Choosing to Be a Designated Organ Donor on Their First Driver's License: Actions,Opinions,Intentions,and Barriers of Asian American and Pacific Islander Adolescents in Hawaii

Abstract

Context

The factors associated with Asian American and Pacific Islander adolescents' decision to be a designated organ donor on their first driver's license are largely unknown.

Objective

To assess knowledge and attitudes about organ donation and socio-cultural factors associated with designated organ donor status in Asian American and Pacific Islander youth in Hawaii.

Design and Setting

Written surveys and focus groups were conducted at high schools and churches.

Participants

Two hundred eight Asian American and Pacific Islander teens, mean age 16 (SD, 2) years, 52.6% females, and 53.4% Catholic.

Main Outcome Measures

Donor status on driver's license, awareness, attitudes, intentions, and barriers to becoming a designated organ donor.

Results

Eighteen percent of teens with a driver's license are designated organ donors. Twenty-one percent have talked to their parents about becoming a designated donor on their license. Of those without a license, 27.7% intended to become a designated donor. Sex, grade level, and immigrant status were not associated with designated organ donor status; however, Catholics were significantly less likely to be donors. Key barriers to being a designated donor included a lack of knowledge or misperceptions due to urban myths about organ donation, parents completing “organ donor” question on driver's license application, and not wanting to have their body “cut up.”

Conclusions

Future organ donor campaigns should educate ethnic minority adolescents about the importance of becoming a designated organ donor on their first driver's license and counter urban myths about deceased organ donation. Guidelines for how to initiate family discussions about organ donation should be sensitive to cultural and religious beliefs.

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References

Port

Merion

Goodrich

Wolfe

. Recent trends and results for organ donation and transplantation in the United States, 2005. Am J Transplant. 2006;6(5 pt 2):1095–1100.

Delmonico

Sheehy

Marks

. Organ donation and utilization in the United States, 2004. Am J Transplant. 2005;5(4 pt 2):862–873.

Nathan

Conrad

Held

. Organ donation in the United States. Am J Transplant. 2003;3(suppl 4):29–40.

Organ Procurement and Transplantation Network. Data reports for data on organ donation, transplantation, and waiting list candidates. http://www.optn.org. Accessed March 7, 2010.

Albright

Glanz

Wong

. Knowledge and attitudes about deceased donor organ donation in Filipinos: A qualitative assessment. Transplant Proc. 2005;37(10):4153–4158.

Spigner

Weaver

Cardenas

Allen

. Organ donation and transplantation: Ethnic differences in knowledge and opinions among urban high school students. Ethn Health. 2002;7(2):87–101.

Joun

Coonan

LeGrande

. Attitudes of Korean-Americans in and around New York City toward organ transplantation. Transplant Proc. 1997;29(8):3751–3752.

Lam

McCullough

. Influence of religious and spiritual values on the willingness of Chinese-Americans to donate organs for transplantation. Clin Transplant. 2000;14(5):449–456.

Alden

Cheung

. Organ donation and culture: A comparison of Asian American and European American beliefs, attitudes, and behaviors. J Appl Soc Psychol. 2000;30(2):293–314.

10.

Braun

Onaka

Horiuchi

. End-of-life preferences in Hawaii. Hawaii Med J. 2000;59(12):440–446.

11.

Braun

Yang

Onaka

Horiuchi

. Asian and Pacific Islander mortality differences in Hawaii. Soc Biol. 1997;44(3–4):213–226.

12.

Organ Procurement and Transplantation Network. Deceased Donors Recovered in the U.S. by donor ethnicity (1988- 2009). Health Resources and Services Administration, US Department of Health and Human Services. http://optn.transplant.hrsa.gov/latestData/rptData.asp. Accessed March 7, 2010.

13.

Organ Procurement and Transplantation Network. Deceased Donors Recovered in the U.S. by Donor Age (ethnicity added to field report): Donors recovered Jan. 1, 1988-Nov. 30, 2009. U.S. Department of Health and Human Services, Health Resources and Services Administration. http://optn.transplant.hrsa.gov/latestData/rptData.asp. Accessed June 20, 2010.

14.

U.S. Census Bureau. Annual Estimates of the resident population by sex, race, and Hispanic origin for the United States: April 1, 2000-July 1, 2008. http://www.census.gov/popest/national/asrh/NC-EST2008-srh.html. Accessed June 20, 2010.

15.

Gallup Organization. National survey on organ and tissue donation attitudes and behaviors. Health Resources and Services Administration, Division of Transplantation. http://www.organdonor.gov/survey2005/introduction.shtm. Accessed June 20, 2010.

16.

Donate Life America. National Donor Designation Report Card. Richmond, Virginia: Donate Life America; 2009. http://www.donatelife.net/pdfs/DLA_Report_Card_2009.pdf. Accessed June 20, 2010.

17.

Siminoff

Gordon

Hewlett

Arnold

. Factors influencing families' consent for donation of solid organs for transplantation. JAMA. 2001;286(1):71–77.

18.

Smith

Kopfman

Lindsey

Yoo

Morrison

. Encouraging family discussion on the decision to donate organs: The role of the willingness to communicate scale. Health Commun. 2004;16(3):333–346.

19.

Sirois

Sears

Jr. Marhefka

. Do new drivers equal new donors? An examination of factors influencing organ donation attitudes and behaviors in adolescents. J Behav Med. 2005;28(2):201–212.

20.

Baughn

Rodrigue

Cornell

. Intention to register as organ donors: A survey of adolescents. Prog Transplant. 2006;16(3):260–267.

21.

Godin

Belanger-Gravel

Gagne

Blondeau

. Factors predictive of signed consent for posthumous organ donation. Prog Transplant. 2008;18(2):109–117.

22.

Reubsaet

Brug

Nijkamp

. The impact of an organ donation registration information program for high school students in the Netherlands. Soc Sci Med. 2005;60(7): 1479–1486.

23.

Reubsaet

Van den Borne

Brug

Pruyn

Van Hooff

. Determinants of the intention of Dutch adolescents to register as organ donors. Soc Sci Med. 2001;53(3):383–392.

24.

Bresnahan

Lee

Smith

. A theory of planned behavior study of college students' intention to register as organ donors in Japan, Korea, and the United States. Health Commun. 2007;21(3):201–211.

25.

Morgan

Miller

. Beyond the organ donor card: The effect of knowledge, attitudes, and values on willingness to communicate about organ donation to family members. Health Commun. 2002;14(1):121–134.

26.

U.S. Census Bureau. The Asian Population: 2000. Chinese was the largest Asian group in the United States, followed by Filipinos and Asian Indians. US Department of Commerce. http://www.census.gov. Accessed June 20, 2010.

27.

Anantachoti

Gross

Gunderson

. Promoting organ donation among high school students: An educational intervention. Prog Transplant. 2001;11(3):201–207.

28.

Bresnahan

Lee

Smith

Shearman

Yoo

. Reservations of the spirit: The development of a culturally sensitive spiritual beliefs scale about organ donation. Health Commun. 2007;21(1):45–54.

29.

Vinokur

Merion

Couper

Jones

Dong

. Educational web-based intervention for high school students to increase knowledge and promote positive attitudes toward organ donation. Health Educ Behav. 2006;33(6):773–786.

30.

Thornton

Wong

Cardenas

. Ethnic and gender differences in willingness among high school students to donate organs. J Adolesc Health. 2006;39(2):266–274.

31.

Weaver

Spigner

Pineda

Rabun

Allen

. Knowledge and opinions about organ donation among urban high school students: Pilot test of a health education program. Clin Transplant. 2000;14(4 pt 1):292–303.

32.

Siminoff

Burant

Youngner

. Death and organ procurement: Public beliefs and attitudes. Soc Sci Med. 2004; 59(11):2325–2334.

33.

Piccoli

Soragna

Putaggio

. Efficacy of an educational program on dialysis, renal transplantation, and organ donation on the opinions of high school students: A randomized controlled trial. Transplant Proc. 2004;36(3):431–432.

34.

Waldrop

Tamburlin

Thompson

Simon

. Life and death decisions: Using school-based health education to facilitate family discussion about organ and tissue donation. Death Stud. 2004;28(7):643–657.

35.

Weaver

Shiu-Thornton

Spigner

Chan

Allen

. Organ donation among Asians and Pacific Islanders: Preliminary research findings. J Health Care Poor Underserved. 2003;14(2):182–193.

36.

Park

Hee Sun

Shin

Yoon Sook

Yun

. Differences between white Americans and Asian Americans for social responsibility, individual right and intentions regarding organ donation. J Health Psychol. 2009;14(5):707–712.

37.

Morse

Afifi

Morgan

. Religiosity, anxiety, and discussions about organ donation: Understanding a complex system of associations. Health Commun. 2009;24(2):156–164.

38.

Albright

Wong

Cruz

Dela MR

Abe

Sagayadoro

. Factors associated with organ donation in Filipino Americans: Results from Hawaii's Bayanihan Project. Hawaii Med J. 2007; 66(7):181–184.

39.

Anderson

. Health and illness in Pilipino immigrants. West J Med. 1983;139(6):811–819.

40.

Araneta

Barrett-Connor

. Ethnic differences in visceral adipose tissue and type 2 diabetes: Filipino, African-American, and white women. Obes Res. 2005;13(8):1458–1465.

41.

. Cultural factors in preventive care: Asian-Americans. Prim Care. 2002;29(3):495–502, viii.

42.

Gomez

Kelsey

Glaser

Lee

Sidney

. Immigration and acculturation in relation to health and health-related risk factors among specific Asian subgroups in a health maintenance organization. Am J Public Health. 2004; 94(11):1977–1984.

43.

State of Hawaii. Rank by detailed Asian race, for the state of Hawaii: 2000. Department of Health http://hawaii.gov/dbedt/info/census/Folder.2005-10-13.2927/sf1/sf1/rankasianall.pdf. Accessed March 7, 2010.

44.

Weller

Ferguson

Port

. Influence of race of cadaveric kidney donor and recipient on graft survival: A multifactorial analysis. Am J Kidney Dis. 1987;9(3):191–199.