The U.S. organ donation system is in a perpetual state of crisis. Over 115,000 patients are waiting for transplants while the waitlist increases by several thousand annually despite over 6,500 dying and 3,500 becoming too sick to receive a transplant. Black men are disproportionally affected by this crisis, due to higher prevalence of poorly controlled hypertension and diabetes and inadequate access to treatment, leading to the highest prevalence of end-stage renal disease and a greater need for kidney transplantation. While Blacks comprise only 13 percent of the total U.S. population, they comprise 34 percent of the 93,000 patients waiting for kidney transplants. Black men comprise 19 percent of the waitlist compared to black women comprising 15 percent, indicating a gender disparity as well. Federally supported interventions have increased the number of black donors such that rates are now proportional to their population percentages, but they remain well below the disproportionate need since organs best match when donors and recipients are of similar race. In this application, we will investigate means for improving organ donor registration among black men using educational video programming produced and distributed in partnership with our network of black owned barbershops in NYC. We will use entertainment education videos and determine how content produced for different audiences (generic multicultural, targeted for black men in our barbershops, and tailored for single viewers based on their prior organ donation beliefs) influences organ donor registration. Our application is a 3- phase qualitative and quantitative research design that includes an intervention development phase using digital video interviewing to both derive and provide culturally specific content for the videos (Aim 1); a 3 arm randomized controlled trial phase, in which customers will be randomized to receive the generic, targeted, or tailored video programming delivered with iPads, after which an immediate organ donation opportunity will be offered through registration online or with a mailed in application (Aim 2); and a failure analysis whereby we will interview some of the participants from the randomized trial who registered and failed to register one month after their educational session to ascertain the influence of the programming (Aim 3). Future studies will involve modifying this video programming based on findings from this research to promote organ donation in black owned barbershops through passive messaging with generic or targeted videos shown on large screen TVs, or with tailored programs using interactive kiosks. Through this work, we hope to reduce organ transplantation disparities through increased registration among black men who comprise a group having a disproportionally greater need for kidney transplants.
This research will lead to increased organ donor registration among black men who visit black owned barbershops and improve understanding as to what video education strategies are best for encouraging organ donor registration in this setting. We have previously shown with our cardiovascular health promotion and cancer prevention research that, as a stage for influential peers, black owned barbershops constitute an existing and unique community setting and peer network that can be utilized to promote healthy behavior for black men. This research meets specific goals of Healthy People 2020 including, 'Decreasing disparities and measuring access to care for diverse populations, including racial and ethnic minorities and older adults' and its agenda advocating use of targeted and tailored interventions for improving health among disadvantaged communities.
