Abstract: FR-PO882
Exploring Stigma in the Context of Living Donor Kidney Donor Transplantation (LDKT) Among African, Caribbean, and Black (ACB) Communities in Toronto, Canada
Session Information
- Diversity and Equity in Kidney Health - II
November 04, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Diversity and Equity in Kidney Health
- 800 Diversity and Equity in Kidney Health
Authors
- Okoh, Princess Nkechi, University Health Network, Toronto, Ontario, Canada
- Ahmadzadeh, Ghazaleh, University Health Network, Toronto, Ontario, Canada
- Ahmed, Ranie, University Health Network, Toronto, Ontario, Canada
- Boakye, Priscilla, Ryerson University Daphne Cockwell School of Nursing, Toronto, Ontario, Canada
- Edwards, Beth, University Health Network, Toronto, Ontario, Canada
- Neves, Paula, University Health Network, Toronto, Ontario, Canada
- Rogers, Emma Sian, University Health Network, Toronto, Ontario, Canada
- Mucsi, Istvan, University Health Network, Toronto, Ontario, Canada
Background
From a medical perspective, LDKT is the best treatment option for kidney failure. Patients from ACB communities are much less likely to receive LDKT than White patients. Stigma surrounding kidney failure and LDKT may contribute to this inequity. This qualitative analysis aims to understand the nature of stigma and how it may influence access to LDKT in ACB communities in Toronto, Canada.
Methods
Self-identified ACB participants (individuals with [on dialysis or after kidney transplant] and without lived experience with kidney failure; and health care professionals [HCPs]) were recruited using purposive and snowball sampling via community networks and social media. Semi-structured in-depth individual interviews (IDIs) and focus groups (FGs) were conducted, audio-recorded, and transcribed verbatim. Reflexive Thematic Analysis was utilized, drawing on the tenets of Critical Race Theory (CRT) and Intersectionality to consider the effects of racialization and the interlocking effects of co-occurring social identities such as race, class, and health status and access to LDKT. Themes were developed, refined, and finalized by the research team.
Results
The sample is comprised of 6 community FGs (n=81), 7 IDIs with HCPs, 9 patient IDIs, and 2 FGs (n=6) with patients with kidney failure. Participants expressed hesitancy around communicating about kidney disease and the need for LDKT due to anticipated and experienced stigma. Participants with kidney failure feared judgment from family, friends, and community (e.g. due to anticipated assumptions about lifestyle choices), as well as from HCPs (e.g. due to anticipated assumptions about health beliefs and behaviours). Participants also described a strong cultural norm of maintaining privacy around health issues, largely limiting any discussion about LDKT.
Conclusion
Stigma is a potential barrier to LDKT as it may prevent discussions about kidney failure and treatment options and reduce the chance of identifying potential living donors. Culturally tailored, competent resources co-developed with ACB communities may help reduce stigma in ACB communities and may improve equitable access to LDKT.
Funding
- Government Support – Non-U.S.