Increasing Organ Donation in Hispanic Americans The Role of Media and Other Comm

[Clark]

http://archsurg.jamanetwork.com/article.aspx?articleid=1772378

Increasing Organ Donation in Hispanic Americans
The Role of Media and Other Community Outreach Efforts
Ali Salim, MD1,2; Eric J. Ley, MD1; Cherisse Berry, MD1; Danielle Schulman, MPH1; Sonia Navarro, BA1; Ling Zheng, MD, PhD1; Linda S. Chan, PhD1
JAMA Surg. Published online November 13, 2013. doi:10.1001/jamasurg.2013.3967

ABSTRACT
Importance  The growing demand for organs continues to outpace supply. This gap is most pronounced in minority populations, who constitute more than 40% of the organ waiting list. Hispanic Americans are particularly less likely to donate compared with other minorities for reasons that remain poorly understood and difficult to change.

Objective  To determine whether outreach interventions that target Hispanic Americans improve organ donation outcomes.

Design, Setting, and Participants  Prospective before-after study of 4 southern California neighborhoods with a high percentage of Hispanic American residents. We conducted cross-sectional telephone surveys before and 2 years after outreach interventions. Respondents 18 years or older were drawn randomly from lists of Hispanic surnames. Awareness, perceptions, and beliefs regarding organ donation and intent to donate were measured and compared before and after interventions.

Intervention  Television and radio commercials about organ donation and educational programs at 5 high schools and 4 Catholic churches.

Main Outcomes and Measures  Number of survey participants who specify intent to donate.

Results  A total of 402 preintervention and 654 postintervention individuals participated in the surveys. We observed a significant increase in awareness of and knowledge about organ donation and a significant increase in the intent to donate (17.7% vs 12.1%; adjusted odds ratio, 1.55 [95% CI, 1.06-2.26; P = .02]).

Conclusions and Relevance  Focused donor outreach programs sustain awareness and knowledge and can significantly improve intent to donate organs in the Hispanic American population. These programs should continue to be evaluated and implemented to influence donor registration.

Despite the growing success of organ transplant as the primary treatment for end-stage organ failure, levels of consent for organ donations continue to be low, and the gap between the demand for and supply of organs continues to widen. The organ shortage is even more pronounced in minority populations, who account for only 31% of donors but represent 55% of those on the waiting list.1

Among US minority populations, the Hispanic American community is the fastest growing. Hispanic Americans are projected to constitute one-quarter of the country’s population by the end of 2050.2 As expected, this population growth parallels a growth in transplant need in the Hispanic American community, with a 260% increase of Hispanic Americans on organ waiting lists compared with a 146% increase among non-Hispanic groups.3 Despite this heightened need for organ donation, Hispanic Americans are 60% less likely to donate organs compared with non-Hispanic whites.3

As part of an ongoing effort to increase organ donation among Hispanic Americans, our research team implemented educational programs in several communities that had a large Hispanic American population in Los Angeles County. These interventions included media campaigns4,5 and educational programs at select high schools6 and churches.7 To assess the lasting effect of these programs over time, telephone surveys were performed approximately 2 years after implementation of the first program. The objective of the present study was to determine whether the outreach programs had an effect on improving intent to donate organs in the Hispanic American population.