Targeting Social Determinants to Improve Chronic Kidney Disease Care
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About
The primary research goals of this application are to characterize social factors including health literacy and numeracy skills of CKD patients and examine associations with knowledge, self-efficacy, self-care behaviors, and clinical outcomes, and to examine the impact of an efficient interactive educational intervention to facilitate patient-provider communication. The investigators will accomplish these goals by executing a cluster-randomized controlled trial and performing detailed analysis of baseline measures. The specific aims of this study are:
Specific Aim 1: Determine the association of social factors with patient kidney knowledge, self-efficacy, participation in self-care behaviors, and clinical outcomes in moderate to advanced CKD.
Hypothesis: In patients with CKD, low health literacy and numeracy is common and associated with older age, non-white race, fewer years of education, lower socioeconomic (income) status, less kidney knowledge, lower self-efficacy of self-care, and less adherence with medication and diet self-care recommendations. Low literacy/numeracy is also associated with higher blood pressures, more proteinuria, and more severe dysfunction of renal clearance.
Specific Aim 2: Evaluate the impact of a tailored literacy-sensitive educational tool used cooperatively by physicians and patients to improve self-care and outcomes in CKD.
Hypothesis: Utilization of a concise literacy-sensitive physician-delivered educational tool will be feasible and associated with higher patient kidney knowledge, self-efficacy of self-care and greater adherence to medication and nutrition recommendations compared to usual care.
Enrollment
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Inclusion criteria
- Receiving care in the Vanderbilt General Nephrology Clinic for at least 1 prior visit past 12 months;
- Serum creatinine available in the medical record in the last 12 months demonstrating Chronic Kidney Disease (eGFR<60mls/min);
- Age 18-80 years;
- English-speaking.
Exclusion criteria
- Pre-existing diagnosis of significant dementia or psychosis as determined by primary provider and documented in the medical record;
- Corrected visual Acuity >60/20 using a Rosenbaum Pocket Vision Screen;
- Patient receives dialysis or has a functional kidney transplant.
Trial design
Primary purpose
Allocation
Interventional model
Masking
273 participants in 2 patient groups
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Data sourced from clinicaltrials.gov
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