Recruitment, Engagement, Experiences, and Self-Reported Changes in a Digital Patient Activation Intervention to Improve Hemodialysis Session Stability: Mixed Methods Study.
Megan Wickens, Jennifer Bragg-Gresham, Rajiv Saran et al.
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In 30 seconds
This mixed methods study evaluated recruitment, engagement, completion, and participant experiences in Dialysafe, a digital education and peer-mentoring intervention at 10 hemodialysis centers. The program aimed to support behaviors that may help prevent intradialytic hypotension. Of 639 eligible patients, 155 (24.3%) enrolled; 58 (37.4%) completed all five mentoring sessions. Among survey respondents, 55 of 55 rated the program good or excellent, and 53 of 54 would recommend it. Participants commonly prioritized communication with their care team and valued peer mentoring, while recruitment and completion findings indicated limited reach and substantial early attrition.
Key findings
- Of 639 eligible patients, 155 (24.3%) were recruited; recruited patients were younger than nonrecruited patients (mean 57.6 vs 64.3 y; P<.001).
- Among 155 recruited patients, 72 (46.5%) met with a peer mentor and 58 (37.4%) completed all 5 sessions; attrition was concentrated before mentoring began.
- Of 79 patients who set goals, 64 (81%) chose communication with the care team; 22 of 54 survey respondents (40.7%) named this as their main behavior change.
- Among mentee respondents, 55 of 55 (100%) rated the program good or excellent, and 53 of 54 (98.1%) would recommend it.
Why it matters
The findings show that a digital intervention combining education and peer support was well received by respondents, but reached a minority of eligible patients and had substantial attrition before mentoring. Communication with the care team emerged as a prominent patient goal. These results help distinguish acceptability among participants from population-level reach when assessing patient activation approaches in hemodialysis.
What to keep in mind
Participants were self-selecting, and recruitment was limited. Satisfaction and behavior-change findings came from survey respondents, so they may not represent all eligible or enrolled patients.