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Background: Most people with chronic kidney disease (CKD) are not aware of their condition. Objectives: To assess screening criteria in identifying a population with or at high risk for CKD and to determine their level of control of CKD risk factors. Method: CKD Health Evaluation Risk Information Sharing (CHERISH), a demonstration project of the Centers for Disease Control and Prevention, hosted screenings at 2 community locations in each of 4 states. People with diabetes, hypertension, or aged ≥50 years were eligible to participate. In addition to CKD, screening included testing and measures of hemoglobin A1C, blood pressure, and lipids. ­Results: In this targeted population, among 894 people screened, CKD prevalence was 34%. Of participants with diabetes, 61% had A1C < 7%; of those with hypertension, 23% had blood pressure < 130/80 mm Hg; and of those with high cholesterol, 22% had low-density lipoprotein < 100 mg/dL. Conclusions: Using targeted selection criteria and simple clinical measures, CHERISH successfully identified a population with a high CKD prevalence and with poor control of CKD risk factors. CHERISH may prove helpful to state and local programs in implementing CKD detection programs in their communities.

A university health center was faced with the challenge of ensuring long-term sustainability. A project was undertaken to assess and implement administrative and financial strategic initiatives that would support and ensure sustainability. As a result of these initiatives, primary care services reflective of the mission of the University would continue to be provided to students, faculty, staff, and community members in a fiscally responsible manner. Client outcomes were also identified through the measurement of quality indicators and patient satisfaction. Financial stability was a major impact of the project. After several years of experiencing significant financial loss, a cost assessment was conducted; as a result, the operations of the Health Center now demonstrate fiscal responsibility.

Purpose The Kidney Early Evaluation Program (KEEP), which was started in 1997, aims to identify persons at risk for chronic kidney disease (CKD) and encourage at-risk persons to seek evaluation and management from a healthcare provider. Methods Community screening was conducted using a standardized questionnaire and test panel that was administered by local affiliates of the National Kidney Foundation (NKF) using volunteer lay and medical personnel. The screening was limited to persons at high risk for CKD, which was defined as those with a personal history of diabetes or hypertension, or a first-order relative with diabetes, hypertension, or kidney disease. The KEEP Data Coordinating Center was established to maintain a de-identified database of demographic information and test results on the screened persons. Results Data on the first 11,246 participants were analyzed. As expected, the KEEP population was enriched with African Americans and was older than the general population. Diabetes was determined by self-report or abnormal blood glucose levels at screening and was present in 2690 of the persons screened. Chronic kidney disease was identified in 47.4% of this population. Conclusions Targeted community screening for kidney disease in a high-risk population can identify a significant number of persons with CKD, enhance awareness of the disease, and may improve health-seeking behavior.

This year, 2011, the National Kidney Foundation’s (NKF) Kidney Early Evaluation Program (KEEP) celebrates its 11th anniversary, approaching 3,500 cumulative screening events conducted by 48 affiliates and reaching more than 165,000 people in communities across the country. KEEP serves as the largest and most comprehensive and sustained multicenter community-based chronic kidney disease (CKD) screening program in the United States. While focused on CKD, KEEP also functions as a unique means of screening for and discovering obesity, diabetes, hypertension, and cardiovascular disease. The NKF’s approach to social marketing (Fig 1), patient education, and advocacy combined with KEEP’s data capabilities, longitudinal tracking, and feedback to clinicians have made the program the nation’s leading effort to screen for and intervene in chronic diseases. KEEP’s structure as an outreach effort, coupled with a sense of activism in recent years regarding primary prevention of chronic disease, has enabled sustained growth and international expansion.

Background The National Kidney Foundation Kidney Early Evaluation Program (KEEP) is a free community-based health-screening program targeting populations at greatest risk of chronic kidney disease (CKD), those with high rates of diabetes and hypertension, and a high proportion of racial/ethnic minorities. The KEEP Longitudinal Survey will adopt methods similar to those used in KEEP to gather follow-up data to measure CKD-related heath status and gauge program effectiveness for repeated KEEP participants with evidence of CKD stages 3 to 5. KEEP has defined objectives to enhance follow-up survey response rates and target vulnerable populations who bear the greatest CKD risk-factor burdens. Methods The KEEP Follow-up Form was assessed for adherence to 6 cognitive design principles (simplicity, consistency, organization, natural order, clarity, and attractiveness) considered to summate the techniques guiding good survey development and for the additional cognitive design principles of readability and variation of readability across survey items. Results The KEEP Follow-up Form was found to include violations of each cognitive design principle and readability principle, possibly contributing to item nonresponse and low follow-up rates in KEEP. It was revised according to empirically substantiated formatting techniques guided by these principles and found during qualitative assessment to be more user friendly, simpler, better organized, more attractive, and easier to read. Subsequent development of the KEEP Longitudinal Survey form also was guided by these principles. Conclusion To ensure ease of use by populations with limited literacy skills, poor health literacy, and limited survey literacy, survey researchers must apply cognitive design principles to survey development to improve participation and response rates.

APPLYING AN EXPANDED SET OF COGNITIVE DESIGN PRINCIPLES TO FORMATTING THE NKF KIDNEY EARLY EVALUATION PROGRAM LONGITUDINAL SURVEY (KEEPLS) Jose Luis Calderon, 2 Erik Fleming, Monica Gannon, Shu-Cheng Chen, 4 Joseph A. Vassaloti, 3 Keith C. Norris,. College of Pharmacy, Health Professions Division, Nova Southeastern University, Fort Lauderdale, Florida, Charles R. Drew University of Medicine and Science, Los Angeles, California, National Kidney Foundation, New York, New York, KEEP Data coordinating Center, Minneapolis, Minnesota, David Geffen School of Medicine, University of California, Los Angeles (UCLA) The Kidney Early Evaluation Program (KEEP) is a targeted, community-based screening of populations at greatest risk for chronic kidney disease (CKD), those with high rates of diabetes, hypertension, and a high proportion of racial/ethnic minorities. The KEEP longitudinal study will adopt survey methods similar to those used in KEEP to gather follow-up (F/U) data to measure CKD-related heath status and gauge program effectiveness for repeated KEEP participants with evidence of moderate to severe kidney function deficiency. KEEP has defined objectives to enhance F/U survey response rates and target vulnerable populations who bear the highest CKD risk factor burdens. The KEEP F/U Form was assessed for adherence to six cognitive design principles (simplicity, consistency, organization, natural order, clarity, attractiveness) considered to summate the techniques guiding good survey development, and for the additional cognitive design principles readability and variation of readability across survey items. The form was found to include violations of each cognitive design principle and readability principle, possibly contributing to item nonresponse and low follow-up rates in KEEP. It was revised according to empirically substantiated formatting techniques guided by the principles, and found during qualitative assessment to be more userfriendly, simpler, better organized, more attractive, and easier to read. To ensure ease of use by populations with limited literacy skills, poor health literacy, and limited survey literacy, survey researchers must apply cognitive design principles to survey development to improve participation and response rates.