Randomized Controlled Trial of a Digital Intervention (KidneyTIME) to Promote Live Donor Kidney Transplantation
Liise K. Kayler, Naoru Koizumi, Jing Nie, Maria Keller, Renee B. Cadzow, Katia Noyes, Jon Von Visger, Heather Gardiner, Thomas H. FeeleyABSTRACT
Background
Digital behavioral interventions are promising to support patients’ pursuit of live donor kidney transplantation (LDKT). This study examined the effectiveness of a patient‐led digital intervention ( KidneyTIME) versus active control on facilitating LDKT.
Methods
An individually randomized (1:1) parallel‐group trial was conducted at a safety‐net hospital transplant program with adult kidney transplant candidates in referral, evaluation, or listed phases who were English‐speaking and had email or text access. KidneyTIME participants received animated video LDKT education and outreach enablement via video sharing. The primary outcome was ≥1 live donor inquiry within 12 months in the intent‐to‐treat population. Secondary outcomes included LDKT knowledge, attitudes, behaviors toward listing and donor outreach, extent of video sharing, and intervention acceptability assessed by survey at 4 timepoints post‐exposure.
Results
Between 4/22 and 7/23, 422 candidates (mean age 54 years; 57% male, 45% income < $30,000) were randomized to KidneyTIME ( n = 212) or active control ( n = 210). Between‐group differences in donor outreach behaviors and receipt of a donor inquiry were not detected. KidneyTIME participants had higher LDKT knowledge ( p = 0.002), new listing behaviors (IRR:1.62, p = 0.005), and extent of video sharing ( p = 0.016). In planned as‐treated analysis, intervention participants who viewed at least one optional video had significantly higher cumulative donor inquiry probability than those who did not (viewer 22.9%; non‐viewer 9.8%, p = 0.029). Intervention acceptability scores were high.
Conclusion
A digital intervention self‐administered by patients did not increase donor inquiries. Preliminary dose effect findings suggest the need to consider how to encourage people to engage more with the intervention.