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ArticleCanadian journal of kidney health and disease2022

Protocol for a Process Evaluation of the Quality Improvement Intervention to Enhance Access to Kidney Transplantation and Living Kidney Donation (EnAKT LKD) Cluster-Randomized Clinical Trial.

Seychelle Yohanna, Mackenzie Wilson, Kyla L Naylor, Amit X Garg, Jessica M Sontrop, Dmitri Belenko, Lori Elliott, Susan McKenzie, Sara Macanovic, Istvan Mucsi and 7 more

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Canadian journal of kidney health and disease, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03329521 (Multicomponent Intervention to Enhance Access to Kidney Transplantation and Living Kidney Donation), which is not on this map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03329521 nacompletednot on this map

Multicomponent Intervention to Enhance Access to Kidney Transplantation and Living Kidney Donation (EnAKT LKD) in Patients With Chronic Kidney Disease: A Pragmatic, Registry-based, Cluster-Randomized Clinical Trial

TypeinterventionalSponsorLondon Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph'sRan2017 to 2021Enrolled26ConditionsKidney Diseases, Kidney Failure, End Stage Renal DiseaseArmsMulticomponent intervention
3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Increasing Access to Living Donor Kidney Transplantation: A Program Report.Canadian journal of kidney health and disease · 2026
    Article
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Seychelle YohannaDivision of Nephrology, McMaster University, Hamilton ON, Canada.ORCID https://orcid.org/0000-0003-0404-7319
Mackenzie WilsonClinical Epidemiology Program, Ottawa Hospital Research Institute, ON, Canada.ORCID https://orcid.org/0000-0002-3265-6579
Kyla L NaylorDepartment of Epidemiology & Biostatistics, Western University, London, ON, Canada.ORCID https://orcid.org/0000-0002-5304-8038
Amit X GargDepartment of Epidemiology & Biostatistics, Western University, London, ON, Canada.ORCID https://orcid.org/0000-0003-3398-3114
Jessica M SontropDepartment of Epidemiology & Biostatistics, Western University, London, ON, Canada.ORCID https://orcid.org/0000-0001-7784-2028
Dmitri BelenkoDivision of Nephrology, University of Toronto, ON, Canada.
Lori ElliottOntario Renal Network, Ontario Health, Toronto, Canada.
Susan McKenzieOntario Renal Network, Ontario Health, Toronto, Canada.
Sara MacanovicDivision of Nephrology, University of Toronto, ON, Canada.
Istvan MucsiOntario Renal Network, Ontario Health, Toronto, Canada.ORCID https://orcid.org/0000-0002-4781-4699
Rachel PatzerHealth Services Research Center, School of Medicine, Emory University, Atlanta, USA.
Irina VoroninOntario Renal Network, Ontario Health, Toronto, Canada.
Iris LuiOntario Renal Network, Ontario Health, Toronto, Canada.
Peter G BlakeDivision of Nephrology, Western University, London, ON, Canada.
Amy D WatermanDivision of Nephrology, University of California, Los Angeles, USA.
Darin TreleavenDivision of Nephrology, McMaster University, Hamilton ON, Canada.
Justin PresseauClinical Epidemiology Program, Ottawa Hospital Research Institute, ON, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Many patients who would benefit from a kidney transplant never receive one. The Enhance Access to Kidney Transplantation and Living Kidney Donation (EnAKT LKD) pragmatic, cluster-randomized clinical trial is testing whether a multi-component quality improvement intervention, provided in chronic kidney disease (CKD) programs (vs. usual care), can help patients with CKD with no recorded contraindications to kidney transplant complete more steps toward receiving a transplant (primary outcome of the trial). The EnAKT LKD intervention has 4 components: (1) quality Improvement teams and administrative support, (2) improved transplant education for patients and healthcare providers, (3) access to support and (4) program-level performance monitoring. Objective: To conduct a process evaluation of the EnAKT LKD quality improvement intervention to determine if the components were delivered, received, and enacted as designed (fidelity), and if the intervention addressed intended barriers (mechanisms of change). Design: A mixed-methods process evaluation informed by new practice implementation and theories of behavior change. Setting: Chronic kidney disease programs in Ontario, Canada, began receiving the EnAKT LKD intervention on November 1, 2017 and will continue to receive it until December 31, 2021. The process evaluation (interviews and surveys) will occur alongside the trial, between December 2020 to May 2021. Participants: Healthcare providers (eg, dialysis nurses, nephrologists, members of the multi-care kidney clinic team) at Ontario's 27 CKD programs. Methods: We will survey and interview healthcare providers at each CKD program, and complete an intervention implementation checklist. Quantitative data from the surveys and the intervention implementation checklist will assess fidelity to the intervention, while quantitative and qualitative data from surveys and interviews will provide insight into the mechanisms of change. Limitations: The long trial period may result in poor participant recall. Conclusion: This process evaluation will enhance interpretation of the trial findings, guide improvements in the intervention components, and inform future implementation. Trial registration: Clinicaltrials.gov; identifier: NCT03329521.

Indexed as

chronic kidney diseasefidelitykidney transplantationliving kidney donationmechanisms of changenormalization process theoryprocess evaluationprotocoltheoretical domains framework

Identifiers

PMID35340770
PMCPMC8943297

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.