Title:  Increasing donor designation rates in teenagers: Effectiveness of a driver’s education intervention

Funding:  HRSA (R39OT26988)

ClinicalTrials.gov:  NCT03013816

Summary

Public education campaigns increase awareness about the success of solid organ transplantation and the need for more organ donors. The benefits of transplantation are now commonly known and the general public has favorable attitudes toward organ donation. However, notwithstanding the impressive results generated by the Organ Donation and Transplantation Collaboratives, the gap between those in need of transplantation and the number of organs donated continues to widen. Despite promoting favorable attitudes toward transplantation and donation, public education campaigns have been criticized for failing to translate those favorable attitudes into behavioral actions. The research grants program in the Division of Transplantation at the Health Resources and Services Administration has supported the development and evaluation of public education programs designed to address this criticism. There continues to be a pressing need to further evaluate public education strategies that show promise in increasing organ donor designations, communicating decisions to family members, and raising actual rates of organ donation.

One of the long-term goals of our research program is to increase rates of organ donation by substantially increasing the proportion of licensed drivers in New England who are registered organ donors. Despite our successful efforts at increasing donor designations via a coordinated public education campaign in Registry of Motor Vehicle (RMV) offices throughout Massachusetts, donor designations among newly licensed adolescent drivers remains lower than for most other age groups. The objective of this application is to evaluate the effectiveness of targeted video interventions designed to increase organ donation knowledge, intentions, and designations among adolescents enrolled in driver’s education classes, as well as to increase the commitment of parents/legal guardians to authorize organ donation in the event of their adolescent’s death.  Therefore, the current study focuses on pairing an organ donation intervention with driver’s education prior to the adolescent’s first organ donation designation opportunity. The central hypothesis is that integrating donation education into the driver’s education curriculum will increase knowledge and attitudes that facilitate the behavioral action of donor designation at the time of getting a new driver’s license. The rationale for the research is that it is important to establish whether a time- and cost-efficient intervention with pre-licensed adolescents can produce a verifiable and demonstrable impact on donor designations before broader dissemination, to determine if it is feasible to conduct such interventions during driver’s education classes, and to determine which type of intervention will be most effective at achieving this objective.

Guided by the Elaboration Likelihood Model (ELM), we will evaluate the relative effectiveness of an informational messaging (IM) organ donation video, a testimonial messaging (TM) organ donation video, or a blended messaging (BM) organ donation video with adolescents during scheduled driver’s education classes. A three group randomized, nested, repeated measures design will be used to evaluate the principal objectives of the application.  Driver’s education classes will serve as the venue for deployment of the three interventions and adolescent participants will complete questionnaires at pre-intervention, post-intervention, and 1-week follow-up. Donor designation status at the time they are issued their first license will then be retrieved by the RMV.

To accomplish the objective of the study, we are pursuing the following four specific aims:

1. Determine the relative effectiveness of three organ donation video interventions on adolescents’ organ donation knowledge, intentions, and communication with parents.
2. Determine the relative effectiveness of three organ donation video interventions on the commitment of parents/legal guardians to authorize organ donation for study participants in the event of their death.
3. Determine the relative effectiveness of three driver’s education video interventions on actual donor designation rates.
4. Determine the sociodemographic and donation-specific variables that are most strongly associated with organ donor designation.

Related Publications

Rodrigue JR, Fleishman A, Fitzpatrick S, Boger M. Organ donation video messaging in motor vehicle offices: Results of a randomized trial. Prog Transplant. 2015; 25:332-8.

Ladin K, Wang R, Fleishman A, Boger M, Rodrigue JR. Does social capital explain community-level differences in organ donor designation? Milbank Q. 2015; 99:609-41.

Rodrigue JR, Fleishman A, Fitzpatrick S, Boger M. Organ donation knowledge, willingness, and beliefs of motor vehicle clerks. Transplantation. 2014; 98:1025-28.

Rodrigue JR, Fleishman A, Vishnevsky T, Fitzpatrick S, Boger M. Organ donation video messaging: Differential appeal, emotional valence, and behavioral intention. Clin Transplant. 2014; 28:1184-92.

Rodrigue JR, Krouse J, Carroll C, McMillen L, Giery K, Fraga Y, Frost T, Edwards E. A Department of Motor Vehicles intervention yields moderate increases in donor designation rates. Prog Transplant. 2012; 22: 18-24.

Baughn D, Rodrigue JR, Cornell DL. Intention to register as organ donors: A survey of adolescents obtaining their driver’s permit/license or enrolled in driver’s education. Prog Transplant 2006; 16:260-7.

Rodrigue JR, Cornell DL, Jackson SI, Kanasky W, Marhefka S, Reed AI. Are organ donation attitudes and beliefs, empathy, and life orientation related to donor registration status? Prog Transplant 2004; 14:56-60.