Relationships, race/ethnicity, gender, age, and living kidney donation evaluation willingness

Racial/ethnic and gender disparities in living donor kidney transplantation are large and persistent but incompletely explained. One previously unexplored potential contributor to these disparities is differential willingness to donate to recipients in specific relationships such as children, parents, and friends. We collected and analyzed data from an online sample featuring an experimental vignette in which respondents were asked to rate their willingness to donate to a randomly chosen member of their family or social network. Results show very large differences in respondents' willingness to donate to recipients with different relationships to them, favoring children, spouses/partners, siblings, and parents, and disfavoring friends, aunts/uncles, and coworkers. Evidence suggesting an interactive effect between relationship, respondent race/ethnicity, respondent or recipient gender, was limited to a few cases. At the p < 0.05 level, the parent-recipient gender interaction was statistically significant, favoring mothers over fathers, as was other/multiracial respondents' greater willingness to donate to friends compared to Whites. Additionally, other interactions were significant at the p < 0.10 level, such as Hispanics' and women's higher willingness to donate to parents compared to Whites and men respectively, women's lower willingness to donate to friends compared to men, and Blacks' greater willingness to donate to coworkers than Whites. We also examined differences by age and found that older respondents were less willing to donate to recipients other than their parents. Together these results suggest that differential willingness to donate by relationship group may be a moderately important factor in understanding racial/ethnic and gender disparities in living donor kidney transplantation.

Social network interventions to reduce race disparities in living kidney donation: Design and rationale of the friends and family of kidney transplant patients study (FFKTPS)

INTRODUCTION

Racial/ethnic disparities in living donor kidney transplantation (LDKT) are a persistent challenge. Although nearly all directed donations are from members of patients' social networks, little is known about which social network members take steps toward living kidney donation, which do not, and what mechanisms contribute to racial/ethnic LDKT disparities.

METHODS

We describe the design and rationale of the Friends and Family of Kidney Transplant Patients Study, a factorial experimental fielding two interventions designed to promote LKD discussions. Participants are kidney transplant candidates at two centers who are interviewed and delivered an intervention by trained center research coordinators. The search intervention advises patients on which social network members are most likely to be LKD contraindication-free; the script intervention advises patients on how to initiate effective LKD discussions. Participants are randomized into four conditions: no intervention, search only, script only, or both search and script. Patients also complete a survey and optionally provide social network member contact information so they can be surveyed directly. This study will seek to enroll 200 transplant candidates. The primary outcome is LDKT receipt. Secondary outcomes include live donor screening and medical evaluations and outcomes. Tertiary outcomes include LDKT self-efficacy, concerns, knowledge, and willingness, measured before and after the interventions.

CONCLUSION

This study will assess the effectiveness of two interventions to promote LKD and ameliorate Black-White disparities. It will also collect unprecedented information on transplant candidates' social network members, enabling future work to address network member structural barriers to LKD.

Recognizing Post-Castration Pain in Piglets: A Survey of Swine Industry Stakeholders and the General Public

We need validated, practical methods for pain assessment in piglets. Pain assessment can help researchers, veterinarians and industry professionals identify the need for analgesia or other pain management approaches when applying painful procedures, such as surgical castration. A pain assessment tool, the Piglet Grimace Scale (PGS), was previously validated in this context, but it is not widely applied. It is important that the PGS can be applied by a range of people, not just pain assessment experts. Our objective was to study the validity and reliability of PGS ratings applied by swine industry professionals and the general public, to assess its potential utility in non-research applications. To do so, we conducted an online Qualtrics survey in which, after completing a brief online training module and a practice test, 119 respondents were asked to rate 9 piglet images showing facial expressions immediately after surgical castration or sham-handling. Respondents were provided information on the castration treatment for each image and had continuous access to the scale throughout the survey. The survey also contained demographic questions. Industry respondents were recruited through networking, and participants from the general public were recruited through Amazon Mechanical Turk. Four trained experts scored each image, and these scores were averaged to produce gold standard scores. Intraclass correlations indicated strong internal consistency among experts, industry and public. ANOVA demonstrated scoring to be moderately comparable between groups. Campbell and Fiske’s Multi-Trait Multi-Method framework provided qualified support for the internal validity and reliability of the PGS scale, even applied by non-experts (industry and public). Both response groups were able to recognize pain in castrated piglets. However, public respondents attributed higher levels of pain to sham-handled piglets than industry respondents (2.83 vs. 2.35; p=0.047), and both response groups systematically overestimated pain experience compared to the experts, suggesting more training may be necessary before using the scale in a diagnostic capacity. Nevertheless, overall findings support wide applicability of PGS, even with minimal training, to improve awareness, recognition and monitoring of swine pain among veterinarians, industry professionals and even members of the public.

Development and Feasibility of an Online Brief Emotion Regulation Training (BERT) Program for Emerging Adults

Mental wellness is a critical component of healthy development in emerging adulthood and serves to protect against stress and promote resilience against psychopathology. Emotion regulation is a key mechanism for effective prevention because of its role in socio-emotional competence and its transdiagnostic significance for psychopathology. In this feasibility study, a brief, time and cost-effective emotion regulation training program for emerging adults (BERT) was developed and tested using the RE-AIM framework. Importantly, building interventions within the context of an implementation framework, such as the RE-AIM framework, enhances the chances that an intervention will be able to scale out and scale up. First, the brainwriting premortem method was utilized to refine program content, conducting focus groups a priori to identify potential program failures prior to program implementation. Undergraduate students (n = 12) attended four focus groups presenting initial program content. Four clinicians were also interviewed to determine program barriers. Qualitative analyses aggregated participant feedback to identify compliments, changes, and concerns about BERT and critical feedback was immediately implemented prior to initial testing. BERT was rooted in cognitive-behavioral practices and informed by the Gross model of emotion regulation. The 5-week program was then examined in a college sample (N = 42) to evaluate implementation (low attrition, high content engagement, favorable attitudes, low incidence of technical errors, costs), reach (enrollment and completion demographics comparable to the population in which recruitment took place), and efficacy (positive change in emotion regulation pre- to post-program). Of the recruited participants, 36 remained in the study where 27 completed at least 80% of program content. Repeated-measures ANOVAs exhibited significant improvements in emotion regulation, psychological distress, and negative affectivity, suggesting promising initial efficacy. Initial data provide support for feasibility and a future randomized control trial. BERT has potential significance for promoting healthy development as its brief electronic format reduced barriers and the program development process incorporated stakeholder feedback at multiple levels to inform better implementation and dissemination.

Enhancing big data in the social sciences with crowdsourcing: Data augmentation practices, techniques, and opportunities

Proponents of big data claim it will fuel a social research revolution, but skeptics challenge its reliability and decontextualization. The largest subset of big data is not designed for social research. Data augmentation–systematic assessment of measurement against known quantities and expansion of extant data with new information–is an important tool to maximize such data's validity and research value. Using trained research assistants or specialized algorithms are common approaches to augmentation but may not scale to big data or appease skeptics. We consider a third alternative: data augmentation with online crowdsourcing. Three empirical cases illustrate strengths and limitations of crowdsourcing, using Amazon Mechanical Turk to verify automated coding, link online databases, and gather data on online resources. Using these, we develop best practice guidelines and a reporting template to enhance reproducibility. Carefully designed, correctly applied, and rigorously documented crowdsourcing help address concerns about big data's usefulness for social research.