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Report on the DOT Grant Program 1999–2004 (PDF - 161KB)
Social and Behavioral Interventions to Increase Organ Donation Grant Program
Project Summaries: Social and Behavioral Interventions to Increase Solid Organ Donation
Fiscal Year 2013 Grantees
This project addresses the documented negative association between Organ Procurement Coordinators’ (OPCs) familial consent rates and racial/ethnic diversity of donation service area. The Positive Deviance (PD) approach provides a theoretical framework for the project. PD indicates that within any community there exist individuals who enact specific behaviors that allow them to thrive despite surrounding circumstances. The project will identify novel communication behaviors employed by OPCs who maintain high consent rates despite being located in racially/ethnically diverse areas (i.e., PD behaviors) and will disseminate such strategies among participating Organ Procurement Organizations (OPOs) toward the goal of improving familial communication and subsequent consent rates. The PD approach encourages OPCs to be active participants in each stage of intervention development, implementation, and evaluation. During the first year of the project, OPCs at 11 participating OPOs will complete interviews designed to identify PD behaviors. A proportion of these OPCs will also participate in a collaborative workshop designed to clarify the meaning of identified PD behaviors and will assist in creating an educational video for dissemination across participating OPOs that discusses and demonstrates such behaviors. During years two and three of the project, participating OPCs will complete educational sessions and refresher courses that employ a variety of active learning methods to increase knowledge of PD behaviors. Project success will be tracked by measuring OPCs’ quarterly consent rates and by examining the association between OPCs’ self-reported use of PD behaviors with familial consent and case characteristics.
This study will develop and test a new approach to educating hospital staff involved in the organ donation process. In many hospitals, OPO staff is not able to reach all staff in person and must rely in part on the hospital’s orientation process to address organ donation. This is typically done as part of a longer presentation, with only a few minutes dedicated to organ donation. The high turnover rate in the nursing profession, especially in the stressful environment of the critical care unit, leads to inconsistent and potentially inadequate knowledge and understanding of the organ donation process. Building on our CME accredited online course for primary care providers, we will develop a new version for use in hospitals. The course will be designed to be relevant for all staff that comes into contact with the organ donation and recovery process – physicians, nurses, social workers, and chaplains. eLearning programs are highly valued by organizations and individual participants due to the low cost, consistency, and flexibility. We hypothesize that in hospitals where all eligible staff has had consistent, up to date training, the environment will be more positively disposed toward donation, and there will be fewer process breakdowns that lead to loss of potential donors, leading to a higher number of donors and higher authorization rate.
This study builds on prior work that developed and tested the Communicating Effectively about Donation (CEaD) training program, a communication skills training program that successfully increased the consent rates of OPO staff who request deceased organ donation at 8 OPOs located around the United States. The purpose of this project is to conduct an effectiveness and implementation study based on the principles of the RE-AIM model (Reach, Efficacy, Adoption, Implementation, Maintenance). One of the unique aspects of the approach is the intent to create capacity in OPOs for assessment and training for sustained and constant improvement once this project is completed. The CEaD does not necessarily supplant local or intensive on-site programs, rather, it provides OPOs with the capacity to allow busy OPO staff to learn and review evidence-based communication skills on a regular and consistent basis and in accordance with their work schedules. The aims of the study are to: (1) Re-package the CEaD as a wholly self-contained communication skills training tool that provides basic and continuous training for any OPO staff to use; (2) Test the uptake and acceptability of the CEaD2 outside the confines of a randomized clinical trial by implementing a social marketing campaign; (3) Test the effectiveness of the CEaD2 training program to improve communication skills and increase authorization to organ donation.
This project will test the effectiveness of disseminating a living donation kidney transplant (LDKT) education program called Explore Transplant (ET) by partnering with a large health insurance organization to deliver video-guided transplant education supported by telephone and mail. The Missouri Kidney Program (MoKP) is a state-wide organization who subsidizes the costs of dialysis medication for low-income ESRD patients, thus they operate as an insurance company. With 900 MoKP dialysis patients, we will conduct an eight-month, group randomized controlled trial (GRCT) where 600 patients will be randomized to receive: (1) no additional transplant education; (2) a video-guided, four-part ET program (Patient-guided education); or (3) a video-guided ET program with discussion facilitated by a case manager (Case-Manager guided). The grant aims are to understand the transplant educational needs and barriers to learning faced by low-income Black and White ESRD patients and improve LDKT knowledge. At the conclusion of this study, we will have assessed how different educational delivery strategies common to health insurance companies affect ESRD patients’ informed LDKT decision-making and developed a set of recommendations for ideal transplant education dissemination nationally by health insurance programs.
Fiscal Year 2012 Grantees
The purpose of this proposal is to create and evaluate a new culturally-targeted living kidney donation (LKD) educational intervention for American Indians with Stage III or greater chronic kidney disease who may become eligible for preemptive referral for transplant. The intervention will be conducted in the places where American Indians in Minnesota receive community based health services. "A Circle of Learning" is a theory-based intervention that integrates LKD education and education on deceased donation with the population's oral tradition of story-telling. It will be delivered by tribal outreach staff. This pilot study is a two-group randomized trial (N = 200) that employs a community-based participatory research approach. The primary outcome of LKD knowledge is measured at baseline and after intervention exposure using the Living Kidney Donation and Transplantation Knowledge Scale developed by Dr. James Rodrigue (Beth Israel Deaconess Medical Center, Harvard Medical School). The consortium includes Hennepin County Medical Center, South Dakota State University, and LifeSource, the Upper Midwest Organ Procurement Organization.
This pilot study is designed to provide a preliminary test of an educational intervention aimed at improving kidney transplant candidates' knowledge of the opportunities for and process, relative benefits and risks associated with living and deceased donor kidney transplantation. The study will also test the program's efficacy in enhancing candidates' communication about these options with members of their social networks (i.e., friends and family). Utilizing a randomized controlled trial, the project has the following objectives: to identify communication factors associated with kidney transplant candidates' reluctance to discuss transplant options with members of their social networks; to develop a culturally sensitive educational program to improve kidney transplant candidates' understanding of the opportunities for and process, risks and benefits of living and deceased donor transplantation and to enhance candidates' intent to discuss their transplant options with others; to conduct a pilot test of the COACH Program to provide preliminary data on the program's efficacy and generalizability.
Fiscal Year 2011 Grantees
This will use a 2x2 factorial cluster randomized controlled trial to test the hypothesis that receiving a message about organ donation from a trusted medical provider in a context where it is possible to have questions answered and fears and misgivings addressed will have a direct effect on people’s decision to join the organ and tissue donor registry. The intervention (conducted in three modalities and one control) is for physicians and their office staff to ask all adult patients whether they are organ donors, and, if not, provide a brochure and donor card and offer to answer any questions. The control condition is a conventional poster and brochure placed in the waiting room of participating physician offices.
The objective of this study is to increase understanding about living kidney donation (LKD) among Hispanic/Latino patients and public by increasing knowledge and positive attitudes about LKD. The study proposes to: develop, test, and evaluate a culturally sensitive, web-based, multimedia educational resource on LKD in Spanish and English tailored to Hispanics. The proposed study will be conducted in partnership with the National Kidney Foundation of Illinois, who will host the website.
This study seeks to increase donation registration among Spanish Language Dominant Hispanics using a portable DVD player to create focused engagement and favorable activation while people wait at the Mexican Consulate. If successful, the results of this study offer a new context (Consulates) and a new method (portable DVD players with headphones) as a means of providing information and placing potential donors in the most efficacious mind set for increasing donor registration rates. Also tested is a new approach to addressing myths about donation based on the Risk Communication Framework.
This study seeks to increase discussions between physicians and patients about organ donation by: 1) showing a donation video to patients in primary care settings waiting to see their physician and 2) providing academic detailing of primary care physicians about the topic of donation. Evaluation outcomes include increases in willingness to donate, discussions with physicians, and consent to donate.
This study will form competitive teams with the aim of increasing organ donor registration. Most teams will be located on college campuses in the New York Metropolitan area. The goal of the study is to register 15,000 new donors.
Fiscal Year 2010 Grantees
This is an extension project to modify an existing and effective federally-funded educational intervention. The primary objective is to increase deceased donation and to increase understanding among patients who are waiting for organs of options for and the process, risks, and benefits of living donation.
This project will rigorously evaluate the efficacy of a novel intervention to engage dialysis center social workers and dialysis patient peer mentors in encouraging patients in Michigan dialysis centers to sign up in the Michigan Organ Donor Registry.
This project will implement and assess the efficacy of a home-based program that directly educates patients, an intervention to educate patients' loved ones, and a combined approach educating patients and families for a comprehensive educational experience about kidney transplantation.
This project will conduct a pilot study to implement and evaluate an intervention to increase organ donor registrations among 50–70 year old adults in this OPO's service area who have not already declared their intent to donate, but who are positive toward organ donation (positive potential non-consenting adults). The effectiveness of a dialogue process that involves participants in a participatory discussion about issues related to organ donation and specifically relates to people their age will be compared to a standard practice community education presentation strategy.
Fiscal Year 2009 Grantees
The need for organs is particularly great among African Americans who make up 12.4% of the U.S. population (14.1% Michigan) but 29% of those on the national waiting list (37.4% Michigan). The primary objective of the Take the Pledge project is to rigorously evaluate the efficacy of a novel intervention in alumni (or graduate) chapters of African American sororities and fraternities in Michigan to increase organ and tissue donation, as assessed by registration in the Michigan Organ Donor Registry. The project is using a cluster randomized design where African American alumni sorority and fraternity chapters are assigned to one of two groups -either an intensive intervention regarding organ donation or a delayed intervention group who initially receive a chronic disease prevention program (comparison chapters). The primary outcome will be actual registrations on the Michigan Organ Donor Registry via mail-in card and internet enrollment. The secondary outcome measure will be determination of differences between pre- and post-test surveys about participants' knowledge and attitudes regarding organ donation.
The goal of this project is to identify, among a diverse cohort of potential kidney transplant candidates, transplant center-based interventions that will increase understanding of the opportunities for and process, risks, and benefits of living kidney donation. The project team will assess transplant candidates' knowledge of living donor kidney transplant (LDKT), correlates of increased understanding of LDKT, and racial/ethnic differences in the understanding of LDKT. This project will test practical interventions that may efficiently increase transplant candidates' understanding of LDKT. These proposed interventions should be applicable and replicable at the 245 kidney transplant centers in the U.S.
As most people indicate they would like to hear about donation from their physicians and heavy patient loads consume the time of most physicians, this study is using MyChart—an electronic medical records system for physicians to communicate with patients outside of the office—to promote donation. MyChart allows patients to view their medical records by computer, to receive health information and education from their physician, and to communicate with them via email. Intervention subjects (N=350) will receive information via a multifaceted web-based education program including narrated programs, video of physicians discussing the importance of donation and enrollment, recipient and donor family testimonials and printable materials. A control group of equal size will not receive the intervention. Data will be collected through pre-post surveys and telephone interviews to gather qualitative information.
The study seeks to identify the most effective message appeal to encourage 18-year-old African American, Caucasian, and Hispanic adults to join the first-person consent donor registry in Illinois. In doing so, the project is conducting a race-stratified random digit dial phone survey (N = 600) to determine current attitudes, non-cognitive beliefs, controllability, efficacy, knowledge, reactance, subjective norms, intentions, and behaviors as they pertain to joining the first-person consent registry. From this information, the team will develop initial ideas for a mailer and tease out which specific appeals and media would attract attention, be comprehensible and relevant, and be void of insensitive material. This will be done through focus groups (N = 12) with 18-year-old African American, Caucasian, and Hispanic residents.
Fiscal Year 2008 Grantees
This project is incorporating an instructional design approach to develop a clerk training package. The target audience is West Virginia Division of Motor Vehicles (DMV) Customer Service Representatives. The project is using a randomized design to evaluate the impact of the web-based training on the probability that the driver's license customer agrees to join the registry.
This study is testing the use of the Communicating Effectively about Donation (CEaD) training program, a component of the Early Referral and Request Approach (ERRA) intervention, to raise consent rates to solid organ donation from the families of deceased patients when requests are made by organ procurement organizations (OPOs). Eight OPOs, located around the United States, and their coordinators who request organ donation, are participating as study sites and participants (n = 80). The proposal has the following specific aims: 1. Test the effectiveness of the CEaD to increase consent rates; 2. Test OPO implementation of the CEaD training under two conditions to ascertain best practices for implementation.
This intervention is assessing whether training dialysis providers to effectively present Explore Transplant, an education program designed to address dialysis patients' fears and questions about deceased and living donation, with their own patients can significantly increase the rates of living donation in four states. During the one-year intervention, the research team will conduct all-day Explore Transplant provider trainings in all four states, staff a transplant hotline, provide monthly podcasts and transplant newsletters, and offer center visits from transplant coordinators, kidney recipients, and living donors.
Fiscal Year 2007 Grantees
This project encourages HMO subscribers to declare their donation intention by enrolling in the state's donor registry and notifying their family of their intention to donate. The study will determine which modalities for HMO delivery of donation education are most effective.
A culturally specific, community-based education program was developed for African American barbers who serve as trusted messengers for some aspects of health education for their customers. The project will determine whether this grassroots intervention can influence African American men, over age 18, to make the commitment to organ donation.
This project explores whether improved transplant education for renal patients, not yet on dialysis, could increase the patients' willingness to pursue preemptive living donor transplant (PLDT). Research shows that PLDT, where a living donor transplant is done before the recipient's kidneys fail, offers better graft survival and lower mortality than living donor transplants following dialysis. The study will look at rural and minority patients' access to transplant education and assess racial, social, economic, and other influences on a patients' willingness to participate in the study.
Nearly 80 percent of Hispanics in the Southwest support organ donation and 35 percent want to be donors but have not registered their decision. This project offers a novel context, the swap meet, as the site for an educational intervention on organ donation. Hispanics represent 99 percent of the populations at the swap meet sites targeted in the study. A swap meet manual will be prepared.
The purpose of this project is to increase the number of living kidney donor consents among Hispanics in Los Angeles using two interventions: (1) a Kidney Health Literacy Intervention to increase comprehension of living kidney donation, and (2) a Living Donor Educational Intervention to facilitate the initiation of discussion between Hispanics in need of a kidney and a potential living donor.
Fiscal Year 2006 Grantees
This project is developing culturally sensitive materials for end-stage renal disease patients and families considering living donation and will test the effectiveness of a culturally sensitive social worker-led intervention to enhance rates of communication, donor evaluations, and transplantation. The social worker will distribute educational materials, facilitate discussion, and use problem-solving techniques to enable families to make decisions about living donation.
The purpose of this project is to increase registration rates through informational and educational interventions targeted at 50- to 70-year-old rural and urban Ohio residents who are not registered to donate. To address a lack of registry rate increase in this group when compared to the overall population, a unique message brochure is being designed based on identified barriers to donation and evaluated for its effectiveness with this population.
Living liver donor self-reports are informing the development and implementation of an educational process targeting potential recipients and living donors. The intervention addresses knowledge of living liver donation, post-donation quality of life, and ability to communicate relevant information to loved ones. Outcome measures include actual living donor consent rates, post-donation living liver donor health, and knowledge of living donation. For the population of individuals consenting to donate but found to be unsuitable for the intended recipient, intent to donate upon death will be measured.
To counter the misperception that people over age 50 are medically unsuitable to donate, age-tailored marketing style messages, rather than the traditional healthcare message, are being delivered to 50- to 65-year-olds in several geographic clusters. The messages are intended to change perceptions about who can donate thereby increasing organ donation entry into the Virginia Donor Registry. The message and the medium of delivery will be evaluated with behavior change and donor registration rates as outcome measures.
A multi-state, culturally-targeted intervention utilizing the Native-American tradition of storytelling and gift giving among the Plains tribes will be delivered to tribal colleges in the US Great Plains to address the need for kidney transplantation and the corresponding low donation consent rate. The intervention incorporates print, video, and web site materials. Outcome measures include improved readiness to sign up to as an organ donor, the move to action, and family notification.
DMV/Circuit Court clerks are being trained to provide simple, accurate information about organ donation and the DMV registry when Kentuckians are obtaining their driver's license. Additional approaches include stocked brochures, mailings with driver's license renewal materials, and outreach and mass media events. This campaign is intended to increase donor registrations and self-reported family discussions.
Fiscal Year 2005 Grantees
A mass media campaign and a grassroots advocacy program will be integrated to improve declaration of intent and family notification. The intervention takes place on a large university campus and consists of a media component, in-class presentations, and support from local religious leaders.
A three-phase intervention will target the 80% of the population that is in favor of donation through structured implementation of focus groups, community forums, and talk radio programs. It is intended to increase donor registration by creating contexts where positive attitudes are accessible, social norms support donation, and perception of difficulty in registering is minimized.
Medical students and medical residents in New York State will receive an educational intervention intended to positively affect knowledge, self-efficacy, and outcome expectations with respect to donation and, for residents, to improve communication with patients and families about donation. The intervention will be delivered via video, lecture, discussion groups, standardized patients, and online learning vignettes.
Cemetery professionals will participate in a program to prepare them to educate their clients, in the context of end-of-life decisions during pre-arrangement meetings, about the importance of donation and methods to declare intent. In addition to increasing rates of declaration of intent, the project is intended to establish effective collaboration among cemeterians, professional organizations, and organ procurement organizations.
In this group-randomized trial, a living donation education program will be implemented to increase dialysis patients' transplant knowledge, willingness to pursue living donation, and rates of living donation. This health education intervention consists of video and print material, exercises, and interactive discussion with health educators and is intended to promote the benefits of and reduce the fears associated with living donation.
Fiscal Year 2004 Grantees
This project implemented an evidenced-based workplace intervention designed to increase intentions to donate organs and tissues among lower socioeconomic and minority populations, mainly African-Americans, and Hispanics. The project used peer educators and a group of multifaceted interventions to increase intentions to donate among employees, to promote communication of this decision with family members, and to persuade family members to become donors themselves.
This study assessed the effectiveness of African American lay health advisors to educate their clients about organ and tissue donation and encourage clients to join the Michigan Donor Registry. The main outcome indicator was measured the number of organ donor registry cards returned to the Michigan Donor Registry. Changes in knowledge about and attitudes towards donation were assessed using pre- and post-tests.
This project sought to advance understanding of donation decision-making, evaluate individually tailored and community-based interventions, and refine these interventions aimed to increase organ donation among African Americans. The project measured intent to be an organ/tissue donor and documentation of that intent, e.g., by signing an organ donor card, and informing the family of the intent to donate.
The purpose of this program is to create a significantly higher rate of signed organ donor cards, driver's licenses, and/or New Jersey organ donor registry entries and a significantly higher rate of family notification of donation intent among employees of organizations in New Jersey who are involved in the Workplace Partnership for Life Campaign interventions.
This project implemented and evaluated a workplace partnership model for donor registration in Louisiana that can be incorporated into the existing infrastructure of home care professional organizations without substantially increasing personnel or operating costs.
This project sought to optimize access to live kidney transplantation for End Stage Renal Disease (ESRD) patients and to assess whether the implementation of an educational program early in the ESRD treatment process, i.e., in dialysis facilities, increases the number of ESRD patients who identify at least one certified willing live kidney donor. The project also measured the proportion of patients who request a kidney donation from family or friends and the number of completed donations.
This project established an ongoing education program for teens on organ and tissue donation in order to increase the number of high school students committed to donation and to encourage discussions with their families about donation. Students who have been trained to provide organ donation information to their peers established high school donation organizations. The project measured outcomes by the increases in family discussions about donation and increases in the declaration to donate, e.g., organ donor registrants.
Fiscal Year 2003 Grantees
The purpose of this two-year project was to implement a dual-featured intervention. The investigators developed and implemented a live organ donor media/community campaign and replicated a deceased donor campaign that was implemented in Tucson and Phoenix. The project aimed to appeal to the enhanced sense of family and community within the Hispanic culture to increase the number of live and deceased donors. Surveys and focus groups evaluated the project's effectiveness.
This project tested the ERRA Model to increase solid organ donation from brain dead patients. The model consists of hospital-tailored intervention modules plus communication modules based upon the information needs of family decision-makers. The intervention targeted OPO requesters, family decision-makers, and health-care providers. The investigators evaluated hospital barriers to time-sensitive referrals, a health care provider's ability to discuss organ donation with patients' families, and OPO requester's ability to optimize their approach to discussions of donation with families.
This two-year project developed and evaluated a health campaign intervention designed to increase intent to donate among Haitians living in Miami-Dade County. The four-phased intervention looked at the use and effectiveness of a theory-driven media and community outreach campaign to enhance intent to donate in immigrant populations. The campaign used native language, focus groups, and trusted community health providers to develop culturally tailored messages.
This project developed and evaluated a hospital-based requestor model in which counselors provided emotional and bereavement support to families of patients dying in the ICU. The intervention also provided education on brain death and the value of donation to families. The effectiveness was measured by the number of families consenting to organ donation, number of potential donors, and changes in attitude and knowledge of organ donation amongst health care providers.
This project compared two types of interventions aimed at increasing willingness to become an organ donor among Chinese Americans. Grassroots campaigns and a paid-media advertising campaigns were implemented in three Chinese neighborhoods in New York City. The investigators designed culturally sensitive interventions that respect local institutions, persons, and beliefs. The relative effectiveness and cost-effectiveness of the interventions were measured by the number of new registrants on the organ donor registry and by survey.
This project sought to increase the number of college students in New York who communicate their intent to donate their organs and tissues by enrolling in the State's donor registry and notifying their family of their enrollment decision. Students participated in a public communication course promoting organ and tissue donation that required them to devise and execute campus-wide campaigns to increase declaration rates and family discussion.
This project studied the Asian Pacific American community from three perspectives: 1) behavior, attitude, willingness, and obstacles to organ donation; 2) receptivity to an organ and tissue donation intervention, and 3) change in organ and tissue donation registry sign-ups if culturally sensitive interventions are administered. The project implemented culturally appropriate interventions and evaluated their effectiveness by changes in awareness, attitude, intent to sign a donor card, and informing family about their decision.
This project pilot-tested a culturally relevant intervention that included printed materials, videos, and social marketing methods that were implemented in reservation schools, organizations, and activities. The intervention was developed within the context of Sioux Indian cultural beliefs and values and was implemented by Sioux Indian personnel. The project's effectiveness was measured by changes in donor card completion, driver's license designation, and family notification.
Fiscal Year 2002 Grantees
This project evaluated the effectiveness of a hospital-based peer support intervention on consent rates, family satisfaction, and coping in three regions with markedly different population characteristics. The project built on the successful implementation and testing of the MOD Squad program. Also funded by DoT, the MOD Squad involved support by mothers of donors to families faced with the death of a loved one. This expanded initiative allowed the grantee to evaluate the transferability and generalizability of the outcomes of the MOD Squad intervention.
The purpose of this project was to test the effectiveness of a media campaign in promoting "all-in-one" kiosks to encourage individuals to register as donors.
The purpose of this project was to evaluate the reproducibility of a model training intervention that had been shown to increase organ donation by 20 percent at a single hospital by implementing it at three additional hospitals in Maryland. The model training intervention uses a standardized patient method with simulated families to teach an organized, interdisciplinary family-centered approach to care, with particular attention to the processes and communications skills for end-of-life decision making and the decoupled model of presenting the option of organ donation. Based on the results of this project, the grantee prepared training materials for dissemination of the model training intervention to hospitals, health systems, and organ procurement organizations throughout the United States.
The project will used a retrospective and prospective design to compare the impact of Ohio's first person consent donor registry and a statewide media campaign on Ohioans' donation attitudes and behaviors.
The primary objective of this research was to implement and evaluate a home-based educational intervention designed to increase living kidney donation rates. Adult patients who have been wait-listed for kidney transplantation were randomized to receive either standard clinic-based education about living kidney donation or clinic-based education plus a home-based intervention involving family members and significant others. It was hypothesized that the clinic-based education plus home-based intervention would reach more people, reduce barriers to living donation, and contribute to higher rates of living kidney donation and transplantation.
The purpose of this grant was to study the effectiveness of three different educational interventions—a Mobile Learning Center, OPO presentations, and teacher taught curriculum—on donation attitudes and behaviors of children in grades six to eight. In addition, the grantee evaluated the project's impact on the attitudes, acceptance, and involvement of the teachers who implemented each intervention.
This university worksite project targeted the willingness of faculty, staff, administrators, and students to sign organ donor cards and discuss organ donation with family members. In addition to increasing the rates of signed cards and family discussion, this project sought to increase knowledge about the most effective channels for organ donation promotion messages. This was a six-site project with three quasi-experimental conditions: Two sites received only mass media messages, while two others received a mass media campaign supplemented with an interpersonal component. These campaign sites were contrasted with two control sites. In sidebar studies at the control sites, a series of qualitative studies examined the factors that impact real-life family discussions about organ donation, with a particular focus on African American families.
The purpose of this project was to increase the number of living kidney donations by targeting the intervention to each patient's and potential donor's stage of cognitive-motivational readiness to consider living donation.
Building upon previously published piloted studies conducted by the investigators, a culturally-sensitive health education intervention employed quasi-experimental techniques to evaluate the effectiveness of a 40-minute health education session designed to measure students' knowledge, opinions, and behaviors related to the organ donation/transplantation process. This classroom-based intervention was administered separately in 12 Seattle area high schools selected for their racial/ethnic and income diversity. The TransTheoretical Model, or Stages of Change framework, was applied through a 33-item questionnaire self-administered to students in randomly selected classes within each school. Indicators of behavioral change was tracked and measured at pre- and post-tests periods in the treatment and control groups.
The purpose of this project was to increase the rate of African American living related and non-related organ donation by training ESRD staff to educate patients and potential donors about living donation and improve their attitudes toward donation and by offering an education and support program for patients.
The purpose of this project was to increase organ and tissue donation by educating and developing better relationships with funeral home personnel and providing educational materials to funeral homes for distribution to clients involved in the pre-planning process.
Fiscal Year 2001 Grantees
This project evaluated the efficacy of a theory-based innovative individualized intervention for increasing organ and tissue donation intention rates among African-American college students. It built upon the success of an ongoing campus-wide intervention to increase donation intentions by adding proactive individually tailored interventions to further increase donation intentions.
This project tested the effects of a program of awareness, education, and training for hospital personnel on rates of organ donation referral and actual donors in a multi-hospital system.
This project studied the utility of a new, comprehensive, centralized statewide organ and tissue donor registry system and its impact on declarations of intent to donate, consent rates, and actual organ and tissue donation. The project also used the registry to evaluate interest in, and actual, unrelated living donation rates within a multi-hospital system.
The purpose of this project was to increase organ donation and the availability of transplantable organs through replication of a family communication coordinator (FCC) protocol in a general hospital. The hypothesis was that the FCC program would increase organ and tissue donation through better care of families faced with the possibility of donation.
This project tested a model program to increase awareness of organ and tissue donation and transplantation in the workplace. Each project year, five major Chicago-area corporations of at least nine branches each participated in study. Corporations were randomly assigned to participate in one of two intervention modes or a control group.
This project will evaluate a series of multimodal interventions to improve attitudes toward and commitment to organ donation in two Mississippi counties with very low donation rates and relatively low support for donation.
This project evaluated the impact of a timed family communication and support intervention on rates of consent for organ donation in five non-transplant hospitals on Long Island. The intervention consisted of utilizing a team of specially trained on-call family communicators to provide information and social support to the family members of patients who were facing imminent brain death.
In response to the paucity of donation research on Middle Eastern ethnic groups in the United States, this project launched and evaluated the effects of a comprehensive community awareness campaign on organ donation rates among targeted Arab-American and Chaldean communities.
The purpose of this project was to increase the consent and donation rate for organ and tissue transplantation by altering the approach to donor families during the consent discussion. Instead of the traditional approach of offering families the option of donating their loved one's organs. Transplant coordinators approached donor families, regardless of the presence of a driver's license or other form of donor designation, using a more proactive approach or "Presumptive Approach to Consent."
The purpose of this intervention was to increase the number of minority organ and tissue donors by increasing intent to donate coupled with family notification of intent to donate among Blacks, Haitians, and Hispanics living in Miami-Dade County, Florida. A secondary purpose was to document project processes and outcomes to enable replication in other multi-ethnic communities.
The purpose of this project was to produce a verifiable and demonstrable increase in organ donations through implementation and testing of a protocol for donation after cardiac death. This model included the modification of existing specialized designated requester training modules to include information related specifically to DCD.
This project implemented a program to educate the legal community about organ/tissue donation and prepare and encourage attorneys to educate their clients about the critical need for donation. Client declarations of intent to donate coupled with family notification served as outcome measures. This intervention also aimed to enhance the level of communication between the legal community and health care providers with the organ procurement organization to increase the likelihood that an individual's wish to donate is fulfilled.
Fiscal Year 2000 Grantees
The purpose of this project was to test the use of church health advocates to promote donation in two Alabama counties. Project components included provision of educational materials, incorporation of the clergy person as an agent of change and promotion of the state donor registry.
This project focused on Chinese and Vietnamese Asian populations, testing the involvement of trained requestors who discuss donation in the native tongue of families of potential donors. It also evaluated the target groups' attitude toward donation as affected by a media campaign and an existing targeted approach for increasing organ donation in Asian communities.
A team of crisis support specialists will provide crisis intervention services to suddenly bereaved and grieving family members of potential organ donors. A subset of the team will be hospital-based full-time. The project team will be evaluated for its effectiveness in supporting families and increasing rates of consent.
The purpose of the project was to evaluate the success and cost-effectiveness of a targeted culturally sensitive media campaign to increase organ and tissue donation in the Hispanic community. Input from community leaders helped to shape the message to be delivered through a variety of media.
Through a teacher training program and a class-assigned family interview, the project provided high school students with the knowledge and incentive to promote family discussion and shared decision-making about organ donation. The approach included a post-discussion "debriefing" session as well as the use of a take-home study guide and a resource manual.
Fiscal Year 1999 Grantees
The purpose of this project was to increase donation consent rates by evaluating and replicating a volunteer program that teaches mothers of organ donors to counsel potential donor families about the option of donation. The project enabled an assessment of the donor family member's role in, and impact on, the donation decision process.
This project tested the impact of a two-pronged approach consisting of outreach efforts and requestor training on family consent among African Americans and Asians in Northern California.
The purpose of this project was to increase donation consent rates among Hispanic families through a comprehensive approach—including community, media, and requester outreach—to increase donor awareness and family discussions.
This project was based on empirical research indicating that families are more likely to consent to organ donation if they are satisfied with the care that their loved ones received at the end of life. The New England Organ Bank and the Education Development Center of Boston collaborated with hospitals in Massachusetts, Rhode Island, and New Hampshire to enhance end-of-life care and improve the donation request process. The study aimed to increase health professionals' comfort and skill discussing death and dying and to build hospitals' capacity to support families through the end-of-life period.
The purpose of this project was to replicate a successful donation-enhancing program launched at Emory University Hospital in Atlanta known as the "Renaissance Project." This end-of-life care model was expanded to four additional Georgia hospitals with the goal of enhancing family support practices and increasing the number of organ donors at each institution.
The purpose of his project was to reverse the declining rate of donation consent among Hispanic families in the Sacramento area by implementing and evaluating an ethnically sensitive media campaign. Such an undertaking is especially critical in California due to the disproportionate rate at which Hispanics are placed on the transplant waiting list because of end-stage organ failure.
The purpose of this project was to increase the number of youth registering to become donors when obtaining a driver's license by encouraging family discussions and promoting an informed donation decision. This program enhanced existing school-age driver curriculum with materials to increase family discussion of organ and tissue donations, raise positive consent rates, and increase youth awareness of organ donation and the need for donors.
This project implemented and evaluated a family-centered program focusing on end-of-life decision making and organ donation discussions with the goal of increasing the frequency of donation consent. The program utilized a multi-disciplinary approach involving such health care professionals as physicians, nurses, hospital clergy, and organ procurement coordinators who play consistent, important, and inter-dependent roles in caring for patients and families when organ donation is possible.
Kentucky Organ Donor Affiliates collaborated with United Parcel Service to study the effect of a work-place donor education program and develop a model that could be used in other corporate education programs throughout the country.
The purpose of this program was to increase family donation discussions and minority community support by implementing and evaluating an intensive education and training program targeting African American religious and spiritual leaders in Harris County, TX. The project prepared clergy to develop and implement effective donation education and support programs for their congregations.
The purpose of this project was to replicate a successful pilot program that significantly increased organ donation by placing "in house procurement coordinators" in two Level 1 Trauma Centers. The grantee replicated the model in Detroit, Seattle, and Houston in hospitals that demonstrated significant untapped donor potential.
This project attempted to improve driver's license renewal efficiency and enhance donor education and registry sign-up by placing in public venues ATM-like kiosks that enable these functions.
The National Kidney Foundation studied the feasibility of incorporating a donation education program into funeral pre-planning activities. The goal of this program was to provide individuals the opportunity to conduct family discussions about donation at the time they are making other end-of-life arrangements.
The purpose of the project was to increase commitment to donate by implementing and evaluating the impact of an organ and tissue donation and transplantation curriculum in elementary and secondary public schools in Oklahoma.
The purpose of this project was to expand a previously existing transplant education Internet site by creating a new path focusing on the donor family's view of organ donation. The project's goal was is to encourage participants to join a donor registry and provide specially designed electronic greeting cards to notify family members of the registrant's desire to donate.
The purpose of this project was to increase the number of African-Americans who were willing to join the Illinois organ donor registry and talk to their families about their decision by assessing the effectiveness of two separate strategies to encourage registry participation and by conducting and evaluating an ethnically sensitive media campaign.
The aim of this project was to improve family donation consent rates by training procurement coordinators to match their donation requests to reflect the family's readiness to donate. This project, involving staff from 16 of the Nation's 61 organ procurement organizations, was the first multi-center study of requester training program effectiveness.
The purpose of this program was to increase the number of African Americans in the Buffalo urban community who have signed donor cards and discussed donation with their families. It trained African American community educators to implement public education programs and increased medical student and resident awareness of the importance of approaching potential donor families in a culturally sensitive manner.