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Due to the high risk of waitlist mortality and post-transplant complications, kidney transplant (KT) patients may benefit from advance care planning (ACP) and palliative care consultation (PCC). We quantified the prevalence and racial disparities in ACP and PCC among KT candidates and recipients.

Introduction:Innovative recruitment strategies such as patient portal messaging (PPM) hold promise for high yield, low-cost recruitment of heart failure (HF) patients for research studies but may impact the diversity of the sample. We aimed to examine strategies used to recruit older adults with advanced HF during COVID-19 in an ongoing prospective palliative care research study.Methods:We used three recruitment strategies including the traditional in-person HF clinic screening or provider referral, and a more innovative direct-to-patient recruitment approach using EHR patient portal messaging (PPM) or email. We compared characteristics of participants recruited via PPM/email and traditional in-person recruitment strategies using chi-squared and t-tests. We used multiple logistic regression to examine associations between participant characteristics and recruitment type.Results:Most participants were recruited through PPM or email (86%, n=247) over 10 months and the remaining participants were recruited through provider referral or in-person recruitment at the heart failure clinic over 6 months (14%, n=40). Among our sample of 287 participants, 67% (n=201) were White, 28% (n=84) were Black, and the remaining 5% (n=13) were Asian, American Indian, or Alaska Native or identify with a non-listed race. The mean age was 68 years old. There was no significant difference in recruitment type by age, gender, or financial strain. There was a significant difference in recruitment type by race and education level. In a multiple logistic regression adjusting for age, gender, and financial strain, Black participants had a lower odds of PPM recruitment than white participants (OR 0.15, p<0.001). Additionally, those with higher education showed higher odds of PPM/email recruitment (OR 4.2 p = 0.001).Conclusions:In this study, PPM was an efficient recruitment strategy with higher odds of recruiting participants of White race and higher education compared to traditional recruitment strategies. Use of both traditional and more innovative direct-to-patient recruitment strategies may promote a more diverse study sample.

For caregivers of people with heart failure, addressing a range of care recipient needs at home can potentially be burdensome, but caregivers may also gain meaning from caregiving. The Caregiver Support Program, a multicomponent strengths-based intervention, is designed to improve outcomes of heart failure caregivers.