An Individuation Intervention to Reduce Socioeconomic Disparities in Chronic Kidney Disease Care
Chronic Kidney Diseases
What this study involves
The registry does not currently label this study as recruiting. Ask about its status before planning a screening visit.
- Study type
- Interventional
- Phase
- Not applicable
- Age range
- 18 years - Not specified
- Sex eligible
- All sexes
- Healthy volunteers
- Not accepted
- Participants
- 216 Estimated
These are starting points, not an eligibility decision. The research team must review the full requirements.
About the research
The goal of this clinical trial is to test whether an individuation intervention can improve the quality of chronic kidney disease (CKD) care for patients with low socioeconomic status (SES) and to understand the mechanisms through which the intervention may improve care delivery and clinical outcomes. The study will involve nephrologists and their patients with CKD, with a focus on reducing healthcare disparities associated with low SES. Researchers will compare nephrologists who receive the individuation intervention with those in the control group to determine whether encouraging physicians to better understand their patients as unique individuals, rather than relying on assumptions associated with socioeconomic status, improves the quality of CKD care for patients with low SES.
Who may be able to participate?
The list below is the sponsor’s full registry wording. It can include conditions, prior treatment, test results and other requirements. A match in search does not mean you qualify.
For Providers:
Inclusion Criteria:
- Nephrologists of any sex, race and ethnicity
- \>18 years of age
- \>=1 clinic at an MGB-affiliated clinic (BWH main campus, 850 Boylston, Foxborough, MGH main campus, 165 Cambridge Street, MGH West Waltham) where they care for patients that have chronic kidney disease (CKD)
For Patients:
Inclusion Criteria:
- Patients of any sex, race and ethnicity of the participating providers who are able to provide consent
- English-speaking
- \>=18 years old
- Insured by Medicaid/Mass Health (as a proxy for low socioeconomic status) or dually insured by Medicaid/Medicare
- Have a diagnosis of CKD or a referral to nephrology for evaluation of CKD
- Have been seen \<=3 times in the past year by the nephrologist
Exclusion Criteria:
- Patients who are incarcerated, pregnant or unable to consent
- Patients from our searches who have opted out of research
Treatment, groups and participation
The registry may describe treatments and study duration without a complete visit calendar. Ask the study team for the exact schedule, procedures, risks, costs and alternatives. Keep your usual care plan unless your treating clinician tells you otherwise.
- Assignment
- Random assignment
- Masking
- Single masked
Intervention
Implicit bias training + individuation
Behavioral: Individuation + Implicit Bias Training
Control
Implicit bias training alone
Behavioral: Implicit Bias Training Alone
Individuation + Implicit Bias Training BEHAVIORAL
This includes nephrologists taking Implicit Association Tests (IATs) and an unconscious bias in medicine course (\~45-60 min.) Those in the intervention arm will then meet with the study team for a 5-10-minute training on individuation, including examples of individuation-based questions. Nephrologists will be encouraged to design and tailor these questions to their own communication styles to facilitate natural conversations about patients' personal characteristics beyond their medical conditions. Each nephrologist will decide how to incorporate this into their visits (e.g., a smartphrase in a note template).
Implicit Bias Training Alone BEHAVIORAL
This includes nephrologists taking Implicit Association Tests (IATs) and an unconscious bias in medicine course (\~45-60 min.)
What researchers are measuring
Outcome measures describe what is being studied. They are not proof that a treatment works.
Primary measures
Percentage of CKD quality metrics achieved
Time frame: 90 days
This includes receipt of angiotensin-converting enzyme inhibitors (ACE-I) or angiotensin II receptor blockers (ARBs), receipt of sodium-glucose co-transporter-2 inhibitors (SGLT2-Is), and measurement of spot albumin/creatinine ratio. For patients with CKD Stages 3a-5, this will also include measurement of hemoglobin, calcium, PTH, phosphate, 25-OH-vitamin D, referral for dialysis access placement (if indicated), and referral to transplant (if indicated)
Secondary measures
Blood Pressure
Time frame: 180 days
Percent at goal (SBP \<120) 6 months after appointment
Change in creatinine/eGFR
Time frame: 180 days
Change in creatinine and eGFR at 6 months compared to baseline
Change in spot albumin/creatinine ratio
Time frame: 180 days
Change in spot albumin/creatinine 6 months compared to baseline
Stereotype activation
Time frame: Date of visit (+7 day lag time)
After each encounter, providers will list the first three patient characteristics that come to mind, which 15 coders blinded to the study purpose will independently rate for low-SES stereotype content on a 1-5 scale, with ratings averaged across coders and characteristics to generate a patient-level stereotype activation score.
Patient-provider care management discussion
Time frame: Date of visit
The patient-provider care management discussion will be operationalized in 3 ways: (1) which quality metrics are discussed (yes/no), (2) their order (rank), and (3) discussion length (seconds). Recorded encounters will be transcribed verbatim with speaker designations and time stamps and analyzed in steps involving coding.
Providers' communication style
Time frame: Date of visit
Providers' communication style will be analyzed using Linguistic Inquiry and Word Count (LIWC), which categorizes words into \>70 linguistic and psychological categories (e.g., pronouns, social words, affect) and calculates the percentage of words in each category.
Patient satisfaction with care
Time frame: Date of visit
Patient satisfaction with care assessed using the 'Patient Satisfaction Questionnaire', with a minimum score of 1 and maximum score of 5. A higher score means a better outcome i.e. extremely satisfied.
Patient centeredness
Time frame: Date of visit
Patient centeredness assessed using the 'Revised Patient Perception of Patient-Centeredness Questionnaire', with a minimum score of 1 and maximum score of 4. A higher score means a better outcome i.e. excellent patient centeredness.
Patient interpersonal trust in the provider
Time frame: Date of visit
Patient interpersonal trust in the provider assessed using the 'Trust in Physician Scale', with a minimum score of 1 and maximum score of 5. A higher score means a better outcome i.e. high trust in the provider.
Review the complete result tables and limitations in the official record.
Open official results ↗Research locations (1)
The overall study status and a local site’s status can differ. Confirm that location’s availability before traveling.
1 locations
Mass General BrighamSomerville, Massachusetts, United StatesStatus unknown
Study team and timeline
- Lead sponsor
- Brigham and Women's Hospital
- Study start
- 2027-01 Estimated
- Primary completion
- 2028-01 Estimated
- Study completion
- 2028-12 Estimated
- First posted
- Nov 6, 2026 Actual
- Last updated
- Nov 10, 2026 Actual
Official study contacts
Official study title
An Individuation Intervention to Reduce Socioeconomic Disparities in Chronic Kidney Disease Care
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Source: ClinicalTrials.gov API v2. Information is submitted by sponsors and investigators. NLM does not approve the safety or science of all listed studies. Registry disclaimer.
Retrieved: Nov 12, 2026 · Last registry update: Nov 10, 2026