Passive-positive organ donor registration behavior: A mixed method assessment of the IIFF Model

Abstract

When it comes to organ donation, the majority of American non-donors are passive-positives - they support organ donation but have yet to register as donors. A quasi-experimental, four-city, pretest/posttest study was conducted to assess the utility of the IIFF Model as a means of increasing registration among these individuals. Focus groups were used as the intervention context. In support of the model's utility, 46.6% of focus group participants signed donor cards at the end of the intervention. Extrapolated to the general population, such a finding could result in millions of new registrants. Retrospective analyses of reasons for non-registration provided before the start of the focus groups reveal that passive-positives placing culpability for non-registration on lack of knowledge or opportunity register signed-up at a rate of 63.6%. Passive-positives claiming to have put off registering because of their discomfort with thoughts of death or fear that organ donors are allowed to die so their organs can be harvested registered at a rate of 5.8%.

Blood and organ donation: health impact, prevalence, correlates, and interventions

“…The IIFF model (Siegel et al, 2010) propose that four factors are key to donation: (1) an immediate and complete registration opportunity ('ICRO' "a card in the hand"), 2 Ferguson, 2011) and shown to be stronger predictors than TPB variables (Morgan et al, 2008;O'Carroll, Dryden, et al, 2011;O'Carroll, Foster, et al, 2011) or knowledge (Morgan et al, 2008). These affective barriers include concerns that clinicians may not try as hard to save the potential donor ("medical mistrust"), disgust at the thought of donation ("ick factor"), that registering in some way hastens one's death ("jinx factor"), and discomfort at the thought of one's body being operated on for organ retrieval ("body integrity").…”

Looking forward to helping: The effects of prospection on prosocial intentions and behavior

“…Prosocial behavior provides clear advantages for the recipients of help (e.g., Siegel et al, 2010;Szreter & Woolcock, 2004) and also benefits the people who enact it. Specifically, behaving prosocially is associated with increases in indices of well-being such as positive affect (Csikszentmihalyi, Patton, & Lucas, 1997;Kahana, Bhatta, Lovegreen, Kahana, & Midlarsky, 2013), life satisfaction, and a sense of meaning in life (Caprara & Steca, 2005;Kahana et al, 2013;Pashak & Laughter, 2012).…”

Increasing organ donor registration rates by providing an immediate and complete registration opportunity: An experimental assessment of the IIFF model

“…Activated beliefs hold the strongest influence over behavior; accordingly, the IIFF requires attention to environmental stimuli to maximize favorable activation. This was strikingly salient in research indicating thinking of death lowers registration (Alvaro, Jones, Robles, & Siegel, 2005) -up to 12 times less (Siegel et al, 2010b). Simply, appropriate activation leads to increased registration (Siegel et al, 2010a).…”

“…The IIFF model (Siegel, Alvaro, & Hohman, 2010a;Siegel, et al, 2010b) offers a framework for increasing registration among passive positives. Its underlying rationale is that while most people have positive donation attitudes, they are not highly vested (Crano & Prislin, 2008) in the issue, and many have ambivalent attitudes (Armitage & Conner, 2000), making behavioral supports (Tolman, 1959) necessary.…”