# Peer mentorship to improve outcomes in patients on maintenance hemodialysis

> **NIH NIH R18** · ALBERT EINSTEIN COLLEGE OF MEDICINE · 2020 · $526,848

## Abstract

PROJECT SUMMARY / ABSTRACT
 The proposed project tests an intervention to improve outcomes in patients with end-
stage renal disease (ESRD). Patients treated with hemodialysis are at disproportionally high
risk for hospitalizations which are both costly to the health care system and are associated with
high morbidity and mortality. A portion of hospitalizations in patients on hemodialysis are
avoidable and may reflect a failure of self-management of dialysis parameters and adherence.
Patient education that is provided by dialysis facilities focuses on dialysis quality metrics set by
Medicare for reimbursement purposes. They seldom inform patients about concrete skills, nor
do they increase self-efficacy with regards to behavioral outcomes. Patient level barriers to
dialysis self-management include low knowledge about the relation of fluid metrics, dialysis
adherence and dietary plans to short and long-term outcomes. We aim to employ the
Information, Motivation and Behavior (IMB) Skills Model of improving adherence in medical
care. We will use a peer mentorship model to provide information and motivation in order to
improve adherence behaviors in patients with ESRD. Peer mentorship has been shown to
increase theoretical and practical knowledge in patients with chronic disease, and peer-mentors
increase perception of social support and self-efficacy in their mentees. We propose a
pragmatic trial evaluating the effects of a peer-mentor program focused on increasing dialysis
self-management in high risk patients on hemodialysis. Our primary outcome is the composite
of emergency department visits and hospitalizations. Our study will be conducted in 2
geographic locations (Bronx, NY and Nashville, TN) to evaluate scalability and acceptability in
different patient populations. We will recruit 20 peer mentors and train them using a curriculum
based on the IMB model of improving adherence. Two hundred patients with ESRD will be
recruited from 7 dialysis centers and will be randomized to either the peer mentorship
intervention or a usual care control group. Trained mentors will implement a telephone
intervention for 3 months and participants will be followed for an additional 15 months to
evaluate study outcomes. This proposal is innovative and addresses challenges related to
patient level barriers to self-management, high hospitalization rates and disproportionate
morbidity and mortality with a low cost, scalable and pragmatic intervention.

## Key facts

- **NIH application ID:** 10005348
- **Project number:** 5R18DK118471-04
- **Recipient organization:** ALBERT EINSTEIN COLLEGE OF MEDICINE
- **Principal Investigator:** Kerri Cavanaugh
- **Activity code:** R18 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $526,848
- **Award type:** 5
- **Project period:** 2018-09-06 → 2023-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10005348

## Citation

> US National Institutes of Health, RePORTER application 10005348, Peer mentorship to improve outcomes in patients on maintenance hemodialysis (5R18DK118471-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10005348. Licensed CC0.

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