Effect of an iPod Video Intervention on Consent to Donate Organs

Abstract

Background The gap between the supply of organs available for transplantation and demand is growing, especially among ethnic groups. Objective To evaluate the effect of a video designed to address concerns of ethnic groups about organ donation. Design Cluster randomized, controlled trial. Randomization was performed by using a random-number table with centralized allocation concealment. Participants and investigators assessing outcomes were not blinded to group assignment. (ClinicalTrials.gov registration number: NCT00870506) Setting Twelve branches of the Ohio Bureau of Motor Vehicles in northeastern Ohio. Participants 952 participants aged 15 to 66 years. Intervention Video (intervention; n = 443) or usual Bureau of Motor Vehicles license practices (control; n = 509). Measurements The primary outcome was the proportion of participants who provided consent for organ donation on a newly acquired driver’s license, learner’s permit, or state identification card. Secondary outcomes included willingness to make a living kidney donation to a family member in need and personal beliefs about donation. Results More participants who viewed the video consented to donate organs than control participants (84% vs. 72%; difference, 12 percentage points [95% CI, 6 to 17 percentage points]). The video was effective among black participants (76% vs. 54%; difference, 22 percentage points [CI, 9 to 35 percentage points]) and white participants (88% vs. 77%; difference, 11 percentage points [CI, 5 to 15 percentage points]). At the end of the trial, fewer intervention than control participants reported having insufficient information about organ donation (34% vs. 44%; difference, −10 percentage points [CI, −16 to −4 percentage points]), wanting to be buried with all of their organs (14% vs. 25%; difference, −11 percentage points [CI, −16 to −6 percentage points]), and having conflicts with organ donation (7% vs. 11%; difference, −4 percentage points [CI, −8 to −2 percentage points]). Limitation How the observed increases in consent to donate organs might translate into a greater organ supply in the region is unclear. Conclusion Exposure to a brief video addressing concerns that ethnic groups have about organ donation just before obtaining a license, permit, or identification card increased consent to donate organs among white and black participants. Primary Funding Source National Institutes of Health and the Robert Wood Johnson Foundation.

Effects of a Video on Organ Donation Consent Among Primary Care Patients: A Randomized Controlled Trial

“…24 The rates of consent for organ donation in the intervention and control arms compared favorably to that of other studies, 2 but were lower than those seen when the same video was shown to individuals applying for their first driver's license at the bureau of motor vehicles. 1 One potential reason for the difference was the disparate study populations. This study population was older, had existing medical conditions, and was more likely to be minority-all potential barriers to consent for organ donation.…”

“…However, this proportion is less than the 39 % who declined to participate in a prior randomized controlled trial of organ donation. 1 About one-sixth of control patients discussed organ donation with their providers and signed up to become organ donors. Thus, it appears that simply participating in an organ donation study (without the video or cueing interventions) was sufficient to encourage some patients to have discussions and sign up to be donors.…”

“…The professionally-produced video (Palazzo Intercreative, Seattle, Washington) had previously been shown to be effective in increasing consent for organ donation. 1 It addressed concerns that have been expressed in organ donation research by depicting an impromptu discussion among an ethnically diverse group of 20 persons of various ages with various relationships to organ donation and transplantation. Both living and deceased organ donation were discussed.…”

“…1 However, some persons remained reluctant to consent to donation. While most people who consent for organ donation do so at the bureau of motor vehicles when obtaining their driver's license, 2 the licensing office staff generally do not have the training to provide sufficient information and to answer personal questions regarding donation.…”

“…3 In our prior work, 34 % of bureau of motor vehicle patrons reported not receiving the information necessary to allay their fears and concerns sufficiently to provide informed consent for donation. 1 Other studies have demonstrated that the general public would like to discuss donation with their primary care physicians. [4][5][6] Preceding work has also demonstrated that primary care physicians believe it is within their scope of practice to discuss donation with their patients, but they do so infrequently because of lack of time, training, and comfort initiating the topic.…”