Determining the Feasibility and Acceptability of a Culturally Tailored Lifestyle Intervention to Improve the Health of Hispanic and Native American Kidney Transplant Recipients

Background: Our team conducted a culturally-tailored diet and exercise clinical pilot trial with kidney transplant (KT) recipients, integrating lifestyle changes into post-KT care prior to discharge from KT surgery. We purposely recruited a diverse sample of KT recipients to test the pilot study’s feasibility and acceptability. Methods: Patients were randomized into usual care (UC) or the intervention arm 2-5 days after KT surgery and prior to discharge. Physical activity for all participants was measured with an activPAL accelerometer. Participants were instructed to wear the activPAL for one week, at four time points throughout the 12-month study period. Intervention participants received a customized exercise and nutrition plan tailored by a physical therapist (PT) and registered dietitian nutritionist (RDN). Feasibility was determined by recruitment/retention rates and intervention activity adherence. Acceptability was assessed by satisfaction ratings (3-month follow-up) and interviews (6-month follow-up). Results: Forty-nine patients were approached, 23 (47%) agreed to participate, and three (13%) subsequently withdrew from the study. The final sample consisted of 20 patients (11 Intervention, 9 UC; 9 Hispanic, 7 Native American, 4 Other). Eighty-two percent of the intervention participants wore the activPAL at all four follow-ups versus 67% of the UC participants. Among intervention arm participants, per-protocol adherence to the PT and RDN visits was 78% and 82%, respectively. Intervention arm participants’ responses to surveys and interviews demonstrated intervention acceptability, ease of participation, and overall satisfaction with the intervention. Conclusion: This pilot effectively delivered a lifestyle intervention to a diverse sample of KT recipients, demonstrating good retention and adherence to the intervention and activity monitoring components. The PT and RDN components were well-received by participants, who also reported satisfaction with the intervention. This study is a vital step to creating a large-scale lifestyle intervention that addresses the post-KT diet and exercise needs of Hispanic and Native American recipients. Funding: Other NIH Support - NCATS grant #UL1TR001449, Clinical Revenue Support