Development and Evaluation of a Culturally Targeted Apolipoprotein L1 Counseling Training Program for Transplant...

Area of Science:

• Nephrology
• Genetics
• Medical Education

Background:

• Apolipoprotein L1 (APOL1) genetic testing is crucial for evaluating living kidney donors of African ancestry.
• Transplant clinicians require enhanced knowledge and skills for effective APOL1 genetic counseling.
• Culturally targeted education is needed to address the complexities of APOL1 in kidney donation.

Purpose of the Study:

• To develop and evaluate a culturally targeted training program for transplant clinicians on APOL1 genetics and living kidney donation counseling.
• To assess the program's impact on clinicians' knowledge, self-efficacy, and beliefs regarding APOL1 testing.
• To improve the quality of genetic counseling for potential living kidney donors (pLDs).

Main Methods:

• A prospective, nonrandomized pretest/posttest clinical trial was conducted across 6 kidney transplant centers.
• Participants included transplant nephrologists, surgeons, nurses, and advanced practice providers.
• An 8-video training program covered APOL1 biology, genetics, counseling skills, cultural sensitivity, and shared decision-making.

Main Results:

• Training significantly increased clinicians' knowledge of genetic variation (P=0.04).
• Post-training, participants reported higher confidence in indicating, interpreting, and communicating APOL1 test results (P<0.001).
• Beliefs about the relationship between genetics and race showed nonsignificant decreases post-training.

Conclusions:

• The training program effectively enhanced transplant clinicians' competence in counseling pLDs about APOL1 genetic testing.
• Dissemination of this program can help integrate APOL1 testing and counseling into national pLD evaluations.
• Improved clinician training is vital for equitable kidney transplantation practices.