Adaptation of Navigate-Kidney: A Community Health Worker Intervention for People With Kidney Disease
Year: 2025
Type: article
Abstract: Introduction: Patient self-management is critical for health outcomes for individuals with dialysis-dependent kidney failure. Latino populations with dialysis-dependent kidney failure have identified key barriers to self-management, including lack of tailored and patient-centered education, and social needs and challenges with health system navigation. Community health worker (CHW) interventions have been effective in reducing health disparities and promoting self-management; however, they have not been used for Latino individuals with dialysis-dependent kidney failure. To address these disparities, we describe adaptation of Navigate-Kidney, a CHW intervention for Latino individuals with hemodialysis-dependent kidney failure. Methods: We used a community participatory approach with implementation science (IS) methodologies and retroactive framework application to guide intervention selection, adaptation, and evaluation of a CHW intervention for Latino individuals with hemodialysis-dependent kidney failure. Data sources included cross-sectional surveys, semistructured interviews, and field observations. Results: Our needs assessment informed the selection and adaptation of a conservative care management-focused CHW intervention for Latino populations with dialysis. The feasibility of the adapted intervention (Navigate-Kidney) was evaluated in a single-arm clinical trial among 40 Latino individuals with dialysis-dependent kidney failure. Postintervention, participants and clinicians reported a need to prioritize support for social needs and health navigation, patient-centered education, and self-management. A randomized controlled trial (RCT), adapted to address these needs demonstrated significant improvement in interdialytic weight gain (IDWG), a surrogate marker for diet self-management. Conclusion: We describe the adaptation of the Navigate-Kidney, a CHW intervention for Latinos with dialysis-dependent kidney failure. IS methodologies can improve effectiveness and uptake of interventions, thereby reducing kidney health disparities.
Source: Kidney International Reports
Institutions: University of Colorado Anschutz, University of Colorado Denver, Boston University, Boston Medical Center, Colorado School of Public Health, Yale University, San Francisco General Hospital, University of California, San Francisco, University of North Carolina at Chapel Hill, Johns Hopkins University, Johns Hopkins Medicine, The University of Sydney, Children's Hospital at Westmead, Westmead Hospital
Language: English
Subfield: Nephrology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,800
Awards: G594972204, G9000091876
OpenAlex ID: W4416023171