{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T14:48:28Z","timestamp":1786373308134,"version":"build-2736575974"},"reference-count":43,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","funder":[{"DOI":"10.13039\/100000102","name":"Health Resources and Services Administration","doi-asserted-by":"publisher","award":["R39OT29879"],"award-info":[{"award-number":["R39OT29879"]}],"id":[{"id":"10.13039\/100000102","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K12 HS026395"],"award-info":[{"award-number":["K12 HS026395"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["P30DK114809"],"award-info":[{"award-number":["P30DK114809"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1 TR000124"],"award-info":[{"award-number":["UL1 TR000124"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1TR001881"],"award-info":[{"award-number":["UL1TR001881"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["CJASN"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background and objectives<\/jats:title>\n                    <jats:p>Many individuals with kidney disease, particularly those belonging to racial and ethnic minority groups and whose primary language is not English, lack knowledge related to kidney disease symptoms, physiologic functions of the kidney, and benefits and risks of kidney transplantation. Valid instruments to assess patients\u2019 knowledge of CKD and kidney transplantation are needed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design, setting, participants, &amp; measurements<\/jats:title>\n                    <jats:p>Using a sample of 977 patients with stages 3\u20135 CKD in the Kaiser Permanente health system, we developed the Knowledge Assessment of Renal Transplantation (KART) 2.0 instrument. We conducted cognitive interviews followed by item response theory (IRT) to reduce 48 candidate items. Construct validity was tested by examining differences in scores between patients who spent &lt;1 and \u22651 hour receiving CKD and transplant education.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Cognitive interviews modified four items and omitted 11. IRT analyses resulted in two scales: the KART 2.0\u2013Transplant Knowledge Scale (16 items; Cronbach\u2019s\n                      <jats:italic toggle=\"yes\">\u03b1<\/jats:italic>\n                      =0.8) and the KART 2.0\u2013CKD Knowledge Scale (nine items; Cronbach\u2019s\n                      <jats:italic toggle=\"yes\">\u03b1<\/jats:italic>\n                      =0.79). Differential item functioning showed that the scales were unbiased to capture knowledge across self-identified race, primary language, CKD stage, and sex. Both scales distinguished patients who had spent &lt;1 and \u22651 hour speaking with health professionals (effect size [ES]=0.33 [transplant], 0.54 [CKD];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001 for both), reading about kidney disease (ES=0.45 [transplant], 0.62 [CKD];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001), reading about kidney transplantation (ES=0.67 [transplant], 0.69 [CKD];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001), and reading about living donor kidney transplant (ES=0.76 [transplant], 0.62 [CKD];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The KART 2.0 is a valid tool to assess patients\u2019 knowledge of CKD and kidney transplantation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2215\/cjn.11490821","type":"journal-article","created":{"date-parts":[[2022,4,7]],"date-time":"2022-04-07T14:25:23Z","timestamp":1649341523000},"page":"555-564","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":12,"title":["The Knowledge Assessment of Renal Transplantation (KART) 2.0"],"prefix":"10.2215","volume":"17","clinical-trial-number":[{"clinical-trial-number":"nct03389932","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Amy D.","family":"Waterman","sequence":"first","affiliation":[{"name":"Department of Surgery and J.C. Walter Jr. Transplant Center, Houston Methodist Hospital, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7164-715X","authenticated-orcid":false,"given":"Devika","family":"Nair","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee"},{"name":"Vanderbilt O\u2019Brien Center for Kidney Disease, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Intan","family":"Purnajo","sequence":"additional","affiliation":[{"name":"Clinical Outcome Solutions, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4031-1714","authenticated-orcid":false,"given":"Kerri L.","family":"Cavanaugh","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee"},{"name":"Vanderbilt O\u2019Brien Center for Kidney Disease, Nashville, Tennessee"},{"name":"Center for Effective Health Communication, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3589-9178","authenticated-orcid":false,"given":"Brian S.","family":"Mittman","sequence":"additional","affiliation":[{"name":"Health Services Research and Implementation Science, Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5762-7881","authenticated-orcid":false,"given":"John Devin","family":"Peipert","sequence":"additional","affiliation":[{"name":"Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois"},{"name":"Northwestern University Transplant Outcomes Research Collaborative, Comprehensive Transplant Center, Feinberg School of Medicine, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2022,4]]},"reference":[{"key":"B1-20241015","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1053\/j.ajkd.2020.07.007","article-title":"The \u201cAdvancing American Kidney Health\u201d Executive Order: Challenges and opportunities for the large dialysis organizations","volume":"76","author":"Lin","year":"2020","journal-title":"Am J Kidney Dis"},{"key":"B2-20241015","doi-asserted-by":"crossref","first-page":"995","DOI":"10.2215\/CJN.08880812","article-title":"Modifiable patient characteristics and racial disparities in evaluation completion and living donor transplant","volume":"8","author":"Waterman","year":"2013","journal-title":"Clin J Am Soc Nephrol"},{"key":"B3-20241015","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1186\/1471-2369-12-28","article-title":"Defensive coping and health-related quality of life in chronic kidney disease: A cross-sectional study","volume":"12","author":"Kaltsouda","year":"2011","journal-title":"BMC Nephrol"},{"key":"B4-20241015","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1186\/1471-2369-15-112","article-title":"Health care provider perception of chronic kidney disease: Knowledge and behavior among African American patients","volume":"15","author":"Kazley","year":"2014","journal-title":"BMC Nephrol"},{"key":"B5-20241015","doi-asserted-by":"crossref","first-page":"694","DOI":"10.2215\/CJN.07680715","article-title":"Educating patients about CKD: The path to self-management and patient-centered care","volume":"11","author":"Narva","year":"2016","journal-title":"Clin J Am Soc Nephrol"},{"key":"B6-20241015","doi-asserted-by":"crossref","first-page":"152","DOI":"10.7182\/pit2014946","article-title":"Hispanic\/Latino concerns about living kidney donation: A focus group study","volume":"24","author":"Gordon","year":"2014","journal-title":"Prog Transplant"},{"key":"B7-20241015","doi-asserted-by":"crossref","first-page":"56","DOI":"10.7182\/pit2014378","article-title":"Culturally competent transplant program improves Hispanics\u2019 knowledge and attitudes about live kidney donation and transplant","volume":"24","author":"Gordon","year":"2014","journal-title":"Prog Transplant"},{"key":"B8-20241015","doi-asserted-by":"crossref","first-page":"1344","DOI":"10.1038\/ki.2011.240","article-title":"Associations among perceived and objective disease knowledge and satisfaction with physician communication in patients with chronic kidney disease","volume":"80","author":"Wright Nunes","year":"2011","journal-title":"Kidney Int"},{"key":"B9-20241015","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1053\/j.ajkd.2010.09.018","article-title":"Development and results of a kidney disease knowledge survey given to patients with CKD","volume":"57","author":"Wright","year":"2011","journal-title":"Am J Kidney Dis"},{"key":"B10-20241015","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1007\/s40615-019-00561-4","article-title":"\u201cI try not to even think about my health going bad\u201d: A qualitative study of chronic kidney disease knowledge and coping among a group of urban African-American patients with CKD","volume":"6","author":"Lissanu","year":"2019","journal-title":"J Racial Ethn Health Disparities"},{"key":"B11-20241015","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1097\/TP.0000000000002349","article-title":"Measurement characteristics of the knowledge assessment of renal transplantation","volume":"103","author":"Peipert","year":"2019","journal-title":"Transplantation"},{"key":"B12-20241015","doi-asserted-by":"crossref","first-page":"969","DOI":"10.1097\/TP.0000000000000161","article-title":"Actual and perceived knowledge of kidney transplantation and the pursuit of a live donor","volume":"98","author":"Gupta","year":"2014","journal-title":"Transplantation"},{"key":"B13-20241015","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1186\/s12882-019-1262-9","article-title":"A randomized controlled trial of Explore Transplant at Home to improve transplant knowledge and decision-making for CKD 3-5 patients at Kaiser Permanente Southern California","volume":"20","author":"Waterman","year":"2019","journal-title":"BMC Nephrol"},{"key":"B14-20241015","doi-asserted-by":"crossref","first-page":"648","DOI":"10.1016\/j.clinthera.2014.04.006","article-title":"Overview of classical test theory and item response theory for the quantitative assessment of items in developing patient-reported outcomes measures","volume":"36","author":"Cappelleri","year":"2014","journal-title":"Clin Ther"},{"key":"B15-20241015","doi-asserted-by":"crossref","first-page":"II28","DOI":"10.1097\/00005650-200009002-00007","article-title":"Item response theory and health outcomes measurement in the 21st century","volume":"38","author":"Hays","year":"2000","journal-title":"Med Care"},{"key":"B16-20241015","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1007\/s11136-007-9198-0","article-title":"Applying item response theory (IRT) modeling to questionnaire development, evaluation, and refinement","volume":"16","author":"Edelen","year":"2007","journal-title":"Qual Life Res"},{"key":"B18-20241015","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1177\/0013164498058003001","article-title":"Item response theory and classical test theory: An empirical comparison of their item\/person statistics","volume":"58","author":"Fan","year":"1998","journal-title":"Educ Psychol Meas"},{"key":"B19-20241015","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1053\/j.ajkd.2011.03.028","article-title":"Health-related quality of life and clinical outcomes in kidney transplant recipients","volume":"58","author":"Molnar-Varga","year":"2011","journal-title":"Am J Kidney Dis"},{"key":"B20-20241015","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1681\/ASN.2018070726","article-title":"Frailty and changes in cognitive function after kidney transplantation","volume":"30","author":"Chu","year":"2019","journal-title":"J Am Soc Nephrol"},{"key":"B21-20241015","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1111\/ajt.14557","article-title":"OPTN\/SRTR 2016 annual data report: Kidney","volume":"18","author":"Hart","year":"2018","journal-title":"Am J Transplant"},{"key":"B22-20241015","doi-asserted-by":"crossref","first-page":"1435","DOI":"10.1681\/ASN.2019121331","article-title":"Measuring patient activation as part of kidney disease policy: Are we there yet?","volume":"31","author":"Nair","year":"2020","journal-title":"J Am Soc Nephrol"},{"key":"B23-20241015","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1111\/jorc.12312","article-title":"Renal replacement knowledge and preferences for African Americans with chronic kidney disease","volume":"46","author":"King","year":"2020","journal-title":"J Ren Care"},{"key":"B24-20241015","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1186\/s12882-018-1075-2","article-title":"Meeting patients where they are: Improving outcomes in early chronic kidney disease with tailored self-management support (the CKD-SMS study)","volume":"19","author":"Havas","year":"2018","journal-title":"BMC Nephrol"},{"key":"B25-20241015","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1007\/s11136-018-1989-y","article-title":"The impact of education on knowledge, adherence and quality of life among patients on haemodialysis","volume":"28","author":"Alikari","year":"2019","journal-title":"Qual Life Res"},{"key":"B26-20241015","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1186\/s12882-015-0186-2","article-title":"Factors affecting willingness to receive a kidney transplant among minority patients at an urban safety-net hospital: A cross-sectional survey","volume":"16","author":"Ilori","year":"2015","journal-title":"BMC Nephrol"},{"key":"B27-20241015","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1053\/j.ajkd.2016.01.022","article-title":"Educational interventions for patients with CKD: A systematic review","volume":"68","author":"Lopez-Vargas","year":"2016","journal-title":"Am J Kidney Dis"},{"key":"B28-20241015","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1016\/j.jdiacomp.2016.10.027","article-title":"Self-management in patients with diabetes and chronic kidney disease is associated with incremental benefit in HRQOL","volume":"31","author":"Zimbudzi","year":"2017","journal-title":"J Diabetes Complications"},{"key":"B29-20241015","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1111\/j.1600-6143.2006.01623.x","article-title":"Increasing live donor kidney transplantation: A randomized controlled trial of a home-based educational intervention","volume":"7","author":"Rodrigue","year":"2007","journal-title":"Am J Transplant"},{"key":"B30-20241015","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1053\/j.ajkd.2007.11.027","article-title":"A randomized trial of a home-based educational approach to increase live donor kidney transplantation: Effects in Blacks and Whites","volume":"51","author":"Rodrigue","year":"2008","journal-title":"Am J Kidney Dis"},{"key":"B31-20241015","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1016\/j.cct.2012.03.015","article-title":"The \u201cHouse Calls\u201d trial: A randomized controlled trial to reduce racial disparities in live donor kidney transplantation: Rationale and design","volume":"33","author":"Rodrigue","year":"2012","journal-title":"Contemp Clin Trials"},{"key":"B32-20241015","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/j.cct.2016.11.011","article-title":"Protocol of the KTFT-TALK study to reduce racial disparities in kidney transplant evaluation and living donor kidney transplantation","volume":"53","author":"Bornemann","year":"2017","journal-title":"Contemp Clin Trials"},{"key":"B33-20241015","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1186\/s12882-015-0153-y","article-title":"The TALKS study to improve communication, logistical, and financial barriers to live donor kidney transplantation in African Americans: Protocol of a randomized clinical trial","volume":"16","author":"Strigo","year":"2015","journal-title":"BMC Nephrol"},{"key":"B34-20241015","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.ekir.2016.04.001","article-title":"A randomized controlled trial of a mobile clinical decision aid to improve access to kidney transplantation: iChoose Kidney","volume":"1","author":"Patzer","year":"2016","journal-title":"Kidney Int Rep"},{"key":"B35-20241015","doi-asserted-by":"crossref","first-page":"362","DOI":"10.7182\/pit2014830","article-title":"Living donor transplant education for African American patients with end-stage renal disease","volume":"24","author":"Arriola","year":"2014","journal-title":"Prog Transplant"},{"key":"B36-20241015","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1007\/s11136-007-9184-6","article-title":"Differential item functioning and health assessment","volume":"16","author":"Teresi","year":"2007","journal-title":"Qual Life Res"},{"key":"B37-20241015","first-page":"538","article-title":"Occurrences and sources of differential item functioning (DIF) in patient-reported outcome measures: Description of DIF methods, and review of measures of depression, quality of life and general health","volume":"50","author":"Teresi","year":"2008","journal-title":"Psychol Sci Q"},{"key":"B38-20241015","doi-asserted-by":"crossref","first-page":"5036","DOI":"10.1172\/JCI141563","article-title":"NIDDK initiatives addressing health disparities in chronic diseases","volume":"130","author":"Roberts","year":"2020","journal-title":"J Clin Invest"},{"key":"B39-20241015","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1001\/jama.2017.19152","article-title":"Association of race and ethnicity with live donor kidney transplantation in the United States from 1995 to 2014","volume":"319","author":"Purnell","year":"2018","journal-title":"JAMA"},{"key":"B40-20241015","doi-asserted-by":"crossref","first-page":"e13380","DOI":"10.1111\/ctr.13380","article-title":"Racial disparities in preemptive referral for kidney transplantation in Georgia","volume":"32","author":"Gander","year":"2018","journal-title":"Clin Transplant"},{"key":"B41-20241015","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1053\/j.ackd.2020.06.003","article-title":"Policy and pandemic: The changing practice of nephrology during the coronavirus disease-2019 outbreak","volume":"27","author":"Truong","year":"2020","journal-title":"Adv Chronic Kidney Dis"},{"key":"B42-20241015","doi-asserted-by":"crossref","first-page":"640","DOI":"10.1053\/j.ajkd.2019.03.430","article-title":"Direct delivery of kidney transplant education to Black and low-income patients receiving dialysis: A randomized controlled trial","volume":"74","author":"Waterman","year":"2019","journal-title":"Am J Kidney Dis"},{"key":"B43-20241015","doi-asserted-by":"crossref","first-page":"e19452","DOI":"10.2196\/19452","article-title":"Mobile health app with social media to support self-management for patients with chronic kidney disease: Prospective randomized controlled study","volume":"22","author":"Li","year":"2020","journal-title":"J Med Internet Res"},{"key":"B44-20241015","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.1016\/j.transproceed.2021.01.038","article-title":"Expansion of patient education programming regarding live donor liver transplantation via virtual group encounters during the COVID-19 pandemic","volume":"53","author":"Joyce","year":"2021","journal-title":"Transplant Proc"}],"container-title":["Clinical Journal of the American Society of Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2215\/CJN.11490821","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T13:44:37Z","timestamp":1786369477000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2215\/CJN.11490821"}},"subtitle":["Development and Validation of CKD and Transplant Knowledge Scales"],"short-title":[],"issued":{"date-parts":[[2022,4]]},"references-count":43,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.2215\/cjn.11490821","relation":{},"ISSN":["1555-9041","1555-905X"],"issn-type":[{"value":"1555-9041","type":"print"},{"value":"1555-905X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4]]},"assertion":[{"value":"2021-08-30","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-02-18","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}