Evidence map›Paper›PMID 35831221›Full record

ArticleSurgery2022

Greater community vulnerability is associated with poor living donor navigator program fidelity.

A Cozette Killian, Alexis J Carter, Rhiannon D Reed, Brittany A Shelton, Haiyan Qu, M Chandler McLeod, Babak J Orandi, Robert M Cannon, Douglas Anderson, Paul A MacLennan and 3 more

Abstract read
In one paragraph

Article in Surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors.

A Cozette KillianUniversity of Alabama Comprehensive Transplant Institute, Birmingham, AL. Electronic address: https://twitter.com/CozetteKale.
Alexis J CarterUniversity of Alabama Comprehensive Transplant Institute, Birmingham, AL. Electronic address: https://twitter.com/carteraj21.
Rhiannon D ReedUniversity of Alabama Comprehensive Transplant Institute, Birmingham, AL. Electronic address: https://twitter.com/rhiruns.
Brittany A SheltonUniversity of Alabama Comprehensive Transplant Institute, Birmingham, AL.
Haiyan QuUniversity of Alabama Comprehensive Transplant Institute, Birmingham, AL.
M Chandler McLeodUniversity of Alabama Comprehensive Transplant Institute, Birmingham, AL.
Babak J OrandiUniversity of Alabama Comprehensive Transplant Institute, Birmingham, AL.
Robert M CannonUniversity of Alabama Comprehensive Transplant Institute, Birmingham, AL.
Douglas AndersonUniversity of Alabama Comprehensive Transplant Institute, Birmingham, AL.
Paul A MacLennanUniversity of Alabama Comprehensive Transplant Institute, Birmingham, AL.
Vineeta KumarUniversity of Alabama Comprehensive Transplant Institute, Birmingham, AL.
Michael HanawayUniversity of Alabama Comprehensive Transplant Institute, Birmingham, AL.
Jayme E LockeUniversity of Alabama Comprehensive Transplant Institute, Birmingham, AL. Electronic address: jlocke@uabmc.edu.

Funding

National Dissemination of I-Corps@NCATS: Accelerating Translation through CommercializationUL1TR003096 · NCATS · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI GUTIERREZ, ORLANDO M, KIMBERLY, ROBERT P. · 2019 to 2023
$43.6M
TRAINING IN CELLULAR PHYSIOLOGY MEMBRANE TRANSPORTT32DK007545 · NIDDK · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI GUTIERREZ, ORLANDO M · 1987 to 2023
$4.5M
Promoting Increases in Living Organ Donation via Tele-navigation (PILOT)R01DK125509 · NIDDK · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI SEGEV, DORRY L. · 2021 to 2025
$3.2M
NCATS NIH HHS UL1 TR003096NIDDK NIH HHS R01 DK125509NIDDK NIH HHS T32 DK007545
6 · The paper itself

Abstract

backgroundCommunity-level factors contribute to living donor kidney transplantation disparities but may also influence the interventions aimed to mitigate these disparities. The Living Donor Navigator Program was designed to separate the advocacy role from the patient in need of transplantation-friends/family are encouraged to participate as the patients' advocates to identify living donors, though some of the patients participate alone as self-advocates. Self-advocates have a lower living donor kidney transplantation likelihood compared to the patients with an advocate. We sought to evaluate the relationship between the patients' community-level vulnerability and living donor navigator self-advocacy as a surrogate for program fidelity.

methodsThis single-center, retrospective study included 110 Living Donor Navigator participants (April 2017-June 2019). Program fidelity was assessed using the participants' advocacy status. Measures of community vulnerability were obtained from the Centers for Disease Control and Prevention Social Vulnerability Index. Modified Poisson regression was used to evaluate the association between community-level vulnerability and living donor navigator self-advocacy.

resultsOf the 110 participants, 19% (n = 21) were self-advocates. For every 10% increase in community-level vulnerability, patients had 17% higher risk of self-advocacy (adjusted relative risk 1.17, 95% confidence interval: 1.03-1.32, P = .01). Living in areas with greater unemployment (adjusted relative risk: 1.18, 95% confidence interval: 1.04-1.33, P = .01), single-parent households (adjusted relative risk: 1.23, 95% confidence interval: 1.06-1.42, P = .006), minority population (adjusted relative risk: 1.30, 95% confidence interval: 1.04-1.55, P = .02), or no-vehicle households (adjusted relative risk: 1.17, 95% confidence interval: 1.02-1.35, P = .02) were associated with increased risk of self-advocacy.

conclusionHaving a greater community-level vulnerability was associated with poor Living Donor Navigator Program fidelity. The potential barriers identified using the Social Vulnerability Index may direct resource allocation and program refinement to optimize program fidelity and efficacy for all participants.

Indexed as

Kidney TransplantationLiving DonorsHumansMinority GroupsRetrospective StudiesRisk

Identifiers

PMID35831221
PMCPMC9633042

What OpenQuestion holds

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Registered trials

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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.