African American Transplant Access Program creates change in Chicago
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BOSTON — The Northwestern Medicine African American Transplant Access Program has promoted and increased opportunities to transplantation in Black communities in Chicago, according to a speaker here.
“Basically, it was simple how we went about this. I did a literature search, and I pulled every single paper on disparities and access to transportation for the Black community,” Dinee C. Simpson, MD, FACS, assistant professor of surgery and director of African American Transplant Access Program (AATAP), said in a presentation at the National Kidney Foundation Spring Clinical Meetings. “We identified barriers and found ones that we could easily create an intervention for.”
In the Black communities of Chicago, Simpson noted there are 80% of the city’s food deserts and medical specialty deserts. Not only do patients struggle with food insecurity, but another barrier is transportation because patients must travel outside of their area for care.
“There are so many dialysis centers, but no grocery stores,” Simpson said. “Patients like to joke with me about how they can give directions just by using the dialysis centers in their community.”
According to Simpson’s research, Black patients:
- are less likely to be referred to nephrologist prior to initiation of chronic dialysis;
- are more likely to be referred at advanced stages of kidney disease;
- are less likely to complete a kidney evaluation and be listed;
- are less likely to have a living donor; and
- wait longer once listed to get transplanted.
To solve these problems within the Black communities of Chicago, Simpson proposed the AATAP. The program focuses on referral for transplantation, evaluation for transplantation and transplantation.
Simpson’s team spoke with the community of Chicago and assessed its resources. A clinic was established in the hospital and also within the community to provide multiple options to patients who may not be able to travel. The team partnered with leaders and churches in the community to build trust between dialysis staff and patients. Similarly, the program implements racial concordance during intake and initial visits due to the positive impact it has on patient perspectives. In addition to their work to address medical mistrust, providers address cultural competency, health literacy and psychosocial support, Simpson said. Once the program was implemented, Simpson’s team focused on sustaining it and embedding the changes in a national level.
Since the launch of AATAP in 2019, there have been more than 150 referrals, a 56% increase in evaluations of Black patients and an 18% increase in listings. The AATAP is looking to expand the program within and beyond the institution. In the future, AATAP looks to expand past transplantation and make other aspects of health more accessible to Black communities, Simpson said.
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Simpson D. Increasing access to transplantation for African Americans. Presented at: National Kidney Foundation Spring Clinical Meetings; April 5-10, 2022; Boston.
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