Who follows through? Different factors predict initial commitment vs. Following through in a national survey of organ donor registration

OBJECTIVE

Little research has investigated factors that determine whether people falter in the face of an obstacle or successfully follow through on an initial commitment to act. We integrated multiple theories (the Reasoned Action Approach [RAA], Prototype Willingness Model, and anticipated regret theory) to test which factors predict initial commitment to register as an organ donor and to discover whether different factors predict initial commitment vs. following through with registration.

METHODS

Participants from a nationally representative UK sample (N = 1,008) reported their beliefs about organ donation and indicated their decision to register. An obstacle that participants could not foresee was that they had to complete registration in a second survey 3 days after making their initial commitment.

RESULTS

Findings showed that 14.8% of participants followed through, 19.7% demonstrated initial commitment, and 65.5% declined to register. Linear discriminant function analysis derived two functions that distinguished these registration patterns. The first function discriminated participants who declined to register from the other groups. The declined group had lower scores on RAA variables compared to their counterparts. The second function distinguished participants who made an initial commitment to register from those who followed through. Follow-through was associated with less anticipated negative affect, more favorable descriptive norms, and stronger identification with organ donors.

CONCLUSIONS

The present findings indicate that even modest friction leads to a large reduction in follow-through. Moreover, different factors influence initial commitment vs. following through. Whereas RAA variables predicted initial commitment, following through was a function of anticipated negative affect and social processes.

Moderating Role of Religiosity and the Determinants to Attitude, Willingness to Donate and Willingness to Communicate Posthumous Organ Donation Decisions among University Students in Pakistan

Organ transplantation is considered an alternative treatment to save lives or to improve the quality of life and is a successful method for the treatment of patients with end-stage organ diseases. The main objective of the current study was to explore the determinants of the attitudes and willingness to communicate the posthumous organ donation decisions to the families. Questionnaires were used to test the hypothesized relationships. The results confirmed altruism, knowledge, empathy, and self-identity as the antecedents to attitude. We also found perceived behavioral control, moral norms, and attitude as significant antecedents to the willingness to donate organs after death. The results of the study also indicated that those who were willing to sign the donor card were also willing to communicate their decision to their families. Religiosity moderated the relationship between willingness to donate and signing the donor card, and it strengthened the relationship. The findings of this study would provide insight into the factors which can influence posthumous organ donation among university students in Pakistan.

Socio-Cultural Factors Contributing to Being an Organ Donor in Iranian Employees

AIMS

The purpose of this study was to use a culturally modified Organ Donation Model (ODM) to explore the significant factors and ways in which these factors could influence signing the donor card.

METHODS

This cross-sectional study was conducted among 600 employees from 57 offices in Hamadan, Iran, in 2018. Participants were selected randomly and surveyed on being a donor and their perceptions regarding signing the donor card. Structural equation modeling (SEM) was conducted to determine the inter-relationship between the studied variables.

RESULTS

Participants' mean age was 39.5 (SD = 7.0). 20% of participants had a signed donor card. Descriptive norms (β = 0.53, p < 0.001), non-cognitive beliefs (β=-0.33, p < 0.001), anticipated regret (β = 0.28, p < 0.001) and subjective norms (β=-0.17, p < 0.01) had significant direct effects on signing the donor card.

CONCLUSION

This study provides socio-culturally informed evidence on individuals' signing donor card. These factors could provide a guide to policymakers to develop the community-based interventions.

Predicting long-term healthy eating behaviour: understanding the role of cognitive and affective attitudes

OBJECTIVES

There are few tests of the ability of cognitive and affective attitudes to predict long-term performance of health behaviours. We assessed relationships between cognitive and affective attitudes and healthy eating behaviour over periods of 4, 6 and 10 years. Design: A prospective survey measuring cognitive and affective attitudes at baseline (T1) and 6 years (T2), and self-report healthy eating behaviour at baseline (T1), 6 (T2) and 10 (T3) years later in a sample of UK adults recruited through General Practice (N = 285). Results: When considered simultaneously, affective attitude (T1 and T2) predicted healthy eating behaviour cross-sectionally (at T1 and T2) and prospectively (over 4 [T2-T3], 6 [T1-T2] and 10 [T1-T3] years) whereas cognitive attitude did not. Stability of affective attitude (T1-T2) moderated the affective attitude-behaviour relationship in some (T1-T2, T1-T3), but not all (T2-T3), prospective analyses. Change in affective attitude, but not cognitive attitude (T1-T2), predicted change in behaviour over 6 (T1-T2) and 10 (T1-T3) years. Conclusions: The findings indicate that affective attitudes can be significant predictors of healthy eating behaviour over prolonged time periods suggesting they may be useful targets for interventions designed to produce long-term change in eating behaviour.

Reasons for (not) Signing the State Registry: Surveying Department of Motor Vehicles Customers in New York State

Context

Prior research examining rationales for enrolling as an organ donor is biased because of its reliance on college student samples and retrospective recall.

Objective

To characterize New York state residents' registry enrollment decisions in close proximity to a registration opportunity.

Design

Surveys were conducted with customers exiting Department of Motor Vehicle offices.

Participants

A total of 1325 customers were surveyed upon exiting 1 of 18 Department of Motor Vehicle offices spanning 9 counties.

Main Outcome Measure

Customers making donation-relevant transactions (ie, license renewal/registration) reported whether they had registered as a donor that day, and all other customers reported whether they had registered as a donor in the past. Customers reported reasons to justify their enrollment decision through short interview questions.

Results

Among current donation-relevant transactions (n = 299), 27% reported enrolling in the registry. Of remaining customers, 39% reported enrolling in the state registry in the past. For those who elected not to enroll, many failed to communicate a reason for their decision, or reported a lack of opportunity to sign or decisional uncertainty. Among enrollees, reasons for registration included the altruistic benefits of donation, prior registration, personal experience with donation, and rational arguments for donation.

Conclusion

The value of point-of-decision survey data are discussed in relation to strategic efforts to promote organ donor registration.

Awareness of legislation moderates the effect of opt-out consent on organ donation intentions

BACKGROUND

With the worldwide shortage of organs to meet the demand for transplants, many countries are considering whether introducing opt-out consent would increase the availability of donor organs. This research assessed whether people's willingness to donate their organs for transplant purposes was greater in opt-out than opt-in countries and whether such effects were moderated by people's awareness of their nation's legislative system.

METHODS

Using secondary data from the 2010 Eurobarometer (n=29,288), this study compared people's willingness to donate their organs in a representative sample from 19 opt-out and 10 opt-in consent countries from across Europe.

RESULTS

The majority of participants (66.04%) stated that they were willing to donate their organs for transplant purposes. The proportion of people who were willing to donate their organs did not differ between opt-in (65.97%) and opt-out (66.37%) countries. However, the effect of consent on willingness to donate was moderated by people's awareness of their nation's organ donation legislation. When people were aware of their nation's legislation, the proportion of people who were willing to donate their organs was greater in opt-out (85.26%) than opt-in (80.72%) countries. By contrast, when people were not aware of their nation's legislation, there was no difference in people's willingness to donate their organs in opt-in (58.63%) and opt-out (59.23%) countries.

CONCLUSIONS

Opt-out consent countries should increase people's awareness of their legislation to improve donor rates. Further research is needed to understand the factors that moderate the effect of opt-out consent legislation on organ donation.

Choosing to be a designated organ donor on their first driver's license: actions, opinions, intentions, and barriers of Asian American and Pacific Islander adolescents in Hawaii

CONTEXT

The factors associated with Asian American and Pacific Islander adolescents' decision to be a designated organ donor on their first driver's license are largely unknown.

OBJECTIVE

To assess knowledge and attitudes about organ donation and sociocultural factors associated with designated organ donor status in Asian American and Pacific Islander youth in Hawaii.

DESIGN AND SETTING

Written surveys and focus groups were conducted at high schools and churches.

PARTICIPANTS

Two hundred eight Asian American and Pacific Islander teens, mean age 16 (SD, 2) years, 52.6% females, and 53.4% Catholic.

MAIN OUTCOME MEASURES

Donor status on driver's license, awareness, attitudes, intentions, and barriers to becoming a designated organ donor.

RESULTS

Eighteen percent of teens with a driver's license are designated organ donors. Twenty-one percent have talked to their parents about becoming a designated donor on their license. Of those without a license, 27.7% intended to become a designated donor. Sex, grade level, and immigrant status were not associated with designated organ donor status; however, Catholics were significantly less likely to be donors. Key barriers to being a designated donor included a lack of knowledge or misperceptions due to urban myths about organ donation, parents completing "organ donor" question on driver's license application, and not wanting to have their body "cut up."

CONCLUSIONS

Future organ donor campaigns should educate ethnic minority adolescents about the importance of becoming a designated organ donor on their first driver's license and counter urban myths about deceased organ donation. Guidelines for how to initiate family discussions about organ donation should be sensitive to cultural and religious beliefs.

Choosing to Be a Designated Organ Donor on Their First Driver's License: Actions, Opinions, Intentions, and Barriers of Asian American and Pacific Islander Adolescents in Hawaii

Context

The factors associated with Asian American and Pacific Islander adolescents' decision to be a designated organ donor on their first driver's license are largely unknown.

Objective

To assess knowledge and attitudes about organ donation and socio-cultural factors associated with designated organ donor status in Asian American and Pacific Islander youth in Hawaii.

Design and Setting

Written surveys and focus groups were conducted at high schools and churches.

Participants

Two hundred eight Asian American and Pacific Islander teens, mean age 16 (SD, 2) years, 52.6% females, and 53.4% Catholic.

Main Outcome Measures

Donor status on driver's license, awareness, attitudes, intentions, and barriers to becoming a designated organ donor.

Results

Eighteen percent of teens with a driver's license are designated organ donors. Twenty-one percent have talked to their parents about becoming a designated donor on their license. Of those without a license, 27.7% intended to become a designated donor. Sex, grade level, and immigrant status were not associated with designated organ donor status; however, Catholics were significantly less likely to be donors. Key barriers to being a designated donor included a lack of knowledge or misperceptions due to urban myths about organ donation, parents completing “organ donor” question on driver's license application, and not wanting to have their body “cut up.”

Conclusions

Future organ donor campaigns should educate ethnic minority adolescents about the importance of becoming a designated organ donor on their first driver's license and counter urban myths about deceased organ donation. Guidelines for how to initiate family discussions about organ donation should be sensitive to cultural and religious beliefs.