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

Worksite Campaigns

An alternate way of reaching the public with organ donation promotion messages can be accomplished by bringing campaigns to the workplace. Because workplaces are communities where people spend much of their time they may prove to be potentially productive contexts for public education, especially when the stories of co-workers who have been affected by organ donation are told through internal media, as is the case with three of the campaigns discussed below.

An early worksite campaign project was conducted in Kentucky with United Parcel Service¹¹. A campaign that included site visits and the use of internal media to disseminate information about organ donation as well as the personal stories of two UPS employees (a donor husband and the father of a girl on the transplant waiting list). External media in the form of billboards located on roads leading in and out of the UPS worksite were also used to disseminate general information about organ donation. A 10% stratified random sample responded to pre/post-test surveys. Compared to another branch of UPS that served as a control site, the intervention site showed statistically significant increases in the willingness to become a donor, to talk with family members about organ donation as well as the intent to talk with family about donation in the future, knowledge about organ donation, and attitudes toward donation.

Because this worksite campaign used only one company and could not pinpoint the campaign elements that contributed to campaign success, a subsequent campaign¹² using six matched worksites was planned, using universities as the sites of two types of campaigns (contrasted against control sites). The project, called the University Worksite Organ Donation Project (conducted in AZ, AL, NC, NJ, PA, and TX) heavily utilized internal media including campus papers and newsletters in addition to more traditional outlets such as billboards and radio. In one of the quasi-experimental conditions, only media messages (including those that featured the stories of members of the university community) were used to promote organ donation. In another condition, the media campaign was supported by on-site visits by OPO staff and volunteers. A random stratified pre/post-test mail survey demonstrated that compared to the control condition, there was a statistically significant advantage to adding on-site visits on whether respondents reported signing a donor card or talked to family about organ donation. However, the media-only campaign did not produce results that were statistically different from the control condition. The project organizers argue that the outreach component offers community members the opportunity to “put a human face” on the issue of organ donation because many volunteers are transplant recipients or donor family members. Additionally, the site visits provide an opportunity to ask questions about organ donation that may linger even after seeing ads or billboards promoting organ donation.

In Chicago¹³, a worksite campaign was developed that involved 12 companies, each with three separate branch locations which were randomized to the three quasi-experimental conditions: control (general health presentation, with organ donation information imbedded), basic (a concerted educational effort that included testimonials from transplant recipients), and enhanced (where additional information was provided to help employees persuade family members to also become donors). The interventions were delivered via “lunch and learn” sessions. Based on a pre-test survey and one month follow-up post-test survey, the project demonstrated success in producing greater willingness to donate and greater perceptions of the benefits of donation relative to the control groups. The intervention groups as well as the control groups showed statistically significant increases in the willingness to talk with family members. However, it should be noted that only between 5 and 45 people attended these sessions, with an average attendance of 22 people. Although access to corporations to conduct lunch-and-learn sessions is generally easy to negotiate, the limited number of people within large corporations who receive the message compromises the total potential impact of this type of worksite intervention. The extra time and effort to secure company-wide access for a comprehensive worksite campaign is likely to reap far greater rewards because public education necessarily operates on an economy of scale.

A larger-scale series of worksite campaigns was developed in New Jersey¹⁴. This ongoing project has completed campaigns with 18 companies, but will eventually reach employees in a total of 45 companies. Companies are divided into three quasi-experimental conditions that mirror those of the University Worksite Organ Donation Project (mass media campaigns contrasted against campaigns that also include on-site visits by staff and volunteers). In addition to expanding the number and diversity in the type of companies reached, campaigns last only 10 weeks. Preliminary results from pre/post-test telephone or paper surveys of a random sample of employees indicate that campaigns that include on-site visits are more successful than those that use only internal media to disseminate information about organ donation. Further, campaigns that publicize the stories of co-workers who have been touched by organ donation are more effective than campaigns that use only general stories about local people who have been personally affected by organ donation. These findings generally mirror the results of both the United Parcel Service Project and the University Worksite Organ Donation Project. Project researchers intend to conduct an in-depth analysis of the structural features of organizations that contribute to the success (or failure) of worksite campaigns, which should help other OPOs make decisions about where best to devote limited public education and outreach resources.

Worksite campaigns show considerable promise for replication. A blueprint for successful campaigns is slowly emerging, which includes particular elements, multiple on-site visits to encourage employees to become declared donors, and publicizing the personal stories of employees from each organization. Gaining (and maintaining) access to large organizations for worksite campaigns appears to be the principal challenge facing these campaigns, which nevertheless hold the promise of reaching many thousands of people with organ donation information as well as easy opportunities to become potential organ donors.