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J Palliat Med. 2019 Jan 31. doi: 10.1089/jpm.2018.0439. [Epub ahead of print]

Peer Navigator Intervention for Latinos on Hemodialysis: A Single-Arm Clinical Trial.

Author information

1
1 Department of Medicine, Denver Health, Denver, Colorado.
2
2 Department of General Internal Medicine, University of Colorado School of Medicine, Aurora, Colorado.
3
3 Office of Research, Denver Health, Denver, Colorado.
4
4 Institute for Health Research, Kaiser Permanente Colorado, Denver, Colorado.
5
5 Colorado School of Public Health, University of Colorado, Denver, Colorado.
6
6 Aurora Mental Health Center, Aurora, Colorado.

Abstract

BACKGROUND:

Latinos with end-stage renal disease (ESRD) have worse mental and kidney composite health-related quality of life (HRQOL) scores compared to non-Latino ESRD patients. Latino ESRD patients uniquely report that social factors (e.g., lack of care coordination, food insecurity, and low health literacy) and mental health influence their HRQOL. We developed a culturally tailored peer navigator (PN) intervention to improve the HRQOL of Latinos on hemodialysis.

OBJECTIVE:

To determine the feasibility of the PN intervention.

DESIGN:

Single-arm prospective study. The PN provided individualized support with advance care planning, care coordination, and counseling about the importance of diet and mental health.

SETTING AND PARTICIPANTS:

Latino with ESRD receiving scheduled outpatient thrice-weekly hemodialysis or reliant on emergency-only hemodialysis in Denver.

MAIN MEASURES:

Recruitment, retention rates, data completeness, intervention dose, patient- and staff-reported satisfaction with the intervention.

RESULTS:

Of 49 eligible patients, 40 (82%) agreed to participate. The majority of participants received scheduled outpatient hemodialysis (75%), 20 were women (50%), with a mean (standard deviation [SD]) age of 56 (13) years. No participants withdrew from the intervention. One participant died. The mean (SD) number of PN visits per participant was 7 (2) and the mean (SD) length of the visits was 97 minutes (49). The majority of visits took place at the hemodialysis facility (59%) and home (27%). The vast majority of participants reported that the PN improved their quality of life as a patient on hemodialysis (95%).

CONCLUSIONS:

The PN intervention achieved feasibility goals and was well received by participants.

KEYWORDS:

Latinos; health-related quality of life; hemodialysis; patient navigators; renal failure; undocumented immigrants

PMID:
30702365
DOI:
10.1089/jpm.2018.0439

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