The donor shortage is widely considered the single greatest challenge in transplantation today. African Americans (AAs) present a startling incongruity. While representing 34% of kidney transplant candidates, they only make up 14% of deceased and 12% of living donors. Thus, there have been increasing efforts to enhance AAs’ commitment to organ and tissue donation (OTD) in order to increase the donor pool. Project Giving ACTS (About Choices in Transplantation and Sharing) is a culturally-sensitive OTD education intervention that seeks to increase donation-related knowledge, attitudes, and registration on the state donor registry. This multi-level evaluation study tests the following hypotheses: a. Intervention participants will demonstrate significantly improved OTD-related knowledge, attitudes, endorsement of pro-donation statements, and willingness to donate and decreased endorsement of anti-donation statements from pre- to post educational intervention. b. Intervention ZIP codes will demonstrate a greater increase in new donor registrations than control ZIP codes.Methods
This study used a single-group, pre-post design at the individual level and a multiple time series design at the ZIP code level. The Giving ACTS intervention consists of a DVD and booklet that was shown to 1,582 participants in groups of 3 to 19 people in community settings.Results
At the individual level, there was a significant increase in 4 of 5 outcomes from baseline to immediate follow-up: Knowledge (B=−.4), attitudes (B=−2.4), endorsement of pro-donation statements (B=−1.1), and willingness to donate (B=−.3; all ps =.000). However, a time-series analysis demonstrated little difference in new donor registrations between the intervention and control ZIP codes (see Figure 1).Conclusions
Increasing public commitment to OTD among AAs is challenging because of generally low levels of knowledge and negative attitudes towards OTD. Whereas Giving ACTS may have helped improve knowledge, attitudes, and willingness to donate among participants, it was unrelated to population-level change in registration rates, perhaps due to: (1) low population penetration for the study; (2) the need for a more intensive individually-tailored intervention; and (3) long histories of distrust of healthcare. Additional research is needed to determine how to increase state donor registrations, particularly in areas with low registration rates and high concentrations of AAs.Conclusions
National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases (5R01DK079713-10).Conclusions
1. United States Census Bureau (2017). Race. Available at https://www.census.gov/topics/population/race.html. Accessed April 14, 2017.Conclusions
2. Organ Procurement and Transplantation Network (2017). National Data: Donors. Available at https://optn.transplant.hrsa.gov/data/view-data-reports/national-data/. Accessed April 14, 2017.