The proposed research has two specific aims: (1) to continue our five-year prospective assessment of the incidence of noncompliance among kidney transplant patients; and (2) to develop and evaluate survey-based intervention strategies aimed at reducing noncompliance in a sample of kidney transplant patients. We propose to continue our prospective chart study for the entire grant period, collecting and monitoring the kinds of medical history and self-report data that we have built into a nationally unique scientific database. This database has enabled our research team to track the differential predictors of noncompliance post-transplant, and to use that knowledge to develop and evaluate a patient education intervention. We also propose to develop and evaluate the use of survey interventions that will be specifically targeted at the underlying psychological bases of noncompliance. Social psychological research on persuasion suggest that persuasion is maximized when the persuasive appear matches the underlying cognitive or affective basis for the problem attitude and/or behavior. Two samples of transplant patients will be interviewed during the course of this intervention study. First, a cross sectional sample of transplant patient who participated in our patient education intervention study will be interviewed three times by telephone in Year 1. In addition, during year 1, we will begin to collect data on a longitudinal sample. Patients transplanted 9/1/96 and thereafter, will be interviewed in order to design an appropriate intervention strategy beginning one year after their transplant date. For example, patients whose chart and intervention study data suggests an emotional basis for noncompliance will receive, via intervention surveys three times a year, an emotion-based appear to improve compliance. elf-report and chart based measures will be used to assess patient compliance rates over time.
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