The U.S. organ donation system remains in a perpetual state of crisis. Over 115,000 patients in the U.S. are waiting for organ transplants, and the waitlist increases by several thousand annually despite over 10,000 dying or becoming too sick to receive a transplant. Latinos are disproportionally affected by this organ crisis due to their higher prevalence of diabetes and end-stage renal disease from inadequate access to treatment. Of the 115,000 waiting, over 95,000 require kidneys, and of these, 19.2 percent are Latino despite Latinos comprising only 16.7 percent of the U.S. population. Latinos also comprise 15.8 percent of recipients but only 13.1 percent of donors. These rates remain well below the disproportionate need since organs best match when donors and recipients are of similar race. We will investigate means for improving organ donor registration among Latinos using educational videos about uncontrolled donation after circulatory death (uDCDD) produced and distributed in partnership with our network of Latino owned barbershops and beauty parlors. uDCDD programs consider candidates for donation no matter timing or location of death, so long as consideration occurs after all life sustaining efforts are exhausted. Video content will include live footage from uDCDD programs in Spain, which has markedly improved rates of kidney transplantation compared to the U.S. If successful, we estimate that uDCDD programs could provide 22,000 more donation opportunities annually in the U.S. Educational models will inform the design of our uDCDD videos to test how genre (expert testimonials, documentary with live uDCDD footage) and ending choices (uplifting, negative consequences, unresolved) impact immediate registration after viewing. Our application is a 3-phase qualitative and quantitative research design that includes an intervention development phase using qualitative interviewing to both derive and provide culturally specific content for the videos (Aim 1); a 2x3 randomized controlled trial, in which we will randomize customers to receive one of six videos delivered with iPads, after which an immediate organ donation opportunity will be offered through registration online or with a mail application (Aim 2); and a failure analysis whereby we will interview some of the participants from the randomized trial who failed to register one month after their educational session to ascertain their reasons (Aim 3). This research will provide a model for future studies, in which we will modify our videos based on our research findings and distribute them in Latino-owned barbershops and beauty parlors using large screen TVs or interactive kiosks. Through this work, we hope to reduce organ transplantation disparities through increased registration among Latinos who comprise a group having a disproportionally greater need for kidney transplants.
This research will use educational videos to inspire increased organ donor registration among Dominicans and Puerto Ricans who visit Latino owned barbershops and beauty parlors, a community setting where we have previously shown with our cardiovascular health promotion and cancer prevention research constitutes a unique peer network that can be utilized to promote healthy behavior for customers. Videos will present how uncontrolled donation after circulatory determination of death (uDCDD) programs that consider candidates for donation no matter timing or location of death, so long as consideration occurs after all life sustaining efforts are exhausted, are promising means for solving the organ donation crisis for Latinos, a population with disproportionally greater need. 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.
