We tested the efficacy of religiously tailored and ethically balanced education upon living kidney organ donation intent among Muslim Americans. Pre-post changes in participant stage of change, preparedness, and likelihood judged efficacy. Among 137 participants, mean stage of change toward donation appeared to improve (0.59; SD ± 1.07, P < .0001), as did the group's preparedness to make a donation decision (0.55; SD ± 0.86, P < .0001), and likelihood to donate a kidney (0.39; SD ± 0.85, P < .0001). Mean change in likelihood to encourage a loved one, a co-worker, or a mosque community member with ESRD to seek a living donor also increased (0.22; SD ± 0.84, P = .0035, 0.23; SD ± 0.82, P = .0021, 0.33; SD ± 0.79, P < .0001 respectively). Multivariate ordered logistic regression models revealed that gains in biomedical knowledge regarding organ donation increased odds for positive change in preparedness (OR = 1.20; 95% CI 1.01-1.41, P = .03), while increasing age associated with lower odds of positive change in stage of change (OR = 0.98, 95% CI 0.96-0.998, P = .03), and prior registration as an organ donor lowered odds for an increase in likelihood to donate a kidney (OR = 0.22; 95% CI 0.08-0.60, P = .003). Our intervention appears to enhance living kidney donation-related intent among Muslim Americans [Clinicaltrials.gov number: NCT04443114]. K E Y W O R D S behavior change, bioethics, islam, organ transplantation 2 of 12 | PADELA Et AL. with donation. 5-9 Consequently, there is a urgent need for tailored programs that improve donation knowledge, attitudes, and behaviors among minority groups. Muslim Americans are one such population. They number between 5 and 7 millions, comprised of individuals from African, Arab, and South Asian ancestry, and will double in number by 2030. 10-14 Although national statistics on kidney failure, donation, and transplantation are not aggregated by religion, local research finds ethnic/racial subgroups within this community to suffer from high rates of diabetes, hypertension, and resultant kidney failure. 15-24 Despite this, Muslim Americans tend to hold negative attitudes toward organ donation, particularly deceased donation. For example, among over 1016 Arabs in Michigan we found only 35% held deceased donation to be always justified while 20% considered it to never be justifiable. Muslims were 1.5 times less likely to support organ donation than Christians. 25 Our mosque-based survey of 93 Arab, South Asian, and African American Muslims similarly found only 39% agreeing with deceased donation. 26 This general lack of acceptability is also found among Muslim minorities abroad. 27-30 Many factors influence Muslims' attitudes toward donation, but chief among them are religious values, beliefs, and edicts. 29,31-33 This effect on donation, both positive and negative, holds across mark-This study involved a collaboration between the Initiative on Islam and Medicine (II&M) at University of Chicago (UC), the National Kidney Foundation of Illinois (NKFI), and Gift of Hope (GoH). We thank...