TY - JOUR
T1 - The Knowledge Assessment of Renal Transplantation (KART) 2.0 Development and Validation of CKD and Transplant Knowledge Scales
AU - Waterman, Amy D.
AU - Nair, Devika
AU - Purnajo, Intan
AU - Cavanaugh, Kerri L.
AU - Mittman, Brian S.
AU - Peipert, John Devin
N1 - Funding Information:
A.D. Waterman was supported by National Institutes of Health (NIH), National Center for Advancing Translational Sciences, University of California, Los Angeles, CTSI grants UL1 TR000124 and UL1 TR001881, and Health Resources and Services Administration grant R39OT29879. D. Nair and K.L. Cavanaugh were supported by NIH grants K12 HS026395 and P30DK114809.
Publisher Copyright:
© 2022 by the American Society of Nephrology.
PY - 2022/4
Y1 - 2022/4
N2 - Background and objectives Many individuals with kidney disease, particularly those belonging to racial and ethnic minority groups and whose primary language is not English, lack knowledge related to kidney disease symptoms, physiologic functions of the kidney, and benefits and risks of kidney transplantation. Valid instruments to assess patients’ knowledge of CKD and kidney transplantation are needed. Design, setting, participants, & measurements Using a sample of 977 patients with stages 3–5 CKD in the Kaiser Permanente health system, we developed the Knowledge Assessment of Renal Transplantation (KART) 2.0 instrument. We conducted cognitive interviews followed by item response theory (IRT) to reduce 48 candidate items. Construct validity was tested by examining differences in scores between patients who spent,1 and $1 hour receiving CKD and transplant education. Results Cognitive interviews modified four items and omitted 11. IRT analyses resulted in two scales: the KART 2.0–Transplant Knowledge Scale (16 items; Cronbach’s a50.8) and the KART 2.0–CKD Knowledge Scale (nine items; Cronbach’s a50.79). Differential item functioning showed that the scales were unbiased to capture knowledge across self-identified race, primary language, CKD stage, and sex. Both scales distinguished patients who had spent,1 and $1 hour speaking with health professionals (effect size [ES]50.33 [transplant], 0.54 [CKD]; P,0.001 for both), reading about kidney disease (ES50.45 [transplant], 0.62 [CKD]; P,0.001), reading about kidney transplantation (ES50.67 [transplant], 0.69 [CKD]; P,0.001), and reading about living donor kidney transplant (ES50.76 [transplant], 0.62 [CKD]; P,0.001). Conclusions The KART 2.0 is a valid tool to assess patients’ knowledge of CKD and kidney transplantation.
AB - Background and objectives Many individuals with kidney disease, particularly those belonging to racial and ethnic minority groups and whose primary language is not English, lack knowledge related to kidney disease symptoms, physiologic functions of the kidney, and benefits and risks of kidney transplantation. Valid instruments to assess patients’ knowledge of CKD and kidney transplantation are needed. Design, setting, participants, & measurements Using a sample of 977 patients with stages 3–5 CKD in the Kaiser Permanente health system, we developed the Knowledge Assessment of Renal Transplantation (KART) 2.0 instrument. We conducted cognitive interviews followed by item response theory (IRT) to reduce 48 candidate items. Construct validity was tested by examining differences in scores between patients who spent,1 and $1 hour receiving CKD and transplant education. Results Cognitive interviews modified four items and omitted 11. IRT analyses resulted in two scales: the KART 2.0–Transplant Knowledge Scale (16 items; Cronbach’s a50.8) and the KART 2.0–CKD Knowledge Scale (nine items; Cronbach’s a50.79). Differential item functioning showed that the scales were unbiased to capture knowledge across self-identified race, primary language, CKD stage, and sex. Both scales distinguished patients who had spent,1 and $1 hour speaking with health professionals (effect size [ES]50.33 [transplant], 0.54 [CKD]; P,0.001 for both), reading about kidney disease (ES50.45 [transplant], 0.62 [CKD]; P,0.001), reading about kidney transplantation (ES50.67 [transplant], 0.69 [CKD]; P,0.001), and reading about living donor kidney transplant (ES50.76 [transplant], 0.62 [CKD]; P,0.001). Conclusions The KART 2.0 is a valid tool to assess patients’ knowledge of CKD and kidney transplantation.
KW - CKD
KW - education
KW - knowledge
KW - transplantation
KW - transplants
KW - Minority Groups
KW - Ethnicity
KW - Renal Insufficiency, Chronic/diagnosis
KW - Kidney Transplantation/psychology
KW - Humans
KW - Health Knowledge, Attitudes, Practice
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U2 - 10.2215/CJN.11490821
DO - 10.2215/CJN.11490821
M3 - Article
C2 - 35332061
AN - SCOPUS:85128246583
SN - 1555-9041
VL - 17
SP - 555
EP - 564
JO - Clinical Journal of the American Society of Nephrology
JF - Clinical Journal of the American Society of Nephrology
IS - 4
ER -