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

Community Outreach Campaigns with Mass Media Components

Because of the high cost of purchasing mass media, many project teams elected to focus exclusively on community outreach activities. However, a member of DoT-funded, community-based projects included some type of mass media component (radio, television, and/or print) because of the opportunities afforded by federal funding. It should be noted that because the efficacy of organ donation public education campaigns had not yet been tested (and indeed, principles that can lead to successful outcomes are still being evaluated), OPOs have been largely reluctant to devote significant resources to media campaigns. Thus, the grant program will eventually give OPOs the opportunity to determine future courses of action based on the lessons learned from these projects.

Two projects, one in California⁶ and the other in Arizona⁷, targeted Latinos with a Spanish-language media campaign. Interestingly, pre/post-test telephone surveys (conducted in Spanish) of Hispanics in Arizona revealed little movement in self-reported behavior change, such as signing a donor card (although there were such increases in California). However, both areas reported an increase in the willingness to talk about organ donation with family members. Perhaps as a function of increased family discussion about donation, actual consent rates rose in both areas during the project periods, and at a rate that exceeded any increase in consent by the White population, providing evidence of the effectiveness of such targeted campaigns. For example, consent rates in Arizona among Hispanics rose 11% while the consent rate for whites rose 6%. In Southern California, similar results were found for the same type of campaign. In addition to improvements in knowledge and attitudes as demonstrated through pre/post telephone surveys, one Hispanic consent rate in Southern California increased from a baseline of 32% to 48%, 55%, and 57% during the three years of the project. Given the large population of Hispanics in California and Arizona, these projects have resulted in increased numbers of organs available for transplant which translates into many lives saved.

An ongoing project in Charlotte, North Carolina⁸ is targeting African Americans with combined outreach activities and a supporting mass media campaign. Community-based activities include outreach in Black churches (presentations, church bulletin inserts), outreach through the Black Medical Association (continually stocking brochures with donor cards in all area clinics, doctor's offices and dental offices that serve primarily African Americans), and participation in Black community events (including festivals, health fairs, and sponsorship of a large annual gospel concert).

The media campaign consists principally of radio and television PSAs produced by the Coalition for Donation, the national public education organization funded by OPOs. Because one of the key outcome measures is donor registry activity, the success of the program can be tracked in the interim. Relative to baseline activity on the donor registry for both African Americans and non-African Americans, it is clear that over the course of the last seven months, African Americans are registering as donors at an increasing rate, and at a rate of increase that exceeds that of non-African Americans. The actual consent rate for donation among African Americans has jumped 56% during the project period, while the consent rate for non-African Americans has held steady, providing evidence that this African American targeted campaign is effective.

As with the community outreach campaigns, projects that reinforced grassroots efforts with media components tended to focus on specific minority groups. Perhaps because of the concentrated focus on the specific goal of changing behavior in a single population, these projects were highly successful, not just in raising knowledge or awareness about organ donation, but in improving actual consent rates for donation. These significant improvements in tangible outcomes have resulted in an increased number of organs available for transplant, which is especially important in the African American community where tissue-type matching issues remain a concern.