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System Interventions to Achieve Early and Equitable Kidney Transplants (STEPS): Protocol for STEPS, a randomized
L Ebony Boulware1, Patti L Ephraim2, Tariq Shafi3
1Wake Forest University School of Medicine, 525 Vine Street, Winston-Salem, NC 27101, USA.
Contemporary Clinical Trials
|April 8, 2025
Summary
The STEPS trial tests a new approach to kidney care, combining electronic health record surveillance and patient-centered outreach to improve early kidney transplant access, especially for Black and rural patients. This intervention aims for more equitable kidney transplant evaluations and outcomes.
Area of Science:
- Nephrology
- Transplant Surgery
- Health Services Research
Background:
- Chronic kidney disease (CKD) disproportionately affects Black individuals and those in rural areas.
- Access to timely kidney transplantation remains a challenge, with disparities in evaluation and access.
- Equitable identification and navigation are crucial for improving transplant rates in underserved populations.
Purpose of the Study:
- To investigate the effectiveness of the System Interventions to Achieve Early and Equitable Kidney Transplants Study (STEPS) intervention.
- To determine if an equitable, patient-centered approach improves access to early kidney transplants.
- To reduce disparities in kidney transplant access for Black and rural populations.
Main Methods:
- A pragmatic clinical trial involving 1168 participants across three health systems.
- Intervention arm: STEPS Surveillance and Outreach Program plus Augmented Usual Kidney Care.
- Control arm: Augmented Usual Kidney Care with electronic surveillance and best practice alerts.
Main Results:
- Recruitment of 1168 participants completed between March 2022 and March 2024.
- Outcomes measure progress toward and completion of kidney transplant evaluations.
- Patient-reported outcomes will be assessed to quantify differences between study arms.
Conclusions:
- The STEPS intervention aims to enhance equitable access to kidney transplantation.
- Findings will inform strategies for improving transplant rates among diverse CKD patient groups.
- The study addresses critical disparities in kidney transplant care access.
Related Concept Videos
01:28Kidney Transplant I: Introduction
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01:28Chronic Kidney Disease III: Interprofessional Care
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