Report on Social and Behavioral Interventions to Increase Organ Donation Grant Program 1999-2004

Common Problems Experienced by Project Teams

Some of the grant-funded project teams experienced problems that are common to most funded projects; few of these problems appear to be specific to the organ procurement field.

First, several projects suffered from unevenness in the implementation of the intervention. This was most common to multi-site projects where liaisons at each site could not be adequately supervised. Second, some projects struggled with the revocation of access to the study sites. The leaders of some project teams were able to recover access through negotiation with study site personnel, while others did not appear to try to preserve access.

This second issue points to the importance of having adequate project leadership. Some projects appear to have been “handed over” to community outreach staff within the OPO even though the Principal Investigator of the project was named as the Executive Director/CEO of the OPO. While some projects in this type of situation were ultimately successful, a disproportionate number of these “handovers” to staff members inexperienced with the complex administrative tasks inherent to grant-funded projects had significant difficulties. A charismatic, likeable leader(s) also appear to facilitate cooperation among OPOs when projects span OPO service areas. (However, this is not to imply that this is a sufficient condition for multi-OPO project success.) Another theme among projects experiencing significant problems is the loss of project leadership when key personnel either left the OPO or otherwise withdrew from the project.

Another personnel issue pertains to the involvement of researchers. The most successful projects involved researchers in the development of the project so that solid intervention procedures could be incorporated. These projects had ongoing involvement from researchers throughout the project period. On the other hand, researchers who were simply “tagged on” to project teams who had responsibilities limited solely to intervention evaluation often found themselves in a position where the intervention simply could not be evaluated because the methodological design was deeply flawed. Similarly, academic researchers (rather than market researchers) have an inherent motivation to construct interventions that can be subjected to rigorous evaluation procedures because their professional reputations rest on the ability to publish results in peer-reviewed journals. Market researchers’ responsibilities, on the other hand, end when a final report is delivered to the OPO. The requirement to disseminate grant project findings then fall to OPO staff, who have little or no experience writing journal articles.

Finally, hiring culturally competent personnel to staff minority-focused projects was occasionally an issue. Project teams that already had these staff members on board were able to navigate potential obstacles such as identifying appropriate sites for interventions, the right types of community partners, and could inform other project team members of potential problems such as whether key concepts could be translated into another language. Some projects assumed that being promised access by a leader of an association meant that member organizations would indeed cooperate. An important lesson is that access must be negotiated with every site that would be included in a project; even then, access is sometimes difficult to maintain.