TEAMWORK & VOLUNTEERISM: Solutions Dept. UrologyDept. Urology Dept. NephrologyDept. Nephrology Medicine InstituteMedicine Institute Cleveland Clinic Interdepartmental Clinical CollaborationsCleveland Clinic Interdepartmental Clinical Collaborations Wellness InstituteWellness Institute Dept. Pastoral Care ServicesDept. Pastoral Care Services Dept. Social WorkDept. Social Work PharmacyPharmacy Division of NursingDivision of Nursing Nutrition ServicesNutrition Services Institutional Services (Pt. Education, OPSA, Sponsored Research, etc.)Institutional Services (Pt. Education, OPSA, Sponsored Research, etc.) Corporate CommunicationsCorporate Communications Governmental & Community RelationsGovernmental & Community Relations DiversityDiversity BioethicsBioethics BiostatisticsBiostatistics Cleveland Clinic Lerner College of MedicineCleveland Clinic Lerner College of Medicine Lerner Research InstituteLerner Research Institute

Partnerships and Sponsors: ChurchFraternitySorority Community Organizations CorporateIndividuals

Health Screenings: Identification of Diseases in Early Treatable States

Solutions: Dedicated Health Literacy Education -Increase awareness of preventive health -Increase health screenings -Promote healthy lifestyles -Promote participation in clinical trials by minorities -Promote awareness of family medical history Health Literacy Saves LivesHealth Literacy Saves Lives

Kidney Disease and Kidney Transplantation Diabetes and high-blood pressure cause most kidney disease and kidney failure.Diabetes and high-blood pressure cause most kidney disease and kidney failure. Control of your blood pressure and blood sugar may prevent kidney disease.Control of your blood pressure and blood sugar may prevent kidney disease. Kidney transplantation is a way to treat kidney failure. More AA are needed to donate their kidneys while living or after death.Kidney transplantation is a way to treat kidney failure. More AA are needed to donate their kidneys while living or after death.

DiabetesDiabetes Risk factors for diabetes are:Risk factors for diabetes are: -Genetics -Obesity -Lack of exercise -Other predisposing factors

Solutions: Promote and Empower Patients Toward Compliance Patient Compliance: How To Improve It

Solution: Promotion of Family Support Systems and Awareness of Family Medical History

Solutions: Individual & Community Empowerment

Solution: Outcomes Research

A nalysis of Disparities in Kidney Transplantation by Race at Cleveland Clinic Section of Renal Transplantation Minority Mens Health Center C. Modlin, C. Zaramo, J. Alster, L. Zhou, D. Goldfarb, S. Flechner, and A. Novick

Living Related (LR) Cadaveric (CAD) Health Disparities in Renal Graph Survival in Tx Patients by Race and Source of Allograft

Dialysis 1 st Week Post-Tx Significant Disparities in Dialysis following the First Week of Post Renal Transplantations (Post-Tx, p<0.001*) 52.14% 15% 8.16% 5.14% Percentage (%) African American (CAD) Caucasian (CAD) African American (L) Caucasian (L) Race/ Ethnicity *p<

Post-Tx Serum Creatinine (CAD) 7 days 12 mos.

Racial disparities in deceased donor kidney transplantation are compounded by longer pre-transplant dialysis duration in African American patients Ho Yee Tiong*#, Charles Modlin#, Joan M. Alster**, Ismail R. Saad#, Barbara Mastroinni, Kathy Savas, and Stuart M. Flechner# Cleveland, OH #Cleveland Clinic Glickman Urological Institute, Section of Renal Transplantation; Minority Mens Health Center **Cleveland Clinic Department of Quantitative Health Sciences Conclusions:Conclusions: Lower deceased donor allograft survival in AA recipients compared with non-AA recipients occurs despite equivalent donor allocation and immunosuppression.Lower deceased donor allograft survival in AA recipients compared with non-AA recipients occurs despite equivalent donor allocation and immunosuppression. Medicaid insurance status and days on waiting list may be surrogate factors for socio-economic status that are different between AA and non-AA recipients.Medicaid insurance status and days on waiting list may be surrogate factors for socio-economic status that are different between AA and non-AA recipients. Longer pre-transplant dialysis duration in AA patients compounds the impact of race on allograft survival difference and should be specifically targeted in programs to improve outcomes.Longer pre-transplant dialysis duration in AA patients compounds the impact of race on allograft survival difference and should be specifically targeted in programs to improve outcomes.

Through Our Research, We Have Concluded Through Our Research, We Have Concluded that education of AAs with kidney disease: that education of AAs with kidney disease: The merits and advantages of kidney transplantation over maintenance dialysis The merits and advantages of kidney transplantation over maintenance dialysis The benefits of living donor renal transplantation over deceased donor transplantation The benefits of living donor renal transplantation over deceased donor transplantation The merits of preemptive renal transplantation The merits of preemptive renal transplantation Educating family members of those with kidney disease regarding early screenings for kidney disease in families Educating family members of those with kidney disease regarding early screenings for kidney disease in families

Cleveland Clinic Minority Organ Donation and Kidney Transplantation Initiatives

Promotion of Organ Donor Registration in African Americans

An Innovation to Promote Organ Donation in African American Populations: Methodology/Interventions. Outreach contest strategically targeted towards twenty-eight 28 (n=28) NE Ohio BMVs (March 1st 2007 to June 30th, 2007) to promote, encourage and assist in outreach educational programs regarding organ donation and registry/issuance.

Results The overall consequence of the Out-Reach Organ Donation Registry Contest and collaborative has resulted in a mean increase of % (baseline registration rates ranging from 15.7 to 53.35%) in all the functional BMVs. One BMV in particular, predominantly AA, won 1st place for the number of donation registries: (* 6.425% {*p< 0.05} Wade Park in Cleveland, Ohio © 2007).

Transplantation Proceedings Volume 40, Issue 4, Pages , May 2008Transplantation Proceedings Volume 40, Issue 4, Pages , May 2008 Volume 40, Issue 4 Volume 40, Issue 4

Culturally Sensitive & Competent Team to Promote Organ Donor Registration

Expanding Organ Donation Acceptance and Transplant Rates in African Americans AND Promotion of Prevention of Kidney Disease in African Americans

Cleveland Clinic – Lifebanc Community Partnership to:Cleveland Clinic – Lifebanc Community Partnership to: -Promote Organ Donor Awareness -Increase Registration among African Americans -Promote Prevention

AA Kidney Failure in NE Ohio >1800 patients in Northeast Ohio are on waiting list for organ transplant, >50% African American.>1800 patients in Northeast Ohio are on waiting list for organ transplant, >50% African American. Numerous factors persistently limit acceptance of organ donation among AAs:Numerous factors persistently limit acceptance of organ donation among AAs: -distrust of health care providers, -limited awareness and health literacy, -poor health among compatible potential living donors in AAs.

Specific Aim 1: Focus Groups To gain a deeper understanding of NE Ohio AAs knowledge, attitudes and ideas about chronic kidney and organ donationTo gain a deeper understanding of NE Ohio AAs knowledge, attitudes and ideas about chronic kidney and organ donation -Surveys, -Community Conversations/ Focus Groups Teleange ThomasTeleange Thomas Yolanda Hamilton: Lifebanc Multicultural CouncilYolanda Hamilton: Lifebanc Multicultural Council Robert AllenRobert Allen Greg LockhartGreg Lockhart Dr. Modlin & MMHCDr. Modlin & MMHC

Specific Aim 2 Develop and test effectiveness of HOME GROWN print and video mass media presentationsDevelop and test effectiveness of HOME GROWN print and video mass media presentations -incorporate information gained from Specific Aim 1

Organ Donation Grant Focus Groups MODLIN 9HR8ijqIhttp:// 9HR8ijqIhttp:// 9HR8ijqIhttp:// 9HR8ijqI

Solution: Public Media Campaign

Green Chair Organ Donation Message ZsB7DOUhttp:// ZsB7DOUhttp:// ZsB7DOUhttp:// ZsB7DOU

Solution: Promotion of Living Kidney Donation in African Americans

Laparoscopic Living Donor Nephrectomy

Solution: Promotion of Living Kidney Donation in African Americans

Living Related Renal Transplantation