashville, Tennessee, United States

Kerri L. Cavanaugh, MD, MHS, FASN

• Resnicow, Kenneth A., University of Michigan, Ann Arbor, Michigan, United States

Kenneth A. Resnicow, PhD

• Wolever, Ruth Q., Vanderbilt University Medical Center, Nashville, Tennessee, United States

Ruth Q. Wolever, PhD

• Umeukeje, Ebele M., Vanderbilt University Medical Center, Nashville, Tennessee, United States

Ebele M. Umeukeje, MD, MPH, FASN

Background

Compared to Whites, African Americans (AA) have a four-fold higher prevalence of end-stage kidney disease (ESKD) and higher hemodialysis (HD) treatment non-adherence rates. We pilot-tested (NCT05003115) and confirmed feasibility of culturally tailored motivational interviewing (MI) to improve HD adherence in AA. We describe our efficacy trial protocol (NCT05735743) and hypothesize that the intervention improves HD adherence.

Methods

Multi-site, 2-arm, parallel group (MI vs. Usual Care) RCT of ≥ 18 years old, AA HD patients (n=150, 2:4:2 stratified block randomization), who missed or shortened ≥1 session by ≥15 minutes/2 months before enrollment. Trained health coaches (HC) conduct MI sessions. Intervention fidelity is assessed pre-enrollment and mid-RCT, via MI Treatment Integrity Scale. MI patients receive 6 sessions in 8 weeks, culturally tailored to prioritize AA patient-identified contributors to nonadherence, including racial identity (Fig 1). Survey completion and EMR abstraction occur at baseline, 8, and 24 weeks; adherence data is abstracted to week 24. Primary and secondary outcomes are proportions of missed HD minutes at 8 and 24 weeks, respectively.

Results

IRB approval was obtained. Manual of procedures, intervention manual, and study charter were developed. HC received protocol, logistics, and further MI training. Enrollment was launched upon DSMB and site approval. RCT activities are ongoing.

Conclusion

Findings will determine efficacy of culturally tailored MI on improving HD adherence in AA. Improved HD adherence will reduce morbidity, mortality, healthcare costs, and racial disparities in ESKD.

Figure 1

Funding

• NIDDK Support