# MOBILIZE: Mobility & Transportation Solutions to Improve Hemodialysis Access

> **NIH NIH K23** · UNIVERSITY OF CALIFORNIA AT DAVIS · 2024 · $193,085

## Abstract

PROJECT SUMMARY
5.8 million individuals miss or delay medical care because of a lack of transportation. Persons with end stage
kidney disease (ESKD) particularly depend on reliable transportation to dialysis sessions. In 2022, 84% of
individuals newly diagnosed with ESKD initiated their treatment at an in-center hemodialysis (HD) facility,
requiring they travel three times a week for HD. Yet 10% of patients with ESKD treated with HD miss dialysis at
least monthly, and 35% miss treatment at least once every three months. Missing dialysis has significant
individual and health system consequences, including increased emergency department visits,
hospitalizations, and premature mortality and contributes to persistent racial and socioeconomic disparities in
ESKD prevalence and outcomes. This Mentored Patient-Oriented Career Development Award (K23) will
provide me with the training and mentorship needed to become an independent clinician-investigator and
leader on transportation insecurity, social risk, and healthcare access for patients with ESKD. I am a family
physician and medical anthropologist trained in qualitative and health services research and bring a unique
perspective on how individual and community social context impacts healthcare. To achieve my long-term
research and career goal of improving patients’ access to health care services and addressing longstanding
health inequities, I need additional skills in (1) epidemiologic design and advanced quantitative analysis skills;
(2) policy development and evaluation in transportation and ESKD, with emphasis on quality metrics; (3)
clinical intervention development and implementation of future transportation solutions. I will accomplish the
study’s goals through the following aims.
 Aim 1: Quantify social risk levels in a diverse group of patients with ESKD treated with in-center HD
 and associations with key HD outcomes in a prospective cohort study of 300 patients using the
 Accountable Health Communities (AHC) instrument.
 Aim 2: Assess the predictive validity of a novel transportation screening tool, the Transportation
 Security Index (TSI), in HD settings to identify patients most likely to miss HD appointments and
 compare its performance to the AHC’s transportation question.
 Aim 3: Identify facilitators and barriers to home dialysis as a component of addressing transportation
 insecurity in the ESKD population by conducting semi-structured interviews with patients, dialysis staff,
 and policy makers.
The current proposal aligns with NIDDK’s priority area of developing interventions to integrate social and
medical care to improve health equity and will break new ground by evaluating social risk within the ESKD
population, with a focus on transportation insecurity.

## Key facts

- **NIH application ID:** 10949925
- **Project number:** 1K23DK140602-01
- **Recipient organization:** UNIVERSITY OF CALIFORNIA AT DAVIS
- **Principal Investigator:** Na'amah Razon
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $193,085
- **Award type:** 1
- **Project period:** 2024-09-01 → 2028-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10949925

## Citation

> US National Institutes of Health, RePORTER application 10949925, MOBILIZE: Mobility & Transportation Solutions to Improve Hemodialysis Access (1K23DK140602-01). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10949925. Licensed CC0.

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