Providing Resources to Enhance African American Patients' Readiness to Make Decisions About Kidney Disease (PREPARED) Study
Providing Resources to Enhance African American Patients' Readiness to Make Decisions About Kidney Disease (PREPARED) Study
African Americans are less likely than Whites to receive kidney transplants, despite their
 being more than two-fold as likely as Whites to develop end stage renal disease (ESRD).
 Living related kidney donation (LD) offers patients an opportunity to bypass many barriers to
 receipt of deceased kidney transplants (e.g. waiting lists and immunological
 incompatibility), but minorities are less likely to receive living related kidney transplants
 (LRT). Evidence suggests African Americans may not discuss LD/LRT with their families or
 physicians at optimal rates, and thus may not have adequate information to initiate or
 participate in shared decision-making regarding LD/LRT. African Americans may also have
 financial concerns regarding convalescence and out of pocket expenses related to LD/LRT,
 another barrier impeding LD/LRT.

 The primary goals of this study are to overcome these important barriers by enhancing ethnic
 minorities' consideration of LD/LRT through the promotion of shared decision-making regarding
 LD/LRT and provision of financial assistance for out of pocket expenses. The investigators
 specific aims are: a) to develop culturally sensitive informational (audiovisual) and
 financial interventions and b) to perform a randomized controlled trial to assess their
 effectiveness in increasing pursuit of LD/LRT among African American patients with ESRD and
 their families. The investigators hypothesize: (1) Patients and families who view
 informational materials designed to promote shared decision-making regarding LD/LRT will be
 more likely than patients and families not viewing these materials to discuss LD/LRT with
 family and with health care professionals. Patients and families viewing such informational
 materials will also be more likely than those not viewing these materials to pursue and
 complete the LD/LRT process and (2) patients and their families who are offered the
 intervention to promote shared decision-making plus a financial assistance intervention for
 potential live kidney donors will be more likely than patients and families not offered both
 interventions to pursue and complete the LD/LRT process.
The investigators will enroll 210 adult African American patients with new-onset ESRD from
 dialysis facilities in the Baltimore metropolitan area and measure their initial commitment
 to pursue LD/LRT. Participants will then be randomized to one of three groups: 1)
 informational intervention alone (PREPARED education), 2) informational intervention plus
 living donor financial assistance program (PREPARED plus financial assistance), and 3) no
 intervention (Usual Care). The investigators will follow participants for up to 6 months for
 progression in their commitment to LD/LRT.
Inclusion Criteria:

 -  Age 18 or older

 -  End-stage renal disease (ESRD) receiving hemodialysis for less than 2 years

 -  Self-reported as African-American

 -  English Speaking

 Exclusion Criteria:

 -  Dementia

 -  Prior Kidney Transplant

 -  Non-English Speaking

 -  Cancer within 2 years prior to recruitment date

 -  Stage 4 Congestive Heart Failure

 -  End Stage Liver Disease

 -  Unstable Coronary Artery Disease

 -  Pulmonary Hypertension

 -  Severe Peripheral Vascular Disease

 -  Chronic Debilitating Infections