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Feeley TH. Increasing Organ Donor Registrations in Motor Vehicles Offices Through Health Communication. HEALTH COMMUNICATION 2024:1-5. [PMID: 38467598 DOI: 10.1080/10410236.2024.2326259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
Health communication research has played a prominent role in the body of scholarship seeking to meaningfully increase the number of life-saving organs available to waitlisted patients. The current paper builds on earlier work in communication seeking to promote organ donation to individuals in community and organizational settings. The goal of this essay is to review health communication-based interventions seeking to meaningfully increase organ donation registrations in motor vehicles' offices (DMV) transactions in the USA. For convenience, I use the acronym DMV, although it is understood different states use different titles for this office. Before describing the nature and impact of communication interventions and their impact in DMV contexts, I will provide context for the problem and briefly review the role of DMV registrations in relation to demand for organs in the United States.
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Quick BL, Morrow E, Bigman CA, Reynolds-Tylus T, Williamson LD. An evaluation of the license to save lives program to promote organ, eye, and tissue donation among teenagers. Clin Transplant 2024; 38:e15183. [PMID: 37943531 DOI: 10.1111/ctr.15183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 10/19/2023] [Accepted: 10/26/2023] [Indexed: 11/10/2023]
Abstract
As the number of designated organ donors continues to lag behind the number of waiting list patients, teenagers remain a promising demographic of potential organ donors. The current study enlisted Michigan and Ohio driver education students to participate in an online digital learning intervention, License to Save Lives (LTSL). Students were randomly assigned to either an interactive or noninteractive LTSL intervention. Across both states, the pretest-posttest design revealed greater knowledge among students following exposure to either the interactive or noninteractive LTSL program. No attitudinal or behavioral differences emerged between the interactive and noninteractive conditions. Michigan (39.82%) and Ohio (58.10%) students registered to be organ donors at a respectable rate. The results are discussed with an emphasis on feasibility and sustainability as well as the promise for digital games to promote organ donation knowledge, attitude, and registration among teenagers.
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Affiliation(s)
- Brian L Quick
- University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Ethan Morrow
- University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Cabral A Bigman
- University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
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Pullen BLC. Opening a Door: Organ Donation, Transplantation, and Pediatricians. Am J Transplant 2023; 23:1819-1821. [PMID: 37890787 DOI: 10.1016/j.ajt.2023.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/29/2023]
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Olsacher A, Bade C, Ehlers J, Fehring L. How to effectively communicate health information on social media depending on the audience's personality traits: An experimental study in the context of organ donation in Germany. Soc Sci Med 2023; 335:116226. [PMID: 37734177 DOI: 10.1016/j.socscimed.2023.116226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 09/01/2023] [Accepted: 09/04/2023] [Indexed: 09/23/2023]
Abstract
OBJECTIVE The shortage of organs donated for transplantation is a global concern. Even though increasing awareness can boost organ donation registration rates (thus leading to a higher number of available organ transplants), public organ donation campaigns lack effectiveness and are rarely tailored to audiences. To further enhance the effectiveness of digital health (i.e., organ donation) communication, we assessed the perception of social media organ donation campaign strategies (i.e., transformational, informational, neutral) as a function of personality traits (i.e., Big Five). METHOD Data was collected through an online experiment with 1000 participants (i.e., German citizens between 18 and 70 years) who were recruited via Facebook and Prolific between Jun-Aug 2022. Perceived message effectiveness of the organ donation posts was measured on a 5-point Likert scale applying the AIDA model and consequently analyzed using multiple regression analyses. RESULTS Messaging strategy applied in the social media campaigns served as a predictor for message effectiveness depending on the personality traits of the audience when controlling for demographics and donor status. Extraversion was positively associated with higher message effectiveness of the transformational post while neuroticism showed a significant positive association with informational content. Agreeableness was positively correlated with transformational as well as informational post effectiveness. Furthermore, higher perceived post effectiveness increased the likelihood to sign-up for further organ donation information. CONCLUSION Our results show that Instagram in Germany is an underleveraged but potentially effective platform to spread organ donation knowledge. Based on our results, we urge public health authorities to revisit and start tailoring their (digital) health (i.e., organ donation) campaigns to audiences (i.e., personality traits) to increase their effectiveness.
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Affiliation(s)
- Alexandra Olsacher
- Didactics and Educational Research in Health Care, Faculty of Health, School of Medicine, Witten/Herdecke University, Germany
| | - Celina Bade
- Faculty of Health, School of Medicine, Witten/Herdecke University, Germany
| | - Jan Ehlers
- Didactics and Educational Research in Health Care, Faculty of Health, School of Medicine, Witten/Herdecke University, Germany
| | - Leonard Fehring
- Faculty of Health, School of Medicine, Witten/Herdecke University, Germany; Helios Universitätsklinik Wuppertal, Klinik für Gastroenterologie, Hepatologie, Endokrinologie und Diabetologie, Wuppertal, Germany.
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Rodrigue JR, Shenkel J, Boger M, Pomahac B, Fleishman A. Video Messaging to Increase Vascularized Composite Allograft Donation Willingness in United States Military Veterans. Transplant Direct 2022; 8:e1355. [PMID: 36204186 PMCID: PMC9531254 DOI: 10.1097/txd.0000000000001355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 05/31/2022] [Accepted: 06/02/2022] [Indexed: 11/27/2022] Open
Abstract
Expansion of vascularized composite allograft (VCA) transplantation depends on the public's willingness to donate VCA organs, including face, extremities, and genitourinary organs. This study evaluated the effectiveness of video messaging on VCA donation willingness in US military veterans, a key stakeholder in VCA transplantation. Methods Participants (n = 556) were randomized to 1 of 3 VCA video messaging interventions (informational, testimonial, or blended), a general (non-VCA) organ donation video message, or a control (nondonation) video message. Questionnaires were completed at pre- and postintervention and at 3-wk follow-up. Results Veterans exposed to any VCA video messaging were more likely to express VCA donation willingness (69%, n = 203/296) than those exposed to general donation messaging (53%, n = 47 of 89; P = 0.006) or No Donation Messaging (37%, n = 36 of 97; P < 0.001). A significantly higher proportion of participants who received Blended VCA Messaging were willing to be VCA donors, compared with the Informational VCA Messaging group (79% versus 61%, P = 0.006). Each VCA messaging video resulted in a significant pre- to postintervention increase in the proportion of participants willing to donate their own face, hands, and legs (P < 0.03). Conclusions Brief educational videos focused on VCA transplantation can have a demonstrable and verifiable impact on rates of VCA donation willingness in veterans.
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Affiliation(s)
- James R. Rodrigue
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA
- Department of Surgery, Harvard Medical School, Boston, MA
| | - Jessica Shenkel
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA
| | | | - Bohdan Pomahac
- Department of Surgery, Yale School of Medicine, Yale University, New Haven, CT
| | - Aaron Fleishman
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA
- Department of Surgery, Harvard Medical School, Boston, MA
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Wall SP, Castillo P, Shuchat-Shaw F, Norman E, Brown D, Martinez-López N, López-Ríos M, Seixas AA, Plass JL, Ravenell JE. Targeting versus Tailoring Educational Videos for Encouraging Deceased Organ Donor Registration in Black-Owned Barbershops. JOURNAL OF HEALTH COMMUNICATION 2022; 27:37-48. [PMID: 35170401 PMCID: PMC9050793 DOI: 10.1080/10810730.2022.2035021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
In the U.S., black men are at highest risk for requiring kidney transplants but are among those least likely to register for organ donation. Prior outreach used videos culturally targeted for Black communities, yet registration rates remain insufficient to meet demand. Therefore, we assessed whether generic versus videos culturally targeted or personally tailored based on prior organ donation beliefs differentially increase organ donor registration. In a randomized controlled trial, 1,353 participants in Black-owned barbershops viewed generic, targeted, or tailored videos about organ donation. Logistic regression models assessed the relative impact of videos on: 1) immediate organ donor registration, 2) taking brochures, and 3) change in organ donation willingness stage of change from baseline. Randomization yielded approximately equal groups related to demographics and baseline willingness and beliefs. Neither targeted nor tailored videos differentially affected registration compared with the generic video, but participants in targeted and tailored groups were more likely to take brochures. Targeted (OR = 1.74) and tailored (OR = 1.57) videos were associated with incremental increases in organ donation willingness stage of change compared to the generic video. Distributing culturally targeted and individually tailored videos increased organ donor willingness stage of change among Black men in Black-owned barbershops but was insufficient for encouraging registration.Abbreviations: CI - confidence interval; DMV - Department of Motor Vehicles; BOBs - Black-owned barbershops; ODBI - organ donation belief index; ODWS - organ donation willingness stage of change; OR - odds ratio.
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Affiliation(s)
- Stephen P. Wall
- Ronald O. Perelman Department of Emergency Medicine, NYU Grossman School of Medicine, New York, New York
- Department of Population Health, NYU Grossman School of Medicine, New York, New York
- Department of Administration, Leadership, and Technology, NYU Steinhardt School of Culture, Education, and Human Development, New York, New York
| | - Patricio Castillo
- Ronald O. Perelman Department of Emergency Medicine, NYU Grossman School of Medicine, New York, New York
- Department of Population Health, NYU Grossman School of Medicine, New York, New York
| | - Francine Shuchat-Shaw
- Department of Administration, Leadership, and Technology, NYU Steinhardt School of Culture, Education, and Human Development, New York, New York
| | - Elizabeth Norman
- Department of Applied Statistics, Social Science, and Humanities, NYU Steinhardt School of Culture, Education, and Human Development, New York, New York
| | - David Brown
- Ronald O. Perelman Department of Emergency Medicine, NYU Grossman School of Medicine, New York, New York
- Department of Population Health, NYU Grossman School of Medicine, New York, New York
| | - Natalia Martinez-López
- Ronald O. Perelman Department of Emergency Medicine, NYU Grossman School of Medicine, New York, New York
- Department of Population Health, NYU Grossman School of Medicine, New York, New York
| | - Mairyn López-Ríos
- Ronald O. Perelman Department of Emergency Medicine, NYU Grossman School of Medicine, New York, New York
- Department of Population Health, NYU Grossman School of Medicine, New York, New York
- Milken Institute School of Public Health, George Washington University, Washington, D.C
| | - Azizi A. Seixas
- Department of Population Health, NYU Grossman School of Medicine, New York, New York
- Department of Psychiatry, NYU Grossman School of Medicine, New York, New York
| | - Jan L. Plass
- Department of Administration, Leadership, and Technology, NYU Steinhardt School of Culture, Education, and Human Development, New York, New York
| | - Joseph E. Ravenell
- Department of Population Health, NYU Grossman School of Medicine, New York, New York
- Department of Medicine, NYU Grossman School of Medicine, New York, New York
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Crawshaw J, Li AH, Garg AX, Chassé M, Grimshaw JM, Presseau J. Identifying behaviour change techniques within randomized trials of interventions promoting deceased organ donation registration. Br J Health Psychol 2021; 27:822-843. [PMID: 34889488 DOI: 10.1111/bjhp.12575] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 10/29/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Increasing deceased organ donation registration may increase the number of available organs for transplant to help save lives. This study aimed to identify which behaviour change techniques (BCTs; or 'active ingredients') are reported within randomized trials of interventions promoting deceased organ donation registration and of those, which are associated with a larger intervention effect. METHODS We conducted a secondary analysis of 45 trials included in a Cochrane systematic review of deceased organ donation registration interventions. Two researchers used the BCT Taxonomy v1 to independently code intervention content in all trial groups. Outcome data were pooled and we used meta-regression to explore associations between individual and combinations of recurring BCTs and effect on registration intention and/or registration behaviour. RESULTS A total of 27 different BCTs (mean = 3.7, range = 1-9) were identified in intervention groups across the 45 trials. The five most common BCTs were: 'Information about health consequences' (71%); 'Instruction on how to perform the behaviour' (47%); 'Salience of consequences' (40%); 'Adding objects to the environment' (28%); and 'Credible source' (27%). Comparator groups in 20/45 trials also included identifiable BCTs (n = 12, mean = 3.1, range = 1-7). Meta-regression revealed that a combination of the three most common BCTs was associated with a larger intervention effect size for registration behaviour (k = 8, β = .19, p = .02). CONCLUSIONS Trials of deceased organ donation registration interventions focus predominantly on providing information, instruction, and a means to register. While potentially effective, a much wider set of possible BCTs could be leveraged to address known barriers to registration.
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Affiliation(s)
- Jacob Crawshaw
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ontario, Canada.,School of Epidemiology & Public Health, University of Ottawa, Ontario, Canada
| | - Alvin H Li
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ontario, Canada
| | - Amit X Garg
- Lawson Health Research Institute, London, Ontario, Canada.,Institute for Clinical Evaluative Sciences (ICES), London, Ontario, Canada.,Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada.,Division of Nephrology, Western University, London, Ontario, Canada
| | - Michaël Chassé
- Department of Medicine (Critical Care), University of Montreal Hospital, Quebec, Canada
| | - Jeremy M Grimshaw
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ontario, Canada.,School of Epidemiology & Public Health, University of Ottawa, Ontario, Canada.,Department of Medicine, University of Ottawa, Ontario, Canada
| | - Justin Presseau
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ontario, Canada.,School of Epidemiology & Public Health, University of Ottawa, Ontario, Canada.,School of Psychology, University of Ottawa, Ontario, Canada
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Morinelli TA, Taber DJ, Su Z, Rodrigue JR, Sutton Z, Chastain M, Tindal TT, Weeda E, Mauldin PD, Casey M, Bian J, Baliga P, DuBay DA. A Dialysis Center Educational Video Intervention Increases Patient Self-Efficacy and Kidney Transplant Evaluations. Prog Transplant 2021; 32:27-34. [PMID: 34874194 DOI: 10.1177/15269248211064882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction: The optimal treatment for end-stage kidney disease is renal transplant. However, only 1 in 5 (21.5%) patients nationwide receiving dialysis are on a transplant waitlist. Factors associated with patients not initiating a transplant evaluation are complex and include patient specific factors such as transplant knowledge and self-efficacy. Research Question: Can a dialysis center-based educational video intervention increase dialysis patients' transplant knowledge, self-efficacy, and transplant evaluations initiated? Design: Dialysis patients who had not yet completed a transplant evaluation were provided a transplant educational video while receiving hemodialysis. Patients' transplant knowledge, self-efficacy to initiate an evaluation, and dialysis center rates of transplant referral and evaluation were assessed before and after this intervention. Results: Of 340 patients approached at 14 centers, 252 (74%) completed the intervention. The intervention increased transplant knowledge (Likert scale 1 to 5: 2.53 [0.10] vs 4.62 [0.05], P < .001) and transplant self-efficacy (2.55 [0.10] to 4.33 [0.07], P < .001. The incidence rate per 100 patient years of transplant evaluations increased 85% (IRR 1.85 [95% CI: 1.02, 3.35], P = .0422) following the intervention. The incidence rates of referrals also increased 56% (IRR 1.56 [95% CI: 1.03, 2.37], P = .0352), while there was a nonsignificant 47% increase in incidence rates of waitlist entries (IRR 1.47 [95% CI: 0.45, 4.74], P = .5210). Conclusion: This dialysis center-based video intervention provides promising preliminary evidence to conduct a large-scale randomized controlled trial to test its effectiveness in increasing self-efficacy of dialysis patients to initiate a transplant evaluation.
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Affiliation(s)
| | - David J Taber
- Medical University of South Carolina, Charleston, SC, USA.,Ralph H. Johnson Veterans' Hospital, Charleston, SC, USA
| | - Zemin Su
- Medical University of South Carolina, Charleston, SC, USA
| | - James R Rodrigue
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Zachary Sutton
- Medical University of South Carolina, Charleston, SC, USA
| | - Misty Chastain
- Medical University of South Carolina, Charleston, SC, USA
| | | | - Erin Weeda
- Medical University of South Carolina, Charleston, SC, USA
| | | | - Michael Casey
- Medical University of South Carolina, Charleston, SC, USA
| | - John Bian
- Medical University of South Carolina, Charleston, SC, USA
| | | | - Derek A DuBay
- Medical University of South Carolina, Charleston, SC, USA
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Wall SP, Castillo P, Shuchat Shaw F, Norman E, Martinez-Lopez N, Lopez-Rios M, Paulino H, Homer B, Plass JL, Ravenell JE. Including Medical Footage and Emotional Content in Organ Donation Educational Videos for Latinx Viewers. HEALTH EDUCATION & BEHAVIOR 2021; 49:424-436. [PMID: 34253089 DOI: 10.1177/10901981211022240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We assessed whether videos with medical footage of organ preservation and transplantation plus sad, unresolved, or uplifting stories differentially affect deceased organ donor registration among clients in Latinx-owned barbershops and beauty salons. In a 2 × 3 randomized controlled trial, participants (N = 1,696, mean age 33 years, 67% female) viewed one of six videos. The control portrayed a mother who received a kidney (uplifting), excluding medical footage. Experimental videos included medical footage and/or showed a mother waiting (unresolved) or sisters mourning their brother's death (sad). Regression models assessed relative impact of medical footage and storylines on: (1) registry enrollment, (2) donation willingness stage of change, and (3) emotions. Randomization yielded approximately equal groups relative to age, sex, education, religion, nativity, baseline organ donation willingness, beliefs, and emotions. Overall, 14.8% of participants registered. Neither medical footage, sad, nor unresolved stories differentially affected registration and changes in organ donation willingness. Sad and unresolved stories increased sadness and decreased positive affect by ~0.1 logits compared with the uplifting story. Educational videos about organ donation which excluded or included medical footage and varying emotional valence of stories induced emotions marginally but did not affect viewers' registration decisions differently. Heterogeneity of responses within video groups might explain the attenuated impact of including medical footage and varying emotional content. In future work, we will report qualitative reasons for participants' registration decisions by analyzing the free text responses from the randomized trial and data from semistructured interviews that were conducted with a subset of participants.
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Affiliation(s)
- Stephen P Wall
- NYU Grossman School of Medicine, New York City, NY, USA.,NYU Steinhardt School of Culture, Education, and Human Development, New York City, NY, USA
| | | | - Francine Shuchat Shaw
- NYU Steinhardt School of Culture, Education, and Human Development, New York City, NY, USA
| | - Elizabeth Norman
- NYU Steinhardt School of Culture, Education, and Human Development, New York City, NY, USA
| | | | - Mairyn Lopez-Rios
- NYU Grossman School of Medicine, New York City, NY, USA.,George Washington University Milken Institute School of Public Health, Washington, DC, USA
| | - Hehidy Paulino
- NYU Grossman School of Medicine, New York City, NY, USA.,Weill Cornell Medical College, New York City, NY, USA
| | - Bruce Homer
- The City University of New York, New York City, NY, USA
| | - Jan L Plass
- NYU Steinhardt School of Culture, Education, and Human Development, New York City, NY, USA
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Ward S, Boger M, Fleishman A, Shenkel J, Calvo A, Pomahac B, Zwolak R, Krishnan N, Rodrigue JR. Attitudes Toward Organ, Tissue, and Vascularized Composite Allograft (VCA) Donation and Transplantation: A Survey of United States Military Veterans. Transplantation 2021; 105:1116-1124. [PMID: 32639399 DOI: 10.1097/tp.0000000000003376] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND There are 20 million living US armed forces veterans; however, the organ donation attitudes of veterans have not been examined. METHODS Over a 17-month period, a convenience sample of 1517 veterans in New England completed a survey to assess attitudes about organ, tissue, and vascularized composite allograft (VCA) donation. RESULTS Most veterans (96%) supported the donation of organs and tissue for transplantation, and 59% were registered as an organ and tissue donor. Being younger (adjusted odds ratio [aOR]: 0.960.970.98; P = 0.01), female (aOR: 1.061.462.03; P = 0.02), non-Hispanic white (aOR: 1.302.073.30; P = 0.01), Hispanic (aOR: 1.282.434.61; P = 0.01), and having more trust that the transplant process is fair and equal (aOR: 1.191.401.65; P = 0.01) were predictive of donor registration. Also, most veterans were willing to donate their face (57%), hands/arms (81%), legs (81%), penis (men: 61%), and uterus (women: 76%) at time of death; donation willingness was higher for upper and lower limbs than for face or genitourinary organs (P < 0.001). Those unwilling to donate VCA organs expressed concerns about identity loss, psychological discomfort of self and others, body integrity, funeral presentation, and religious beliefs. Most (54%) felt that VCA donation should require permission of legal next-of-kin at the time of one's death, even if the decedent was a registered donor. CONCLUSIONS There is a high level of support for organ, tissue, and VCA transplantation and donation among veterans, despite limited educational campaigns targeting this population. There is high potential among veterans to further increase donor registry enrollment and raise awareness about VCA benefits for severely injured service members.
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Affiliation(s)
- Stephanie Ward
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA
| | | | - Aaron Fleishman
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA
| | - Jessica Shenkel
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA
| | - Amanda Calvo
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA
| | - Bohdan Pomahac
- Department of Surgery, Brigham and Women's Hospital, Boston, MA
- Harvard Medical School, Boston, MA
| | - Robert Zwolak
- Department of Surgery, Veterans Affairs Medical Center, Manchester, NH
- Department of Surgery, Veterans Affairs Medical Center, White River Junction, VT
| | - Namrata Krishnan
- Department of Medicine, Veterans Affairs Medical Center, West Haven, CT
- Department of Medicine, Yale School of Medicine, New Haven, CT
| | - James R Rodrigue
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA
- Harvard Medical School, Boston, MA
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11
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Li AH, Lo M, Crawshaw JE, Dunnett AJ, Naylor KL, Garg AX, Presseau J. Interventions for increasing solid organ donor registration. Cochrane Database Syst Rev 2021; 4:CD10829. [PMID: 35608942 PMCID: PMC8164549 DOI: 10.1002/14651858.cd010829.pub2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND A solution for increasing the number of available organs for transplantation is to encourage more individuals to register a commitment for deceased organ donation. However, the percentage of the population registered for organ donation remains low in many countries. OBJECTIVES To evaluate the benefits and harms of various interventions used to increase deceased organ donor registration. SEARCH METHODS We searched the Cochrane Kidney and Transplant Register of Studies up to 11 August 2020 through contact with an Information Specialist using search terms relevant to this review. Studies in the Register are identified through searches of CENTRAL, MEDLINE, and EMBASE, conference proceedings, the International Clinical Trials Register Search Portal and ClinicalTrials.gov. SELECTION CRITERIA We included all randomised controlled trials (RCTs), cluster RCTs and quasi-RCTs of interventions to promote deceased organ donor registration. We included studies if they measured self-reported or verified donor registration, intention to donate, intention to register a decision or number of individuals signing donor cards as outcomes. DATA COLLECTION AND ANALYSIS Two authors independently assessed retrieved studies and extracted data from included studies. We assessed studies for risk of bias. We obtained summary estimates of effect using a random-effects model and expressed results as risk ratios (RR) (95% confidence intervals; CI) for dichotomous outcomes and mean difference (MD; 95% CI) or standardised mean difference (SMD; 95% CI) for continuous outcomes. In multi-arm trials, data were pooled to create single pair-wise comparisons. Analyses were stratified by specific intervention setting where available. MAIN RESULTS Our search strategy identified 46 studies (47 primary articles, including one abstract) comprising 24 parallel RCTs, 19 cluster RCTs and 3 quasi-RCTs. Sample sizes ranged from 138 to 1,085,292 (median = 514). A total of 16 studies measured registration behaviour, 27 measured intention to register/donate and three studies measured both registration behaviour and intention to register. Interventions were delivered in a variety of different settings: schools (14 studies), driver's motor vehicle (DMV) centres (5), mail-outs (4), primary care centres (3), workplaces (1), community settings (7) and general public (12). Interventions were highly varied in terms of their content and included strategies such as educational sessions and videos, leveraging peer leaders, staff training, message framing, and priming. Most studies were rated as having high or unclear risk of bias for random sequence generation and allocation concealment and low risk for the remainder of the domains. Data from 34/46 studies (74%) were available for meta-analysis. Low certainty evidence showed organ donation registration interventions had a small overall effect on improving registration behaviour (16 studies, 1,294,065 participants: RR 1.30, 95% CI 1.19 to 1.43, I2 = 84%), intention to register/donate (dichotomous) (10 studies, 10,838 participants: RR 1.21, 95% CI 1.03 to 1.42, I2 = 91%) and intention to register/donate (continuous) (9 studies, 3572 participants: SMD 0.23, 95% CI 0.11 to 0.36, I2 = 67%). Classroom-based interventions delivered in a lecture format by individuals from the transplant community may be effective at increasing intention to register/donate (3 studies, 675 participants: RR 1.33, 95% CI 1.15 to 1.55, I² = 0%). Community interventions targeting specific ethnic groups were generally effective at increasing registration rates (k = 5, n = 4186; RR 2.14, 95% CI 1.35 to 3.40, I² = 85%), although heterogeneity was high. In particular, interventions delivered in the community by trained peer-leaders appear to be effective (3 studies, 3819 participant: RR 2.09, 95% CI 1.08 to 4.06, I² = 87%), although again, the data lacked robustness. There was some evidence that framing messages (e.g. anticipated regret) and priming individuals (e.g. reciprocity) in a certain way may increase intention to register/donate, however, few studies measured this effect on actual registration. Overall, the studies varied significantly in terms of design, setting, content and delivery. Selection bias was evident and a quarter of the studies could not be included in the meta-analysis due to incomplete outcome data reporting. No adverse events were reported. AUTHORS' CONCLUSIONS In our review, we identified a variety of approaches used to increase organ donor registration including school-based educational sessions and videos, leveraging peer leaders in the community, DMV staff training, targeted messaging and priming. The variability in outcome measures used and incompleteness in reporting meant that most data could not be combined for analysis. When data were combined, overall effect sizes were small in favour of intervention groups over controls, however, there was significant variability in the data. There was some evidence that leveraging peer-leaders in the community to deliver organ donation education may improve registration rates and classroom-based education from credible individuals (i.e. members of the transplant community) may improve intention to register/donate, however, there is no clear evidence favouring any particular approach. There was mixed evidence for simple, low-intensity interventions utilising message framing and priming. However, it is likely that interest in these strategies will persist due to their reach and scalability. Further research is therefore required to adequately address the question of the most effective interventions for increasing deceased organ donor registration.
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Affiliation(s)
- Alvin H Li
- Department of Epidemiology and Biostatistics, Western University, London, Canada
| | - Marcus Lo
- London Health Sciences Centre, London, Canada
| | - Jacob E Crawshaw
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Alexie J Dunnett
- Department of Medicine - Nephrology, London Health Sciences Centre, London, Canada
| | | | - Amit X Garg
- Department of Medicine, Epidemiology and Biostatistics, Western University, London, Canada
| | - Justin Presseau
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
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12
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Reynolds-Tylus T, Quick BL, Bigman CA, Williamson LD. An examination of teenagers' beliefs toward organ donor registration. Clin Transplant 2021; 35:e14237. [PMID: 33527535 DOI: 10.1111/ctr.14237] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 12/10/2020] [Accepted: 01/23/2021] [Indexed: 11/29/2022]
Abstract
Teenagers represent a promising target population for organ donor registration efforts, as in the US teenagers age 15-17 may register their intent for organ donation, which later translates to consent at age 18. However, teenagers constitute a relatively understudied population in the organ donation literature. A sample of teenagers (N = 466) ranging in age from 13 to 19 was recruited from driver's education schools in Ohio and Michigan in order to learn more about their perceived reasons for and against registering as an organ donor. A coding scheme was developed, and responses were coded by two trained coders. In line with previous work in adult samples, our results revealed the three most common reasons for registering were prosocial benefits, rational arguments, and personal experience. In contrast to previous work among adults, the two most common reasons for not registering were bodily integrity and religious reasons. Several novel beliefs among teenagers that were both supportive and non-supportive of organ donor registration were identified. Findings from the current study are discussed with an emphasis on implications for practitioners working to promote organ donor registration among teenage audiences.
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Affiliation(s)
| | - Brian L Quick
- Department of Communication, University of Illinois at Urbana-Champaign, Urbana, IL, USA.,College of Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Cabral A Bigman
- Department of Communication, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Lillie D Williamson
- Department of Communication Arts, University of Wisconsin-Madison, Madison, WI, USA
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13
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Van Pilsum Rasmussen SE, Uriarte J, Anderson N, Doby B, Ferzola A, Sung H, Cooney C, Brandacher G, Gordon E, Segev DL, Henderson ML. Public education materials about Vascular Composite Allotransplantation and donation in the United States: Current scope and limitations. Clin Transplant 2020; 34:e14066. [PMID: 32810365 DOI: 10.1111/ctr.14066] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 07/28/2020] [Accepted: 08/11/2020] [Indexed: 11/27/2022]
Abstract
As the field of Vascular Composite Allotransplantation (VCA) grows, demand for VCA donations will increase. The public should be made aware of this treatment option to support patients' informed decision-making and authorization for deceased donation. We assessed the availability and quality of existing VCA public education materials from organ procurement organizations (OPOs), transplant centers, the Organ Procurement and Transplant Network, Veterans Affairs, and the Department of Defense. A content analysis was performed to identify topics covered and important gaps. In total, 1314 public education materials were analyzed, including OPO Facebook posts (61.6%), OPO Twitter posts (29.9%), websites (6.4%), and written documents (eg, fact sheets, research reports) (2.1%). Upper extremity (34.7%) and face (34.5%) transplants were more commonly covered than reproductive (6.4%) or other VCA types (2.8%). Most materials (76.6%) referenced a specific VCA story. However, few materials described which patient population could benefit from VCA (eg, Veterans, amputees, burn victims, 16.4%), the authorization requirements for VCA donation (6.6%), or the appearance of transplanted VCA organs (1.2%). Current VCA public education materials do not adequately educate the public. More comprehensive education materials are needed to prepare the public to authorize VCA donation, become potential donors, or learn about transplant options.
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Affiliation(s)
| | - Jefferson Uriarte
- Center for Health Services and Outcomes Research, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Naomi Anderson
- Center for Health Services and Outcomes Research, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Brianna Doby
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Alexander Ferzola
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Hannah Sung
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Carisa Cooney
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Gerald Brandacher
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Elisa Gordon
- Center for Health Services and Outcomes Research, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.,Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Dorry L Segev
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.,Department of Acute and Chronic Care, Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
| | - Macey L Henderson
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Department of Acute and Chronic Care, Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
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14
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Stadlbauer V, Zink C, Likar P, Zink M. Family discussions and demographic factors influence adolescent's knowledge and attitude towards organ donation after brain death: a questionnaire study. BMC Med Ethics 2020; 21:57. [PMID: 32646404 PMCID: PMC7346659 DOI: 10.1186/s12910-020-00499-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 06/29/2020] [Indexed: 11/21/2022] Open
Abstract
Background Knowledge and attitude towards organ donation are critical factors influencing organ donation rate. We aimed to assess the knowledge and attitude towards organ donation in adolescents in Austria and Switzerland. Methods A paper-based survey was performed in two secondary schools (age range 11–20 years) in Austria and Switzerland. 354/400 surveys were sufficiently answered and analyzed. Results Our study found that knowledge on organ donation is scarce in adolescents. Less than 60% of those surveyed thinks that a person is dead when declared brain dead. 84.6% would authorize organ donation after brain death for themselves, but only 69% would authorize organ donation after brain death for a close relative. 93.7% would accept a donor organ if they needed one. Family discussions, rather than school discussions, influenced knowledge on organ donation, the percentage of respondents who have a firm opinion on organ donation and the rate of declaration of this opinion. Age, gender, nationality and religion also influenced knowledge and attitude towards organ donation. Nearly one third of adolescents are of the opinion that selling non-vital organs should be legalized. Conclusion Since having had family discussions, a potentially modifiable factor, was positively associated with knowledge and attitude towards organ donation, we postulate that educational programs stimulating family discussions on organ donation may be a promising strategy to increase knowledge.
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Affiliation(s)
- Vanessa Stadlbauer
- Department of Internal Medicine, Research Unit "Transplantation Research", Division of Gastroenterology and Hepatology, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria.
| | - Christoph Zink
- Department of Anaesthesiology and Intensive Care Medicine, Hospital of the Brothers of St. John of God, St. Veit an der Glan, Austria and Hospital of the Elisabethinen Klagenfurt, Klagenfurt, Austria
| | - Paul Likar
- Department of Anaesthesiology and Intensive Care Medicine, Hospital of the Brothers of St. John of God, St. Veit an der Glan, Austria and Hospital of the Elisabethinen Klagenfurt, Klagenfurt, Austria
| | - Michael Zink
- Department of Anaesthesiology and Intensive Care Medicine, Hospital of the Brothers of St. John of God, St. Veit an der Glan, Austria and Hospital of the Elisabethinen Klagenfurt, Klagenfurt, Austria
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