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Kidney transplant is superior to dialysis for the treatment of end-stage kidney disease, but accessing transplant requires high patient engagement to overcome barriers. We sought to develop an educational counselling intervention for patients along with their social support networks to help patients access the waiting list.Utilizing an Intervention Mapping approach, we established a conceptual framework to develop a behavioural intervention that can be reproduced across kidney transplant centres. The approach includes needs assessment, identifying behavioural determinants and process objectives and integrating targeted behavioural change theory.The Intervention Mapping process resulted in the development of a group counselling session, titled Journey to Transplant (JtT). This intervention was designed for kidney transplant candidates along with members of their social support networks and guided by a transplant healthcare professional. The session begins with standardized educational information to improve knowledge and normalize emotional barriers to transplant. This education is followed by a tailored counselling intervention, including the presentation of the individual patient's calculated likely outcomes on the kidney transplant waiting list. Finally, JtT incorporates patient and support network goal setting to address the specific barriers for that patient in accessing kidney transplantation.A systematic Intervention Mapping approach to develop the JtT intervention helps ensure the intervention is efficacious, acceptable and feasible for transplant centres to implement. JtT engages the patient's social support network, targeting known barriers to transplant and utilizing established behaviour change theory to motivate concrete actions to improve the likelihood of kidney transplantation.This study includes a patient and family advisory committee comprised of kidney transplant candidates and their family members to guide the final language and content of the intervention guide, and the conduct of the implementation and pilot testing of the intervention. However, patients and family members were not involved in the intervention mapping development process itself described in this manuscript, which was informed by focus group data from patient and family study participants.

Supplemental Digital Content is available in the text., Background. For liver transplant candidates on the waiting list, deciding to accept a donor organ with known or potential risk factors can be stressful and can lead to declined offers. Current education for patients and family often takes place during transplant evaluations and can be overwhelming and result in low retention and poor understanding of donor quality. Methods. In the first phase, we sought to understand provider experiences when counseling patients about donor risks and donor offers. We conducted interviews and focus groups with liver transplant providers at 1 local center and at a national clinician conference. Twenty providers participated: 15 hepatologists and 5 surgeons. The provider feedback was used to create an initial outline of content that is consistent with decision support frameworks. In a second phase, graphic design collaborators created mockups of a patient-friendly tool. We reviewed mockups with 4 transplant coordinators and 9 liver transplant candidates for feedback on clarity and utility to prepare for an organ offer. Patient responses allowed a comparison of perceived readiness to receive an offer call before and after viewing mockups. Results. We identified themes relating to the offer process, repetition and timing of education, and standardization and tailoring of content. The results indicated a gap in available education after the evaluation session, and information specific to offer decisions is needed. Patient feedback emphasized the need to review the offer process before a real offer. Conclusions. Patients and providers responded favorably to a patient tool addressing existing gaps in education while waiting for a donor offer. Additional patient, family, and provider feedback will guide the development of an interactive tool to prepare patients and families for an offer decision.

Patients in the US in need of a life-saving organ transplant must complete a long process of medical decisions, and a first step is to identify a transplant center to complete an evaluation. This study describes a patient-centered process of testing and refinement of a new website (www.transplantcentersearch.org) that was developed to provide data to patients who are seeking a transplant center. Mixed methods, including online surveys and structured usability testing, were conducted to inform changes in an iterative process. Survey data from 684 participants indicated the effects of different icon styles on user decisions. Qualitative feedback from 38 usability testing participants informed improvements to the website interface. The mixed methods approach was feasible and well suited to the need to address multiple development steps of a patient-facing tool. The combined methods allowed for large survey sample sizes and also allowed interaction with a functioning website and in-depth qualitative discussions. The approach is applicable for a broad range of target user groups who are faced with challenging decisions and a need for information tailored to individual users. The survey and usability testing concluded with a functioning website that is positively received by users and meets the objective to support patient decisions when seeking an organ transplant.

BACKGROUND: The Scientific Registry of Transplant Recipients provides transplant program-specific information, but it is unclear what patients and stakeholders need to know. Acceptance criteria for the candidate waitlist and donor organs vary by program and region, but there is no means to search for programs by the clinical profiles of recipients and donors. METHODS: We examined variability in program-specific characteristics that could influence access to transplantation. We also conducted three interviews and three focus groups with heart transplant candidates and recipients. Participants evaluated prototypes of a patient-specific search tool and its capacity to identify programs tailored to specific patient needs. Patient experiences and feedback influenced the development of tools. RESULTS: The distribution of recipient and donor characteristics influenced access to transplantation, as age and body mass index varied across programs (all with p < .01). Several themes emerged related to decision-making and the perceived usability of the patient-specific search. Perceptions of the prototypes varied, but were positive overall and support making the patient-specific search publicly available. Participants revealed barriers to evaluating transplant programs and suggest that patient-specific search results may optimize the process. CONCLUSIONS: The patient-specific tool (http://transplantcentersearch.org/) is valued by heart transplant patients and is important to maximizing access to transplant.

Background. Patients face obstacles in finding a transplant program that meets their healthcare needs. Acceptance criteria and waiting times vary by region and program. The Scientific Registry of Transplant Recipients provides program-specific information, but it is unclear what patients and referring physicians need to know. Methods. We examined variability in program-specific characteristics that could influence access to transplantation. We also conducted 20 interviews and 16 focus groups with transplant candidates, recipients, and their family members. Participants were shown prototypes of a patient-specific search tool and evaluated its capacity to identify programs tailored to the needs of individual patients. Results. The distribution of recipient and donor characteristics that may impact access to transplantation, such as recipients on Medicaid, varied across programs (all with P < 0.01). Several themes emerged related to impressions of access to transplantation and the usability of patient-specific search functions. Perceptions of the prototypes and results varied, but were positive overall and support providing an individualized search of program level data. Participants revealed significant barriers to identifying and evaluating transplant programs and suggest that patient-specific search results reduce the anxiety associated with selecting a program. Conclusions. Providing patient-specific tools is valued by patients and important to maximizing access to transplant.

Variations in candidate and donor acceptance criteria may influence access and mortality for liver transplantation. We sought to understand how recipient and donor characteristics vary across centers and how patients interpret this information, and we used these data to develop a tool to provide tailored information to candidates seeking a center (www.transplantcentersearch.org). We analyzed liver recipient data from the Scientific Registry of Transplant Recipients to determine how recipient and donor characteristics (eg, age, Medicaid use, and human immunodeficiency virus status) varied across programs. Data included recipients and donors at each US program between January 1, 2015, and December 31, 2017. The variation in characteristics was plotted with centers stratified by total transplant volume and by volume of each characteristic. A subset of characteristics was plotted to show variation over 3 years. We created mockups of potential reports displaying recipient characteristics alongside pretransplant and posttransplant outcomes and solicited feedback at patient and family interviews and focus groups, which included 39 individuals: 10 pilot interviews with candidates seeking liver transplant at the University of Minnesota-Fairview (UMNF) and 5 focus groups with 13 UMNF candidates, 6 UMNF family members, and 10 national recipients. Transcripts were analyzed using a thematic analysis. Several themes emerged: (1) Candidates experience gaps in existing education about center options; (2) patients requested information about how selection criteria might impact access to transplant; and (3) information tailored to a candidate's medical characteristics can inform decisions. Characteristics shown on mockups varied across centers (P

This paper is a report of an exploratory study of persuasive design for changing health attitudes and behaviors. The researchers designed a mobile web application for Latino parents about childhood obesity prevention called Lifecast and created three rhetoric theory-driven versions of the application changing rhetorical appeals – rational, emotional and credibility characteristics in graphics and content. The researchers evaluated the appropriateness of the application and its versions observing users and conducting in-depth interviews. In the evaluation, they found that versions did not have notable differences; in general parents and their children were motivated to use all versions of the app and reported some changes in their attitudes. They concluded that an effective strategy of rhetorical appeals should be planned and evaluated iteratively. Future work should focus not only on the appeals of visual and textual elements, but also on the rhetoric of the design concept, format, and interactivity.

OBJECTIVES/GOALS: AA are over-represented on the waitlist for kidney transplant and are often unaware of how waitlist acceptance practices differ across transplant programs and influence access to transplant. We will develop a culturally sensitive transplant program report card to communicate these variations. METHODS/STUDY POPULATION: Scientific Registry of Transplant Recipients (SRTR) data will be used to identity clinical factors strongly associated with AA access to transplant. Interviews and focus groups with AA kidney transplant candidates and their families will collect feedback on the SRTR report card and inform the development of the culturally sensitive report card. Additional focus groups will evaluate its effect on knowledge and medical decision making. We will collaborate with the stakeholders, including AA transplant candidates and their families, transplant programs, SRTR, and providers, to identify strategies to disseminate the report card in the AA community RESULTS/ANTICIPATED RESULTS: To date, no investigation has systematically collected feedback on the SRTR transplant program report card from AA candidates to ensure that the tool is accessible and effective in the AA community. We hypothesize that a culturally sensitive report card will improve AA candidates’ knowledge of program factors that impact access to transplant and enable informed decisions about where they pursue a transplant evaluation. The results of this study have the potential to change how AA patients are counselled while seeking transplantation. DISCUSSION/SIGNIFICANCE OF IMPACT: A culturally sensitive report card can reach more AA patients and enable more informed decision making by providing education about differences in transplant programs that may impact their access to transplant. In the future, we will design a trial to evaluate the prototype.

This paper proposes a model for visual communication design that builds on theories of rhetoric and functional literacy. It begins by analysing literature about the interrelationships between design and the theories of rhetoric and functional literacy. Then, a detailed revision of their components serves to develop a transdisciplinary model. Structural similarities among the theories allowed for comparison and identification of relevant elements in four categories: creator/producer, design method, visual information and audience. Finally, a model is proposed selecting the most relevant components for analysis and research in visual communication design.

One of the biggest problems for students majoring in pre-graphic design is students' inability to apply their knowledge to different design solutions. The purpose of this study is to examine the effectiveness of interactive learning modules in facilitating knowledge acquisition during the learning process and to create interactive learning modules that will enhance students' understanding of the application of design theory and principles to different design problems. The ultimate goal of this project is to create supplemental teaching material that will be used to support teaching and learning for the authors' design foundation courses. Four interactive learning modules were developed in Adobe Flash. The modules include descriptions of the topics, animated tutorials and exercises. Several evaluations were conducted to examine the effectiveness of the learning modules. These evaluations included a usability test of the two module prototypes, an in-depth pre-test and post-test with four pre-graphic design students, interviews with various instructors and surveys with 40 students who were enrolled in foundation courses. Students expressed that the learning modules made it more enjoyable to learn course materials; ultimately, the modules deepened their understanding of design principles.

The Scientific Registry of Transplant Recipients (SRTR) provides federally mandated program-specific transplant data to the public. Currently, there is little understanding of how different program measures are prioritized by patients in selecting a program for transplantation. This study recruited 479 transplant advocacy group members from mailing lists and social media of the National Kidney Foundation (NKF), transplant families (TF), and Transplant Recipient International Organization (TRIO). Survey participants identified how many different programs would be reasonable to consider and viewed four measures that have recently been displayed on SRTR public search result websites and six measures not recently displayed and indicated importance on a 5-point scale. Four hundred two completed the survey (TF = 26; TRIO = 34; NKF = 342). Seventy-eight percent indicated that considering more than one program would be reasonable. Linear mixed models adjusted for organization, education, and gender. Likert scores for pretransplant (transplant rate) and transplant volume measures were similar and were very or extremely important to over 80% of participants. Posttransplant (survival after transplant) was rated as 0.52 points higher, confidence interval (0.41, 0.64). Results indicate that many patient advocacy group members find a choice between two or more programs reasonable and value multiple measures when assessing programs where they may want to undergo transplantation.

This study intended to measure the level of visual understanding of symbols between students in Hong Kong and the United States. The objectives are to investigate possible differences in visual perception and comprehension of symbols and to measure subjects’ level of knowledge about their own cultural images, as well as images of another culture. Twenty business and national symbols-ten from the U.S. and ten from Hong Kong-and an accompanying survey were presented to one hundred and twenty graphic design students at the University of Minnesota and The Hong Kong Polytechnic University. There was significant interaction between different nationalities and the perception of symbols.

With increasing changes in our demographic populations and new immigrants settling in the US, there is an increasing need for visual communications that address the diversity of our populations. This paper draws from the results of the researcher’s several past research and teaching projects that worked with different cultural populations. These projects examined the theme of multicultural design with a particular focus on user experience for audiences from different cultural backgrounds. The nature of the projects included printed materials, web design, video production, and interactive design. The researcher examined users’ preferences for precise language presentation, options of visual layout, cultural related design elements such as images, colors, fonts, and interactive interface design. The goal of this paper is to increase design educators and students’ awareness in designing projects for culturally diverse audiences.

The purpose of The Smart House, Livable Community, Your Future project was to demonstrate how good design, assistive technology, and well-planned community amenities, support independent living as well as increase usability across the lifespan. We used a variety of strategies to share information on smart design to Baby Boomers. A 1,300 square foot exhibition, designed as a home, allowed visitors to tryout assistive technology and observe structural innovations. Workshops explored innovative design for (a) consumers and caregivers; (b) developers, remodelers, contractors, and designers; and, (c) community planners and policy makers. A Smart House, Livable Community, Your Future website provides free, downloadable activities and information to Baby Boomers and encourage community conversations. The paper describes various aspects of the project and summarizes participants’ reactions to the content; the paper also explores implications for designers and planners interested in creating intelligent environments. The project inspired participants to think about strategies for improving the built environment. Multiple outreach formats, an interactive exhibition, workshops, and an interactive website, helped us to reach the Baby Boomer cohort.

Games are increasingly being used to teach content in a variety of courses from elementary to graduate education. This study investigates the effectiveness of using a game, to learning design history content, and it examines students’ preferred learning activities based on learning styles. Forty-two students played a computer game and then responded to a 10-item quiz. Learning style or times played did not impact achievement on the quiz. Students did prefer games as a learning tool, but equally preferred lecture and projects. This study does indicate that games can be used as tools to teach various types of information within a college course. Games added variety to the design history course and made learning facts more fun. The concrete nature of the game was appropriate for this particular group of students, most of whom had concrete learning styles. Finally, the recycling of a previously designed learning object made the project affordable in terms of time and money.

This chapter addresses the design and procedural variables of creating a bilingual Web site information portal for an audience of culturally diverse immigrants. A Web site developed as a resource for a diverse Somali community (http://www.somaliresource. net) is used as a case study for this chapter. The Somali community, which includes immigrants, refugees, and asylees, faces difficulties associated with language barriers. They struggle with the adjustment of life in a completely new system in Minnesota. The aim of this resource is to address some of the Somali’s informational needs in the form of a one-stop bilingual Web site. It is our goal to describe our design process, and offer recommendations on design and procedural variables for working with the Somali cultural group. We envision that graphic designers and other researchers will find it useful to reference this material when they address design issues related to different cultural groups.