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Public Education Efforts to Increase Organ Donation

Project Summaries:

Fiscal Year 2014 Grantees

Grantee: Claremont Graduate University
Project Title: Replication of a mail-based campaign to increase organ donation registration
Investigators at Claremont Graduate University, in collaboration with the Donor Network of Arizona, will replicate and extend a letter-based direct mail campaign in a target population of 16-18 year old Arizona residents (vs. 18 year-olds in Illinois in the original study). Results of the original project indicated that the letter alone elicited a similar registration rate (6.24%) as the letter plus brochure (6.30%) and the rate was significantly greater than that of the brochure alone (3.30%). In the current project, an initial campaign wave will directly replicate the original project (official letter vs. letter plus brochure vs. brochure only). A second wave will assess the impact of an enhanced letter compared to the letter (Standard Letter) used in the Wave 1. The enhanced letter, based on self-determination theory, will include material emphasizing the readers’ transition to adulthood and support for independent decision-making. A third wave will assess the impact of a second enhanced letter compared to the Standard letter. This letter, also drawn from self-determination theory, will include materials emphasizing family and social support for organ donation decisions. An additional aspect of this last wave is that parents of the targeted audience will also receive a letter encouraging their support of their children’s organ donation decisions. The modifications are designed to build on the theoretical processes proposed to underlie the original project so as to further enhance the impact of a direct mail campaign for youth in transition to adulthood—namely by enhancing needs for autonomy.

Grantee: University of Illinois at Urbana-Champaign
Project Title: A randomized controlled experiment to evaluate a multi-message, phased driver facilities campaign
The current project utilizes a multi-message, phased driver facility campaign featuring (a) clerk training, (b) point-of-decision materials, and (c) video monitors strategically placed inside Chicago driver facilities to disseminate organ and tissue donation messages. By varying the order of the intervention arms, the research team will be able to test the effectiveness of each arm individually as well as in conjunction with each of the other components. By utilizing both control and intervention driver facilities, the team can determine if organ donation registration trends observed during the eight-month campaign are due to the intervention arms or an environmental confound or secular trend. In addition to testing the effectiveness of each intervention arm on organ donor registrations, the evaluation strategy will empirically account for exposure to each intervention arm. Perhaps more importantly, the current driver facilities campaign will reach approximately 82% of African-American and 90% of Hispanic Illinois residents.

Grantee: University of Pittsburgh
Project Title: Making organ donors matter: Using psychographic data mining to create tailored public education and outreach campaigns
This project will implement and test a new approach to tailoring media and community outreach campaigns to target particular groups. Specifically, the research team will use data mining techniques to construct a "deep profile" of people who have not designated themselves as organ donors. The deep profile will enable the team to craft messages about organ donation that appeal to people based on a wide range of personal attributes. This technique will help overcome a key limitation of the traditional approach to message development and testing. That is, "targets" are usually grouped into broad demographic categories, e.g., by gender, race, age or geography. Large scale data mining, on the other hand, will allow comparison of donors and non-donors on literally thousands of data points in a wide range of categories and consumer preferences: entertainment, media consumption, politics and ideology, current events, health and fitness, brand preferences, shopping habits, personal finance, technology use, celebrity preferences and lifestyle. It is hypothesized that by crafting messages that appeal to subjects with which non-donors express an affinity, the research team will be able to motivate pro-donation behavior. These profiles will be used to plan and execute campaigns in three segments: health and fitness, faith-based, and grass roots events.

Fiscal Year 2012 Grantees

Grantee: Beth Israel Deaconess Medical Center
Project Title: A DMV-Based Intervention to Increase Donor Registrations: The new England Dissemination Project
The long-term goal of this program is to increase rates of organ donation by substantially increasing the proportion of licensed drivers in New England who are registered organ donors. The objective of this project is to further disseminate and evaluate a targeted division of motor vehicle (DMV) office campaign to increase donor registry enrollment in New England. Based upon a HRSA study that demonstrated the effectiveness of the DMV-based intervention, this project will evaluate its dissemination in other regions of New England as a logical extension of the research program. The central hypothesis is that the educational outreach will yield higher rates of donor registry enrollment by DMV customers (compared to pre-intervention rates) in Rhode Island. The rationale for the proposed research is that it is important to establish whether effective DMV-based education strategies can be disseminated with the same level of effectiveness in other states with different population parameters and DMV processes. To evaluate our central hypothesis, two specific aims will be pursued: 1) To determine the effectiveness of an educational outreach program in DMV offices in Rhode Island, and 2) To evaluate the impact of the educational outreach program on organ donor registration rates in census tracts with low donation rates. The expected outcomes of this study will yield valuable information regarding the dissemination of effective DMV-based strategies in increasing donor registry enrollment in Rhode Island.

Grantee: University of Illinois at Urbana-Champaign
Project Title: Effective Campaign Strategies for Promoting Organ Donation to Mature Adults: A Multi-State Intervention
This study seeks to replicate an empirically validated intervention by identifying the most effective medium and message framing strategies to encourage 50-64-year-old African American, Caucasian, and Hispanic adults to join the Illinois, Iowa, or New York organ donor registries. The grantee will conduct a stratified (by race) random mail survey to identify current beliefs with respect to (a) bodily integrity, disgust, superstitions, and medical mistrust, (b) selfefficacy, knowledge of the need for more registered organ donors, and (c) message framing preferences for each ethnicity. From this information, in year 1, they will randomly distribute mailers to individuals by way of a (a) personalized letter, (b) brochure featuring organ donors, organ recipients, and people awaiting an organ transplant, or (c) both the letter and brochure. In year 2, they will select the most effective medium from year 1, but this time individuals (N = 300,000) will be randomly assigned to a mailer emphasizing the perspective of (a) organ donors, (b) organ recipients, (c) persons on a waiting list, or a (d) combination of the aforementioned frames. Together, the proposed project will replicate a successful HRSA-funded project while extending the reach.

Grantee: Upstate New York Transplant Services
Project Title: Increasing Registry Enrollment via Electronic Health Information Exchange Systems
The goal of this intervention is to increase the number of patients who enroll in the state donor registry and inform their family. It is a replication of an empirically validated intervention providing education through an electronic health information exchange system. This project will utilize HEALTHeLINK, an electronic health information exchange system, to provide patients with access to a web based multimedia education program on organ donation and access to donor registry enrollment linked to their secure personal health record patient portal. A multifaceted web based education program using different modalities for the delivery of information will be used to provide information on organ donation to patients assigned to the intervention. This will include narrated programs, a video of physicians discussing the importance of making an informed decision about donation and registry enrollment, recipients and donor family testimonials and printable education materials. Patients will be encouraged to enroll in the registry via this site and forward information about their commitment to donate to family members and to their primary care physician.

Fiscal Year 2011 Grantees

Grantee: Washington University
Project Title: Training Dialysis Providers to Educate English- and Spanish-Speaking Patients about Living Donation: A National Explore Transplant Intervention
This project will disseminate Explore Transplant to ESRD Networks 9, 10, 15 and 17. These networks oversee 1,223 dialysis centers in 15 states and territories serving over 25,000 transplant-eligible patients. Dialysis providers will participate in in-person Explore Transplant trainings or online e-learning modules and receive access to updated Explore Transplant materials in English and Spanish for patient dissemination.

Grantee: Beth Israel Deaconess Medical Center
Project Title: Massachusetts Registry of Motor Vehicles: Increasing Donor Registry enrollment Using Targeted Community Outreach and Online Media Campaigns.
This project will implement a targeted motor vehicle registry campaign to increase donor registry enrollment in Massachusetts. Public education will include clerk training, organ donation displays and repeated exposure to organ donation PSAs in waiting areas. A second campaign, “Click for Life,” will run a PSA on the RMV website targeting those who are conducting online RMV transactions to register online. The two outreach efforts will be evaluated at the census tract level to determine effectiveness.

Grantee: New York Alliance for Donation, Inc.
Project Title: A DMV-Based Intervention to Increase Organ Donation in New York State
This intervention builds on previous DMV-based interventions and relies on point-of-decision (POD) materials and educational training for Motor Vehicle Representative (MVRs) to increase actionable donor designation. POD materials will include footprint stickers, posters, and clerk cards that include promotional information about donation and instructions on the registry process. Training protocols will educate MVRs about the donation process and provide scripts for responding to anticipated customer queries about the transplantation process.

Grantee: University of Pittsburgh
Project Title: Text2DonateLife: An Innovative Call to Action for Large-Scale Campaigns Using Text Messaging
The proposed project will develop and test a new approach that allows people to register using text messaging, and then use it in a series of collegiate athletic events during the grant period to test and refine the system. Based on the success of the project, the text messaging call to action will then be incorporated into all marketing materials distributed by the Center for Organ Recovery and Education (CORE) and Donate Life American in CORE’s Donor Service Area.

Fiscal Year 2010 Grantees

Grantee: University of Illinois-Champaign
Project Title: A Comparison of Campaigns Designed to Increase Organ Donation to African American, Caucasian, and Hispanic 18-year-olds.
This project 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 (FPC) Donor Registry in Illinois. The project team will conduct a stratified (by race) random digit dial phone survey (N=600) to determine current factors related to joining the FPC donor registry which will inform the development of a mailer to each of the three populations. The team will evaluate a 6-month intervention by employing an experimental 3 x 3 posttest-only design.

Grantee: The University of Pittsburgh
Project Title: Increasing Organ Donation Through the Use of Online Gaming
This project will test the efficacy of a public education campaign using computer games to communicate the need for organ donors and increase donor designations on state registries. This approach is intended not only to reach large numbers of people in a cost- effective way, but also to overcome the gap inherent in traditional public education between the time people receive a message about donation and when they are in a position to take action. By placing a link to the online registry within the game itself, people will be able to designate themselves as donor without significant additional effort.

Grantee: Washington University School of Medicine
Project Title: Improving Dialysis Providers' Ability to Educate Patients about Living Donation: A Multi-State Explore Transplant Intervention
This project will promote broader implementation and evaluation of the Explore Transplant education program within dialysis centers serving 20,000 transplant-eligible patients in 14 states. The project will evaluate improvements in dialysis providers' ability and motivation to educate about transplant, their implementation of Explore Transplant with patients, and patients' level of improved living donation knowledge. The project will assess whether dialysis patients presenting for transplant evaluation who received Explore Transplant had more living donation knowledge than those who did not receive Explore Transplant.

Fiscal Year 2009 Grantees

Grantee: Board of Regents of the University of Wisconsin System
Project Title: Utilization of Social Media, Personalized Messages, and Mass Communications to Increase Solid Organ Donations by U.S. University Students, Their Families and Their Friends
Using multimedia communications, including social media, personalized messages, email marketing, newsletters, and campus newspapers, this project focuses on the development of a replicable model for increasing donor registry enrollment by university students, their families and their friends. A multimedia and social networking communication campaign will be developed and implemented. Four multi-media conditions will be investigated. Overall project goals include: (a) 60–85% donor registration enrollment by AMA student organization members, and (b) a 9–10% increase in donor registry enrollments for each year.

Grantee: Michigan State University
Project Title: University Donor Drive: Increasing Donor Registration through Synchronized Social Identity and Social Networking
The already successful Campus Challenge program run by Gift of Life Michigan and Lifeline of Ohio will be improved by the use of Facebook to present already established "Donate Life" ads which are enhanced with school logos in order to highlight the social identity of the campus affiliation via a competition with other schools. Facebook applications that students can use to educate and persuade their friends and family members to join the web registry will be added, thus utilizing the power of social network influence. The overall registrations from the State of Michigan and the State of Ohio will be tracked. These efforts should yield higher rates of public commitment to become an organ donor, ultimately leading to an improvement in the quality of life for many citizens.

Grantee: The Research Foundation of the State University of New York on behalf of the University of Buffalo
Project Title: A peer-to-peer campus campaign to promote organ donation in minority students in New York City
Consent and conversion rates among downstate residents of New York are among the lowest in the United States. The current project will use peer-to-peer campaigns to increase state registry enrollment by 20% on 5 campuses in Year 1 and 7 campuses in Year 2. The project will capitalize on the gains shown in the existing project and improve outreach by: (1) conducting year-long campaigns, (2) using grassroots methods to recruit student-advocates, and (3) relying on the face-to-face, or interpersonal medium, to promote donation among minority students. It is anticipated that the proposed grant activities will prove a cost-effective, replicable, and sustainable intervention for organ procurement organizations to adopt.

Grantee: Upper Midwest Organ Procurement Organization, Inc., D/B/A LifeSource
Project Title: Hospital Based Public Education Efforts to Increase Organ Donation
This project will use a provider-based comprehensive media and outreach education program that centers on individually-tailored messages delivered by local health care providers with the goal of increasing donor designation. The project will employ an integrated media-based and grassroots outreach effort in the community of Rapid City, South Dakota. The media messages will feature health care providers supported by intensive grassroots outreach consisting of driver's license bureau outreach, workplace partnership for life programs, and community events. The purpose of the project is to bring proven media and community outreach approaches to a geographically isolated city and rural area with the involvement of trusted hospital staff as messengers to increase donor designation. The research evaluation will include surveys pre-intervention and post-intervention surveys within a comparison design.

Grantee: West Virginia University
Project Title: The West Virginia Historically Black College and University Organ Donor Project
The project will perform a replication of the recently completed West Virginia Organ Donor Project. The current proposal looks to test the portability of the campaign's design by performing a replication at an educational institution that is designated as a HBCU (Historically Black College and University). The effectiveness of the campaign will be based on observed differences in registry sign-ups when comparing the control group to the experimental group.

Fiscal Year 2008 Grantees

Grantee: Claremont Graduate University
Project Title: Hispanic organ donation: Replicating and extending media/community outreach
The purpose of this project is to increase donor registry enrollment among Spanish-Language Dominant Hispanics (SLDH) in greater Los Angeles by replicating a media/grassroots campaign found to be successful in three other Southwest SLDH communities. The project will implement intense grassroots efforts in three pre-selected Hispanic communities within greater Los Angeles. The project will include a 15-month media campaign using television and radio advertisements and an 18-month grassroots effort. The grassroots effort will include community presentations at churches and other locations where the target population can be reached. Donor registry enrollment among Hispanics will serve as the key outcome variable.

Grantee: New York Alliance for Donation, Inc.
Project Title: Promoting Organ Donation to Young Adults in New York through New Media
The project seeks to increase the number and proportion of New Yorkers who enroll in the state registry with an emphasis on young adults age 18–24 years. An Internet-based viral marketing campaign will be implemented to increase knowledge of organ donation and to encourage New York residents to sign up as organ donors. Results will be evaluated by the number of hits to and sign ups on the sites, the overall increase (by number and percentage) in the State registry and the increase in 18–24 year-olds on the registry.

Fiscal Year 2007 Grantees

Grantee: National Kidney Foundation of Michigan
Project Title: Body & Soul: A Celebration of Healthy Eating and Living—Organ Donation; Module (Body & Soul)
This project is an evidence- and faith-based program that builds on two previous health-related projects. The organ and tissue donation module will be implemented as part of the entire program in 20 African American churches and include 60 participants per church. The primary outcome will be measured at an 18 month follow-up by the number of actual registrations on the Michigan Organ Donor Registry.

Grantee: SUNY, Buffalo
Project Title: A College-Based Campaign to Increase Organ and Tissue Donation in New York City
This college-based program builds on a previous grant which enrolled nearly 4,000 college students, and seeks to increase organ donor registry enrollments, signing rates, and family notification by 20 percent in this population and among local community members. It should be noted that organ donation registrations in the New York State Organ Registry in the affected zip codes are projected to increase by only five percent. The project could improve this projection by an additional 15 percent.

Grantee: Florida Coalition on Donation
Project Title: Increasing Enrollment in the Donate Life Florida Organ and Tissue Donor Registry: Evaluating the Effectiveness of Two Targeted Educational Initiatives
Two targeted, multifaceted educational campaigns will be conducted at 30 Department of Highway Safety and Motor Vehicles (DHSMV) offices. The educational campaigns are expected to increase donor registry enrollment rates of Hispanic American drivers by 50 percent in these offices when compared to DHSMV Offices without such training.

Grantee: Purdue University
Project Title: Department of Motor Vehicles (DMV) Plus Grassroots Media Educational Program
Trained volunteers will be used to increase donation enrollments at DMV sites, public outreach activities, and at special events such as Donor Sabbath and Donate Life month activities. Targeted audiences include African Americans and those needing to update their organ donor registry enrollment information. Legislation enacted in January 2007 makes Michigan a first person consent State where the consent to donate organs and tissues is legally binding and can not be denied by family members.

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