Storytelling to Promote Living Donor Kidney Transplant

Readiness and Motivation

Elucidate if allowing waitlisted transplant patients to watch two videos from the LDSP will increase their motivation in pursuing LDKT. This was assessed using the validated Decisional Balance Scale measuring perceived pros and cons of pursuing LDKT. Following the prompt, "How important is this statement to your decision about living donor transplant?" was a set of 6 perceived benefits of LDKT (eg, "With a living donor transplant, I will be able to contribute to my family and friends sooner") and 6 perceived disadvantages (eg, "I don't want to involve anyone else in my health problems"). Answer choices were "1: not important," "2: slightly important," "3: important," "4: very important," "5: extremely important." Total attitude scores were calculated by subtracting the sum of perceived disadvantage scores from the sum of perceived advantage scores to obtain a range from -30 (most negative attitude towards LDKT) to +30 (most positive attitude towards LDKT).

Transplant Actions

Elucidate if allowing waitlisted transplant patients to watch two videos from the LDSP will change their actions towards pursuing LDKT. Pro-transplant behaviors were assessed using the validated Stage of Change Scale. Seven actions related to the pursuit of LDKT were listed (eg, "generally talk to people about my interest in transplant," "ask a potential donor directly to be tested"), and participants were asked if they "1: don't plan on doing this," "2: plan on doing this," or "3: already done this." Scores were calculated by summing survey responses to obtain a range from 0 (least number of actions completed in the pursuit of LDKT) to 21 (most number of actions completed in the pursuit of LDKT).

Donor Inquiries and evaluations

Examine if allowing waitlisted transplant patients to watch two videos from the LDSP will increase the number of donor inquiries and donor evaluations.

Health literacy and cultural safety

Test if the LDSP serves as a health-literate and culturally safe education approach that can effectively support racialized communities in pursuing LDKT. Perceived cultural safety, health literacy accessibility, and impact of the storytelling videos were assessed using 7 prompts (eg, "After viewing the video, I feel less alone in my transplant pathway") with answer choices "1: strongly disagree," "2: disagree," "3: neutral," "4: agree," "5: strongly agree." Following survey completion, participants were invited to elaborate on their responses in an open-ended response section.

Transplant knowledge

Knowledge related to LDKT was assessed using the validated KART 2.0 Transplant Knowledge Subscale. This subscale is comprised of 16-question multiple choice questions regarding basic facts about LDKT (eg, "Compared to transplants from donors who have died, how long do transplants from living donors last?"). In our study, wording of some questions were modified to reflect the local healthcare system context. Scores were calculated by summing the number of correct responses to obtain a range from 0 (lowest LDKT knowledge) to 16 (highest LDKT knowledge).