Factors Perceived to Influence the Decision for African Americans to Become Registered Organ Donors at the Department of Motorized Vehicles

Abstract

Background African Americans (AA) are a third as likely as Caucasians to become registered organ donors at the Department of Motorized Vehicles (DMV). The Department of Health and Human Services has set the goal that at least 50% of adults in each state are registered donors. Aims The purpose of this study was to explore the personal, behavioral and environmental factors associated with AA donor registration decision-making at the DMV. Methods Guided by the Social Cognitive Theory, 13 focus groups (n=100 participants) were conducted with AAs who visited the DMV in the past 3 months and made a decision regarding whether to become or to not become a registered donor. The data were analyzed using inductive thematic and qualitative content analyses. Results Study participants expressed a desire to learn more information while waiting in line at the DMV. Knowing a family member or friend in need of an organ transplant, and the desire to make one's own decision were two salient factors associated with the decision to become a registered organ donor. Several aspects of the DMV environment (e.g., noisy, overcrowded, lacking privacy) were cited as deterrents to becoming a registered donor. Discussion This study highlights the personal, behavioral and environmental factors associated with AA organ donor registration decision-making at the DMV. Conclusion The DMV is a setting where many adults make a decision about organ donation. Policies that create an environment in the DMV to support informed decision-making (e.g., privacy, informed clerks, available educational materials, etc.) are indicated.

A quantitative appraisal of African Americans’ decisions to become registered organ donors at the driver’s license office

“…There have been multiple studies conducted identifying barriers to AAs becoming registered organ donors (ROD); including mistrust in hospitals, influence of religious beliefs and spirituality, and lack of accurate information about the donation process and the associated financial aspects (5–7) . While there is a paucity of data regarding the factors associated with AAs positive decision to become RODs, studies have suggested that a desire to learn more about the donation process may be of benefit to RODs (8, 9) . Previously, we conducted a qualitative study based upon social cognitive theory utilizing 13 focus groups of AAs who had frequented a DMV in the past 3 months and made a ROD decision (8) .…”

“…While there is a paucity of data regarding the factors associated with AAs positive decision to become RODs, studies have suggested that a desire to learn more about the donation process may be of benefit to RODs (8, 9) . Previously, we conducted a qualitative study based upon social cognitive theory utilizing 13 focus groups of AAs who had frequented a DMV in the past 3 months and made a ROD decision (8) . The goal of that study was to determine key indicators of AA DMV patrons’ decision whether to become a ROD or to not become a ROD.…”

“…From these data it was determined that positive influences for registering as an organ donor included altruism, familiarity with a registered donor, a deceased donor family or someone in need of an organ donation, and self-determination over the donation process. Factors adversely affecting registration included components of the DMV environment including noise, overcrowding, and lack of privacy (8)…”

Primary care interventions to encourage organ donation registration: A systematic review

“…A strong body of evidence supports the use of active methods of recruitment to organ donation registers in other settings, specifically the Driving Motor Vehicles (DMV) offices in the U.S.A. Numerous studies have investigated how to improve sign-up rates in this setting, the majority of which have found success [40][41][42][43][44][45][46][47][48][49][50][51][52][53]. The generalisability of these studies internationally however, is challenging, due to the unique nature of the DMV to the U.S.A.…”

Rejecting bias: The case against race adjustment for OPO performance in communities of color

“…Because the minority population is higher in OPO 1 than the OPO 2 and OPO 3, risk adjustment for race/ethnicity would give the OPO 1 a bump relative to the other local OPOs, even though the data demonstrate that the lower donation rates in OPO 1 are due to systematic lower donation rates among all racial/ethnic groups. In fact, risk adjustment would "excuse" OPO 1 for having disproportionately lower donation rates poor among Hispanics, which would require further OPO-level data on process measures from targeted education materials at Department of Motor Vehicles (DMVs), [30][31][32] to use of ethnicity-matched requestors for potential Hispanic donors, to hospital development and outreach in hospitals that care predominantly for minority populations,. Unfortunately, such data on different process measures within OPOs are currently not available to researchers.…”