Modifiable Factors Affecting Racial Disparities in Kidney Donation

Metrics of interest include whether donor volunteers present for evaluation, defined as attending the first in-person visit, and whether they complete the donor evaluation, defined as finishing all required steps except donation. Both outcomes are measured as yes or no. Investigators will use logistic regression to examine differences in the likelihood of presentation and completion among Black, Hispanic, and White donors. Initial analyses will examine the relationship between race and each outcome separately. Race will then be included in multivariable models, with survey-based factors added by category. Changes in the size or significance of race effects after adjustment will be evaluated. If the association between race and evaluation outcomes is reduced after accounting for specific modifiable factors, these factors may represent potential targets for future interventions.

Investigators will compare the odds of donating a kidney directly or through paired exchange among Black, Hispanic, and White donor volunteers using logistic regression models. Model fit will be assessed as previously described. As in the primary measure, the bivariate relationship between donor race and each outcome will first be examined using simple logistic regression. Race will then be forced into successive models, with survey variables entered simultaneously by category. Investigators will track whether the magnitude (odds ratio) or significance of the race effect changes as additional factors are included.