Deceased donation remains the major source of organs. Despite the public's stated enthusiasm for organ donation, donation consent rates have remained relatively low. In the U.S. no more than 60% of the families of donation-eligible individuals consent. Improving the rates of consent from deceased donor families is a pivotal means for slowing the rise of the supply-demand gap. The proposed five-year study will test the use of a two-part Early Referral and Request Approach (ERRA) intervention to raise consent rates to solid organ donation from the families of deceased patients at the point where requests are made by Organ Procurement Organizations (OPOs). The ERRA consists of a hospital-based evaluation assessment system and a communication intervention. It targets two key factors that can make a difference to consent to organ donation: 1) time-sensitive referrals by hospitals of potential donor patients to the OPO;and 2) use of effective communication techniques by OPO requesters to discuss organ donation with donation-eligible patients'families. The ERRA intervention is based on 15 years of prior research in the area of obstacles to organ donation and is grounded in the results of a recent study. We will use an experimental design to test the overall efficacy of both elements of the ERRA intervention under two conditions (autonomous and assisted) to ascertain best practices for ERRA implementation. The first module of the ERRA is the Rapid Assessment of Hospital Procurement barriers in Donation (RAPiD). The second module is the Communicating Effectively about Donation (CEaD) that teaches OPO requesters communication skills designed to improve the effectiveness of their requests to donor-eligible families. Eight OPOs, located around the United States, and their OPO coordinators who request organ donation, will participate as study sites and participants (n=80). The proposal has the following specific aims:
Aim 1. Test the effectiveness of the RAPiD to increase timely identification of potential donors through hospital notification of OPOs and the affect of the RAPiD and CEaD training modules on consent rates.
Aim 2. Test OPO implementation of the RAPiD and CEaD modules under two conditions. The two implementation conditions to be tested are: a) a completely autonomous condition in which an OPO does not employ any outside assistance to implement the module, and b) an assisted method whereby trained outside consultants play a role in implementing the modules.

Public Health Relevance

There are over 96,000 patients on the transplantation waiting list but no more than a fraction of these patients will receive an organ transplant in any given year. This study proposes an intervention to help increase the rates of organ donation and alleviate the organ shortage.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Research Project (R01)
Project #
5R01DK081118-03
Application #
8011949
Study Section
Special Emphasis Panel (ZRG1-HOP-Z (90))
Program Officer
Eggers, Paul Wayne
Project Start
2009-01-01
Project End
2012-12-31
Budget Start
2011-01-01
Budget End
2011-12-31
Support Year
3
Fiscal Year
2011
Total Cost
$532,948
Indirect Cost
Name
Virginia Commonwealth University
Department
Other Health Professions
Type
Schools of Medicine
DUNS #
105300446
City
Richmond
State
VA
Country
United States
Zip Code
23298
Siminoff, Laura A; Alolod, Gerard P; Wilson-Genderson, Maureen et al. (2016) A Comparison of Request Process and Outcomes in Donation after Cardiac Death (DCD) and Donation after Brain Death (DBD): Results from a National Study. Am J Transplant :
Traino, H M; Molisani, A J; Siminoff, L A (2016) Regional Differences in Communication Process and Outcomes of Requests for Solid Organ Donation. Am J Transplant :
Siminoff, Laura A; Traino, Heather M; Genderson, Maureen Wilson (2015) Communicating Effectively about Organ Donation: A Randomized Trial of a Behavioral Communication Intervention to Improve Discussions about Donation. Transplant Direct 1:
Siminoff, Laura A; Molisani, Anthony J; Traino, Heather M (2015) A Comparison of the Request Process and Outcomes in Adult and Pediatric Organ Donation. Pediatrics 136:e108-14
Traino, Heather M; Siminoff, Laura A (2013) Attitudes and acceptance of First Person Authorization: a national comparison of donor and nondonor families. J Trauma Acute Care Surg 74:294-300
Siminoff, Laura A; Agyemang, Amma A; Traino, Heather M (2013) Consent to organ donation: a review. Prog Transplant 23:99-104
Traino, H M; Alolod, G P; Shafer, T et al. (2012) Interim results of a national test of the rapid assessment of hospital procurement barriers in donation (RAPiD). Am J Transplant 12:3094-103
Siminoff, Laura A; Step, Mary M (2011) A comprehensive observational coding scheme for analyzing instrumental, affective, and relational communication in health care contexts. J Health Commun 16:178-97
Siminoff, Laura A; Traino, Heather M; Gordon, Nahida H (2011) An exploratory study of relational, persuasive, and nonverbal communication in requests for tissue donation. J Health Commun 16:955-75
Siminoff, Laura A; Traino, Heather M (2009) Improving donation outcomes: hospital development and the Rapid Assessment of Hospital Procurement Barriers in Donation. Prog Transplant 19:180-7