Asian American Adolescents' Willingness to Donate Organs and Engage in Family Discussion about Organ Donation and Transplantation

Abstract

Context—

Despite the growing need for organ donation among Asian Americans, studies suggest that they are reluctant to donate.

Objective—

To examine the association of attitudes and knowledge about organ donation and transplantation with willingness to donate and willingness to engage in family discussion about organ donation among Asian American adolescents.

Design—

A cross-sectional study.

Setting—

The Big Island of Hawaii.

Participants—

Self-identified Asian American adolescents (Japanese, Chinese, Filipino, Korean), ages 16 to 17 years old, and each adolescent's parent or guardian.

Main Outcome Measures—

Asian American adolescents provided demographic information and completed the Modified Organ Donation Attitude Survey, the Organ Donation and Transplantation Knowledge Survey, and the Suinn-Lew Asian Self-Identity Acculturation Scale. A parent or guardian also provided demographic information. Linear regression analyses were used to examine the associations with willingness to donate and to engage in family discussion about organ discussion.

Results—

Willingness to donate was associated with positive knowledge related to general aspects about organ donation and cultural limitations in receiving an organ transplant, a high level of acculturation, and a low level of negative attitudes (R² = 0.402, F = 18.86, P = .005). Asian American adolescents with approving or positive attitudes were likely to engage in family discussion about organ donation (R² = 0.195, F =27.93, P = .005). To reinforce and maintain high levels of knowledge and positive attitudes, organ donation education is most likely needed in high schools.

Get full access to this article

View all access options for this article.

References

Mitch

. Treating diabetic nephropathy—are there only economic issues? N Engl J Med. 2004;351(19):1934–1936.

USDHHS. Healthy People 2010. Atlanta, GA: CDC Office of Disease Prevention and Health Promotion; 2000.

Cheung

Alden

Wheeler

. Cultural attitudes of Asian-Americans toward death adversely impact organ donation. Transplant Proc. 1998;30(7):3609–3610.

Park

Shin

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.

Sanner

. Giving and taking—to whom and from whom? People's attitudes toward transplantation of organs and tissue from different sources. Clin Transplant. 1998;12(6):530–537.

Rumsey

Hurford

Cole

. Influence of knowledge and religiousness on attitudes toward organ donation. Transplant Proc. 2003;35(8):2845–2850.

Churak

. Racial and ethnic disparities in renal transplantation. J Natl Med Assoc. 2005;97(2):153–160.

Rocheleau

. Increasing family consent for organ donation: Findings and challenges. Prog Transplant. 2001;11(3):194–200.

Siminoff

Burant

Youngner

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

10.

Meier

Schultz

Kuhlencordt

. Effects of an educational segment concerning organ donation and transplantation. Transplant Proc. 2000;32(1):62–63.

11.

Wheeler

O'Friel

Cheung

AHS

. Cultural beliefs of Asian Americans as barriers to organ donation. J Transpl Coord. 1994;4:146–150.

12.

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.

13.

Albright

Glanz

Wong

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

14.

Morgan

. The power of talk: African Americans' communication with family members about organ donation and its impact on the willingness to donate organs. J Soc Pers Relat. 2004;21(1):112–124.

15.

United Network for Organ Sharing. Common Myths of Organ Donation. http://www.unos.org/donation/index.php?topic-fact_sheet_7. Accessed June 15, 2011.

16.

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.

17.

Kim

Elliott

Hyde

. The influence of sociocultural factors on organ donation and transplantation in Korea: Findings from key informant interviews. J Transcult Nurs. 2004;15(2): 147–154.

18.

Randhawa

. The impending kidney transplant crisis for the Asian population in the UK. Public Health. 1998;112(4):265–268.

19.

Wong

FWH

Anderson

. Team approach in cross-cultural ethical decision making: A case study. Prog Transplant. 2003; 13(1):38–41.

20.

Holley

McCauley

Doherty

. Patients' views in the choice of renal transplant. Kidney Int. 1996;49(2):494–498.

21.

Bowman

Richard

. Culture, brain death, and transplantation. Prog Transplant. 2003;13(3):211–215.

22.

Gollin

Harrigan

Perez

. Improving Hawaiian and Filipino involvement in clinical research opportunities: Qualitative findings from Hawaii. Ethn Dis. 2005;15(4 suppl 5):111–119.

23.

Berry

. Acculturation as varieties of adaptation. In: Padilla

, ed. Acculturation: Theories, Models, and Some New Findings. Boulder, CO: Westview Press; 1980:9–25.

24.

Muuss

. Theories of Adolescence. 6th ed. New York, NY: McGraw-Hill; 1996.

25.

Fishbein

Ajzen

. Belief, Attitude, Intention, and Behavior: An Introduction to Theory and Research. Reading, MA: Addison-Wesley; 1975.

26.

Horton

. Knowledge regarding organ donation: Identifying and overcoming barriers to organ donation. Soc Sci Med. 1990;31(7):791–800.

27.

Horton

. A model of willingness to become a potential organ donor. Soc Sci Med. 1991;33(9):1037–1051.

28.

Kopfman

Smith

. Understanding the audiences of a health communication campaign: A discriminant analysis of potential organ donors based on intent to donate. J Appl Commun Res. 1996;24(1):33–49.

29.

Skumanich

Kintsfather

. Promoting the organ donor card: A causal model of persuasion effects. Soc Sci Med. 1996;43(3):401–408.

30.

Morgan

Miller

Arasaratnam

. Similarities and differences between African-Americans' and European-Americans' attitudes, knowledge and willingness to communicate about organ donation. J Appl Soc Psychol. 2003;33(4):693–715.

31.

Morgan

Miller

Arasaratnam

. Signing cards, saving lives: An evaluation of the Worksite Organ Donation Promotion Project. Commun Monogr. 2002;69(3):253–273.

32.

Liu

Pope-Davis

Nevitt

. Understanding the function of acculturation and prejudicial attitudes among Asian Americans. Cultur Divers Ethnic Mino Psychol. 1999; 5(4):317–328.

33.

Berry

Trimble

Olmedo

. Assessment of acculturation. In: Lonner

Berry

, eds. Field Methods in Cross-Cultural Research. Beverly Hills, CA: Sage; 1986:291–349.

34.

Koplow

Messinger

. Developmental dilemmas of young children of immigrant parents. Child Adolesc Soc Work. 1990; 7(2):121–134.

35.

Berry

. Acculturation as varieties of adaptation. In: Padilla

, ed. Acculturation: Theory, Models, and Some New Findings. Boulder, CO: Westview Press; 1980:9–25.

36.

Berry

Kim

Minde

. Comparative studies of acculturative stress. Int Migr Rev. 1987;21:491–511.

37.

Berry

Kim

Power

. Acculturation attitudes in plural societies. Appl Psychol. 1989;38(2):185–206.

38.

Willgerodt

Killien

. Family nursing research with Asian families. J Fam Nurs. 2004;10(2):149–172.

39.

Trompeta

Chen

Cooper

. Development of the organ donation and transplantation knowledge survey for use in Asian American adolescents. Transplant Proc. 2010; 42(5): 1427–1431.

40.

Suinn

Ahuna

Khoo

. The Suinn-Lew Asian Self-Identity Acculturation Scale: Concurrent and factorial validation. Educ Psycho Meas. 1992;52(4):1041–1046.

41.

Morgan

Miller

. Communicating about gifts of life: The effect of knowledge, attitudes, and altruism on behavior and behavioral intentions regarding organ donation. J Appl Commun Res. 2002;30(2):163–178.

42.

Rubens

. Racial and ethnic differences in students' attitudes and behavior toward organ donation. J Natl Med Assoc. 1996; 88(7):417–421.

43.

Thornton

Curtis

Allen

. Completion of advanced care directives is associated with willingness to donate. J Natl Med Assoc. 2006;98(6):897–904.

44.

Weaver

Spigner

Pineda

. 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.

45.

Iwamasa

. Acculturation of Asian American university students. Assessment. 1996;3(1):99–102.

46.

Kodama

Canetto

. Reliability and validity of the Suinn-Lew Asian Self-Identity Acculturation Scale with Japanese temporary residents. Psychologia. 1995;38(1):17–21.

47.

Ownbey

Horridge

. The Suinn-Lew Asian Self-Identity Acculturation Scale: Test with a non-student, Asian American sample. Soc Behav Pers. 1998;26(1):57–68.

48.

Suinn

Khoo

Ahuna

. The Suinn-Lew Asian Self-Identify Acculturation Scale: Cross-cultural information. J Multicult Couns Devel. 1995;23(3):139–148.

49.

Cohen

. Statistical Power Analysis for the Behavioral Sciences. 2nd ed. Hillsdale, NJ: Lawrence Erlbaum Associates; 1988.

50.

United Network for Organ Sharing. OPTN Data Collection Forms: Transplant Candidate Registration Form. http://www.unos.org/docs/Kidney-Adult_Transplant_Candidate_Registration.pdf. Accessed September 17, 2011.

51.

Sanner

. A Swedish survey of young people's views on organ donation and transplantation. Transpl Int. 2002;15(12): 641–648.

52.

Tokalak

Basaran

Emiroglu

. Health care professionals' knowledge of procedural issues in transplantation: The need for continuing education programs. Transplant Proc. 2004; 36(1):14–16.

53.

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.

54.

Essman

Thornton

. Assessing medical student knowledge, attitudes, and behaviors regarding organ donation. Transplant Proc. 2006;38(9):2745–2750.

55.

Radecki

Jaccard

. Signing an organ donation letter: The prediction of behavior from behavioral intentions. J Appl Soc Psychol. 1999;29(9):1833–1853.

56.

Tokalak

Kut

Moray

. Knowledge and attitudes of high school students related to organ donation and transplantation: A cross-sectional survey in Turkey. Saudi J Kidney Dis Transpl. 2006;17(4):491–496.

57.

AMS

. Discussion of posthumous organ donation in Chinese families. Psychol Health Med. 2008;13(1):48–54.

58.

Pham

Spigner

. Knowledge and opinions about organ donation and transplantation among Vietnamese Americans in Seattle, Washington: A pilot study. Clin Transplant. 2004;18(6): 707–715.

59.

Albright

Wong

Dela Cruz

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

60.

Craig

Baucum

. Human Development. 9th ed. Upper Saddle River, NJ: Prentice Hall; 2002.

61.

Dwivedi

. Meeting the Needs of Ethnic Minority Children. 2nd ed. London, United Kingdom: Jessican Kingsley Publishers; 2002.

62.

Spigner

Weaver

Pineda

. Race ethnic-based opinions on organ donation and transplantation among teens: Preliminary results. Transplant Proc. 1999;31(1–2):1347–1348.

63.

DeVita

Caplan

. Caring for organs or for patients? Ethical concerns about the Uniform Anatomical Gift Act (2006). Ann Intern Med. 2007;147(12):876–879.

64.

Iltis

Rie

Wall

. Organ donation, patients' rights, and medical responsibilities at the end of life. Crit Care Med. 2009;37(1):310–315.

65.

Verheijde

Rady

McGregor

. Commentary: The United States Revised Uniform Anatomical Gift Act (2006): New challenges to balancing patient rights and physician responsibilities. Philos Ethics Humani Med. 2007;2:19.