# CLARIFy-KD Kidney Health Coaching Supplement

> **NIH NIH U01** · EMORY UNIVERSITY · 2024 · $135,000

## Abstract

ABSTRACT
Racial disparities in advanced chronic kidney disease (CKD) treatment, care, and patient outcomes are
profound, persistent, and pervasive. Despite a large volume of studies linking structural racism to a range of
health outcomes, only recently has there been a surge in attention to the role of racism in driving the well-
documented inequities in CKD. Effective CKD treatment and care can improve quality of life, reduce the need
for deceased donor transplant, decrease the likelihood of allograft failure, and improve long-term patient
survival; yet racial disparities exist at each point along this pathway of care due to structural racism.
The Collaborative Chronic Care Model (CCM) offers a well-established, multi-level framework for organizing
health systems in order to maximize outcomes among patients with chronic diseases such as CKD; however,
alone, it fails to attend to the role of structural racism. We propose multi-level, multi-component interventions
under a new innovative framework to motivate systemic change: we will apply the four foci of Public Health
Critical Race Praxis (PHCRP), a public health framework that addresses change through an anti-racism lens,
to the six components of the CCM to impact CKD care in primary care and acute care access points,
nephrology, and dialysis care settings. In this manner, we propose to redesign structures within Emory
Healthcare to mitigate the effect of structural racism on CKD inequities.
Our long-term goal is to eliminate racial inequities in CKD progression, treatment, and care among patients
within Emory Healthcare by developing a model of care that can be replicated and sustained within health
systems across the country. In the development, implementation, evaluation, and dissemination of the multi-
component, multi-level interventions we will rely heavily on a community-engaged approach at all stages of
implementation. Our central hypothesis is that with substantial guidance from a Community Advisory Board,
comprehensive systems change implemented through an anti-racism lens will improve access to all steps of
care along the CKD continuum among African American patients, thereby decreasing existing racial inequities.
In close collaboration with the U01 Research Coordinating Center, we propose these aims:
1. Apply PHCRP to develop multi-level, multi-component interventions that target patient & provider outcomes
2. Implement multi-level, multi-component interventions across primary care and acute care access points,
nephrology, and dialysis care using the six components of the CCM and PHCRP as organizing frameworks
3. Using a quasi-experimental interrupted time series design, determine the effectiveness of the interventions
on primary outcomes analyzed at the level of patients and provider type
4. Evaluate implementation and support dissemination of the multi-level, multi-component interventions using
the extended RE-AIM framework to assess Reach, Effectiveness, Adoption, Implementation, ...

## Key facts

- **NIH application ID:** 11146072
- **Project number:** 3U01DK137269-02S1
- **Recipient organization:** EMORY UNIVERSITY
- **Principal Investigator:** Kimberly Ruth Jacob Arriola
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $135,000
- **Award type:** 3
- **Project period:** 2023-09-01 → 2028-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11146072

## Citation

> US National Institutes of Health, RePORTER application 11146072, CLARIFy-KD Kidney Health Coaching Supplement (3U01DK137269-02S1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/11146072. Licensed CC0.

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