Hispanic patients receive disproportionately fewer living donor kidney transplants (LDKTs) than non-Hispanic Whites (NHW). The Northwestern Medicine Hispanic Kidney Transplant Program (HKTP), designed to increase Hispanic LDKTs, was evaluated as a non-randomized, implementation-effectiveness hybrid trial of patients initiating transplant evaluation at two intervention and two similar control sites. Using a mixed method, observational design, we evaluated the fidelity of the HKTP implementation at the two intervention sites. We tested the impact of the HKTP intervention by evaluating the likelihood of receiving LDKT comparing pre-intervention (1/2011-12/2016) and post-intervention (1/2017-3/2020), across ethnicity and centers. The HKTP study included 2,063 recipients. Intervention Site A exhibited greater implementation fidelity than intervention Site B. For Hispanic recipients at Site A, the likelihood of receiving LDKTs was significantly higher at post-intervention compared to pre-intervention [odds ratio (OR)=3.17 95% confidence interval (1.04, 9.63)], but not at the paired control Site C [OR=1.02 (0.61, 1.71)]. For Hispanic recipients at Site B, the likelihood of receiving a LDKT did not differ between pre- and post-intervention [OR=0.88 (0.40, 1.94)]. The LDKT rate was significantly lower for Hispanics at paired control Site D [OR=0.45 (0.28, 0.90)]. The intervention significantly improved LDKT rates for Hispanic patients at the intervention site that implemented the intervention with greater fidelity.
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