Table 1:
Existing interventions and their development process.
| Study demographics | ||||||||
|---|---|---|---|---|---|---|---|---|
| Study | Country | Language/ethnicity | Sample size [n (% male)] | Age (years)a | CKD stage | Setting | Intervention description | Development and/or cultural adaptation process |
| Williams (2012) | Australia | Greek-, Italian- or Vietnamese-speaking patients | 29 (63) | Mean: 74 | 2–4 | Nephrology outpatient clinics at a public, tertiary, metropolitan hospital | Intervention to increase medication compliance over 3 months, consisting of: - Individualized medication review by nurse - 20-min educational presentation - Fortnightly motivational interviewing |
Adapted from Williams et al. (2010) |
| Previous literature review and pilot interventions are described in Williams et al. (2010) | ||||||||
| For current study, presentation was translated into community languages and modified for cultural sensitivity. Hospital interpreters and translators were used for face-to-face or phone interactions | ||||||||
| Themes: SDM, HL (education), self-management strategies | ||||||||
| Tracey (2013) | Australia | Aboriginal Australians | b | b | 1–5 | Community based in the remote Goldfields region of Western Australia | Clinical nurse manager, (educator, community nurse) and AHW provided collaborative care to Indigenous CKD patients in remote settings | Novel intervention Nursing team collaborated with AHW to design culturally appropriate patient education materials and training for staff on Aboriginal culture and sensitivity. Priority areas of the community health service were determined in partnership with state-wide care providers and via community consultation. The study aimed to improve the patient journey |
| Themes: HL (education, access to healthcare) | ||||||||
| Barrett (2015) | Australia | Aboriginal Australians | b | b | 1–4 | Community nephrology clinics in a rural town (Kempsey, NSW, Australia) | Development of a new CKD outreach clinic with a nurse practitioner–led team that includes AHWs, chronic disease nurses and GPs. Clinic aimed to identify undiagnosed CKD patients, treat their underlying conditions and provide them with access to healthcare from nurses and doctors | Novel interventionThe article did not justify the intervention design. There was no discussion of how this intervention is culturally sensitive and safe for a vulnerable population group |
| Themes: HL (access to healthcare) | ||||||||
| Conway (2018) | Australia | Aboriginal Australians | 25 | b | 5 | Rural and remote communities in South Australia | Semi-structured interviews with 15 dialysis patients and 10 staff across 9 sites services by a dialysis busThemes: HL (access to healthcare) | Novel interventionLiterature review highlighted that leaving Aboriginal country or homeland caused feelings of grief and loss and financial burden for Indigenous Australians. Semi-structured ‘yarning’ style interviews were conducted |
| Paterson (2010) | Canada | Aboriginal Canadians | b | b | 5 | Community based in Elsipogtog First Nation, Canada | Newly diagnosed patients commencing haemodialysis provided with toolkit containing: - Five 20-min DVDs - Written manual - Calendar diary Themes: SDM, HL (education, access to healthcare) self- management strategies |
Novel intervention This study utilized a community-based research approach. First, a review of relevant literature was conducted. Then, a Community Advisory Committee was formed. This committee conducted individual interviews with key stakeholders, discussed results, synthesized key themes from interviews, and determined the educational content of the toolkit through an iterative process |
| Hotu (2010) | New Zealand | Maori and Pacific Islanders | 65 (54) | Range: 47–75 | 1–4 | Recruited through hospital diabetes/renal care clinics and primary care practices | Utilisation of a Maori and Tongan healthcare assistant, who:- Visited patients - Measured BP - Checked compliance with medication - Provided transport to pharmacy, pathology laboratory and/or local doctorThemes: HL (access to healthcare) |
Novel interventionAimed to provide collaborative, community-based care to Maori/Pacific patients. Conducted an initial literature review that concluded that Maori/Pacific patients may have higher BP, lower family income and more language barriers compared with non-Maori/Pacific CKD patients. The study did not describe any cultural targeting or tailoring beyond employing a Maori and Tongan healthcare assist to provide community care for the intervention group |
| Verseput and Piccoli (2017) | South Africa | Non-English-speaking patients | b | b | 1–5 | Renal unit of a hospital | Pictorial visual aid for renal diet education for newly diagnosed CKD patientsThemes: HL (education), self- management strategies | Novel interventionDiscussed key points of nutrition education for new CKD patients and created a novel visual aid using pictures and analogies to describe concepts (e.g. kidney as a sieve). Tested for feasibility and adapted accordingly (e.g. men did not understand concept of sieve so changed to a car filter) |
| Akhtar (2014) | UK | Urdu- and Punjabi-speaking South Asian Brits | b | b | b | Hospital visits and community outreach | Design of a novel role: CHLO who speaks English, Urdu and Punjabi and has ‘greater sensitivity to the holistic needs of patients’. The CHLO would discuss and explain issues, answer questions, clarify misconceptions and to assist in decision makingThemes: HL (education, access to healthcare) | Novel interventionThe article does not discuss how the CHLO role was designed, whether it was modified from an existing role or any literature relevant to the role |
| Beechem (1995) | USA | Spanish-speaking Mexican-American | 1 (0) | b | 5 | Hospital and hospice | Provision of health services in both English and Spanish through social worker coordinating culturally competent care– Designing a treatment plan for the patient, staff and family to followThemes: self- management strategies, HL (access to healthcare) | Novel interventionThe Spanish-speaking social worker was able to explain the patient's condition and progression in Spanish. This social worker designed a treatment plan for the patient, staff and family to follow that was based upon both best-clinical practice as advised by the healthcare team, but also validated the patient's desire for a ‘Cuarandero’ (a natural healer). The social-worker assisted the patient's family adapt Mexican food recipes to be dialysis friendly and facilitated end-of-life hospice care |
| Song (2009) | USA | English speaking African-Americans | 58 dyads (48) | Mean: 58 | 5 | 6 outpatient dialysis clinics | Patient and surrogate decision-maker dyads have a 1-h interview and training with an experienced nurse interventionist. Used training manuals, role playing and skill demonstration to teach competency in five main areasThemes: HL (education) | Adapted from Song (2005)No description of development processEach intervention session was recorded and monitored for content and process fidelity (consistent content and consistent communication skills used) |
| Park (2014) | USA | English speaking African-American veterans | 15 (100) | Range: 51–66 | 3 | Medical research centre | Decrease BP in hypertensive CKD patients through 14 min of mindfulness meditation (intervention), or 14 min of BP education (control) during two separate random-order visitsThemes: self-management strategies | Adapted from Bauer-Wu et al. (2008)Utilized a guided meditation tape previously designed by a co-investigator [43]. This tape was initially designed for oncology patients, and there was no adaptation for this study's population |
| Cervantes (2019) | USA | English- or Spanish-speaking Latinos | 40 (50) | Mean: 56 | 5 | Inpatient and outpatient dialysis centres | An English and Spanish speaking Latina patient navigator visits patients five times to discuss Advance Care Planning, care coordination, dietary support and mental health supportThemes: education, self-management strategies | Novel interventionPrevious research by same authors indicated the needs and preferences of Latinx CKD patients. An advisory panel (patient and caregiver stakeholders) provided guidance on the content and delivery of the patient navigator intervention |
aAs reported by the study authors.
bUnspecified.
AHW, Aboriginal healthcare workers; BP, blood pressure; CHLO, Cultural Health Liaison Officer; GP, general practitioner; HL, health literacy; SDM, shared decision-making.