Kidney Week

Abstract: TH-PO1185

Community Health Worker Intervention for Latinos Receiving Hemodialysis: A Randomized Controlled Trial

Session Information

• Late-Breaking Science Posters
  October 24, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

• Cervantes, Lilia, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, United States

Lilia Cervantes, MD

• Powe, Neil R., University of California San Francisco Department of Medicine, San Francisco, California, United States

Neil R. Powe, MD, FASN

• Cukor, Daniel, NYU Langone Health, New York, New York, United States

Daniel Cukor, PhD

• Beaty, Brenda, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, United States

Brenda Beaty

• Mcbeth, Lauren, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, United States

Lauren Mcbeth

• Hasnain, Romana, Denver Health Main Campus, Denver, Colorado, United States

Romana Hasnain

• Chonchol, Michel, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, United States

Michel Chonchol, MD, FASN

Background

Latino groups face a disproportionate burden of ESKD, social and structural issues, and subsequent kidney health disparities. While community health worker (CHW) interventions serve to reduce health disparities, effectiveness for Latinos with ESKD remains unknown.

Methods

In a randomized controlled trial, we tested a multi-level CHW intervention among Latino adults with ESKD receiving hemodialysis. Participants were randomized to receive resources for social needs, culturally responsive dietary education, and support from a CHW, or to usual care (i.e., standard treatment). A longitudinal segmented linear model with generalized estimating equations evaluated the effect of the intervention on the primary outcome of interdialytic weight gain (IDWG%) and the secondary outcome of a Patient Activation Measure (PAM).

Results

139 individuals at 5 urban Denver dialysis facilities from 10/7/2020 to 4/29/2022 were recruited and 68 randomized to the CHW arm and 71 to the control arm (Table 1). Baseline characteristics and demographic factors were similar between the groups. The post-intervention slopes differed between the intervention and control, corresponding to a decrease of 0.04% in IDWG per 30 days for intervention participants and an increase of 0.03% per 30 days for usual care (p=0.01) (Figure 1). The median change in PAM for the intervention group was 1.8 points (IQR -2.2, 5.5) compared to -2.2 (IQR -7.4, 2.5) for the usual care group; Wilcoxon text p=0.005.

Conclusion

Among Latino individuals with ESKD receiving standard in-center hemodialysis, a multicomponent CHW intervention reduced IDWG and improved patient activation as compared to usual care.

Funding

• NIDDK Support