Patients' Attitudes on the Use of Expanded Outreach to Find a Kidney Donor: A Mixed-Methods Study.

Rationale & Objective: Access to living donor kidney transplantation (LDKT) can be improved by strategies that expand donor outreach. Kidney transplant candidates' attitudes on such strategies are unclear. This study explored candidates' attitudes on the use of donor outreach strategies with wide reach. Study Design: A Quasi Setting & Participants: Adult kidney transplant candidates at one transplant program in the Northeast who had completed a trial of a behavioral LDKT access intervention. Participants were informed of a variety of donor outreach approaches by viewing a short video and were asked scaled and open-ended questions about their experiences and attitudes towards such approaches, thoughts about the video, and recommendations for support. Analytical Approach: Qualitative data were analyzed for themes and subthemes using conventional content analysis, supplemented by descriptive statistics of demographic and scaled data. Results: All 24 participants had discussed LDKT with at least one person. Over 40% had done or would do any of 12 expanded donor outreach activities. Six themes were identified: (1) reaching people, mainly with conversations; (2) de-motivators to sustain donor outreach; (3) openness to expanded outreach; (4) varied capacity for expanded outreach due to ability, health, economic, social, and technology challenges; (5) recommended human assistance and tools for outreach; and (6) the video was inspirational. Limitations: Small sample of patients at one transplant center may limit representativeness. Conclusions: Kidney transplant candidates are receptive to conducting expanded donor outreach activities. Findings highlighted individual preferences on outreach approaches and the need to address multiple individual and contextual barriers.