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Promoting Increases in Living Organ Donation via Tele-navigation (PILOT)

Award Number: R01DK125509
ORGANIZATION: NATIONAL INSTITUTE OF DIABETES & DIGESTIVE & KIDNEY DISEASES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 04/01/2021
PERIOD OF PERFORMANCE END DATE: 02/28/2026

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Promoting Increases in Living Organ Donation via Tele-navigation (PILOT) - SUMMARY The demand for kidney transplantation continues to greatly exceed the supply, and living kidney donors remain a critical source of organs for their loved ones. Living donor kidney transplantation (LDKT) has decreased in the US since 2004, and importantly, significant geographic disparities in likelihood of LDKT have been identified, with the southeastern US having the lowest rates. Transplant candidate-related and potential living donor-related factors, including difficulty asking family/friends to donate on one’s behalf and lack of knowledge about the donation process, respectively, have been implicated in lower donation rates. Programs have been developed to separate the advocacy role from the transplant candidate in order to overcome barriers associated with asking someone to donate on one’s behalf, and have demonstrated increases in living donor inquiries. Importantly, these programs were developed and implemented in resource-intense urban settings that afforded ready access to high-speed internet, cell phone service and close geographic proximity to urban- based transplant centers, limiting their generalizability to low-resource settings like the rural, southeastern US. Moreover, these programs failed to include targeted interventions to improve potential living donor comfort with the evaluation process, impeding sustained increases in LDKT. Living donor selection is a comprehensive process that begins with potential donor inquiry, screening of potential donors for absolute contraindications to donation (e.g. solitary kidney), evaluation, and ultimately approval. This process is time-consuming, overwhelming, and involves complex and frequent interactions with the healthcare system. Not surprisingly, many potential living donors withdraw from the process prior to approval and donation. Multiple studies have demonstrated the feasibility and efficacy of patient navigator programs in improving outcomes, including more efficient use of healthcare systems. In order to address knowledge gaps within existing programs designed to increase living donation, we utilized the RE-AIM framework to develop and implement a novel Living Donor Navigator Program (LDN). LDN combines advocacy-training to overcome barriers in initiating conversations with and identification of potential living donors with the use of non-clinical navigators to guide donors through the evaluation process. Early results indicate a 7-fold increase in likelihood of an approved donor among LDN participants compared to non-participants; however, assessment of LDN reach and adoption demonstrated that geographic disparities among participants exist. We hypothesize that expansion of the LDN program to include telehealth delivery will overcome geographic disparities in access and facilitate sustained increases in living donation. To this end, we will address the following aims: 1) Conduct qualitative assessments to identify facilitators for LDN telehealth participation, 2) Implement a LDN telehealth program, and 3) Compare the effectiveness of telehealth LDN model vs. standard of care for increasing living kidney donation.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = $631,470 )
2025	2025	UNIVERSITY OF ALABAMA AT BIRMINGHAM	701 S 20TH STREET	BIRMINGHAM	AL	35294	JEFFERSON	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	5	7/29/2025	NON-COMPETING CONTINUATION	$631,470
														Subtotal = $631,470

Issue Date FY: 2024 ( Subtotal = $598,273 )
2024	2024	UNIVERSITY OF ALABAMA AT BIRMINGHAM	701 S 20TH STREET	BIRMINGHAM	AL	35294	JEFFERSON	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	4	3/19/2024	NON-COMPETING CONTINUATION	$623,201
2024	2024	UNIVERSITY OF ALABAMA AT BIRMINGHAM	701 S 20TH STREET	BIRMINGHAM	AL	35294	JEFFERSON	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	002	4	5/16/2024	NON-COMPETING CONTINUATION	$37,391
2024	2024	UNIVERSITY OF ALABAMA AT BIRMINGHAM	701 S 20TH STREET	BIRMINGHAM	AL	35294	JEFFERSON	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	001	4	3/20/2024	NON-COMPETING CONTINUATION	-$62,319
														Subtotal = $598,273

Issue Date FY: 2023 ( Subtotal = $623,201 )
2023	2023	UNIVERSITY OF ALABAMA AT BIRMINGHAM	701 S 20TH ST	BIRMINGHAM	AL	35294	JEFFERSON	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	3	2/22/2023	NON-COMPETING CONTINUATION	$623,201
														Subtotal = $623,201

Issue Date FY: 2022 ( Subtotal = $649,078 )
2022	2022	UNIVERSITY OF ALABAMA AT BIRMINGHAM	701 S 20TH ST	BIRMINGHAM	AL	35294	JEFFERSON	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	2	2/17/2022	NON-COMPETING CONTINUATION	$584,168
2022	2022	UNIVERSITY OF ALABAMA AT BIRMINGHAM	701 S 20TH ST	BIRMINGHAM	AL	35294	JEFFERSON	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	001	2	4/4/2022	NON-COMPETING CONTINUATION	$64,910
														Subtotal = $649,078

Issue Date FY: 2021 ( Subtotal = $653,361 )
2021	2021	UNIVERSITY OF ALABAMA AT BIRMINGHAM	701 S 20TH ST	BIRMINGHAM	AL	35294	JEFFERSON	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	1	3/29/2021	NEW	$653,361
														Subtotal = $653,361

Grand Total All Awards = $3,155,383

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Promoting Increases in Living Organ Donation via Tele-navigation (PILOT)

Award Number: R01DK125509

ORGANIZATION: NATIONAL INSTITUTE OF DIABETES & DIGESTIVE & KIDNEY DISEASES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 04/01/2021

PERIOD OF PERFORMANCE END DATE: 02/28/2026

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