A Sequential Decision Framework for Increasing College Students' Support for Organ Donation and Organ Donor Registration

Abstract

Context

Despite the fact that college students support social causes, this age group has underparticipated in organ donor registration. Little research attention has been given to understanding deeper, higher-order relationships between the antecedent attitudes toward and perceptions of organ donation and registration behavior.

Objective

To test a process model useful for understanding the sequential ordering of information necessary for moving college students along a hierarchical decision-making continuum from awareness to support to organ donor registration.

Design and Setting

The University of Wisconsin organ procurement organization collaborated with the Collegiate American Marketing Association on a 2-year grant funded by the US Health Resources and Services Administration. A total of 981 association members responded to an online questionnaire.

Measures

The 5 antecedent measures were awareness of organ donation, need acknowledgment, benefits of organ donation, social support, and concerns about organ donation. The 2 consequence variables were support for organ donation and organ donation registration.

Results

Structural equation modeling indicated that 5 of 10 direct antecedent pathways led significantly into organ donation support and registration. The impact of the nonsignificant variables was captured via indirect effects through other decision variables. Model fit statistics were good: the goodness of fit index was .998, the adjusted goodness of fit index was .992, and the root mean square error of approximation was .001.

Implications

This sequential decision-making model provides insight into the need to enhance the acceptance of organ donation and organ donor registration through a series of communications to move people from awareness to behavior.

Get full access to this article

View all access options for this article.

References

US Department of Health and Human Services. U.S. Government Information on Organ and Tissue Donation and Transplantation. http://www.organdonor.gov. Accessed January 17, 2012.

Organ Procurement and Transplantation Network. Waiting List Data. http://optn.transplant.hrsa.gov. Accessed January 17, 2012.

Donate Life America. Understand Donation. http://donatelife.net/understanding-donation/statistics. Accessed January 17, 2012.

D'Alessandro

Peltier

Phelps

Increasing organ donations after cardiac death by increasing DCD support among health care professionals: A case report. Am J Transplant. 2008;8(4):897–904.

Donate Life America. National Donor Designation Report Card. http://donatelife.net/wp-content/uploads/2011/04/DLA-Report-BKLT-30733-2.pdf. Accessed July 29, 2011.

Feeley

. College students' knowledge, attitudes, and behaviors regarding organ donation: An integrated review of the literature. J Appl Psychol. 2007;37(2):243–271.

Marshall

Feeley

. A normative approach to shaping college students' attitudes toward organ donation. Commun Stud. 2006;57(4):435–453.

Feeley

Servoss

. Examining college students' intentions to become organ donors. J Health Commun. 2005; 10(3):237–249.

Hall

Robbins

Paiva

Knott

Harris

Mattice

Donation intentions among African American college students: Decisional balance and self-efficacy measures. J Behav Med. 2007;30(6):483–495.

10.

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.

11.

AMS

Tang

. Solving the dilemma: Family communication about organ donation among Chinese, Japanese, and Caucasian American college students. J Appl Psychol. 2009; 39(7):1639–1659.

12.

Pitts

Raup-Krieger

Kundrat

Nussbaum

. Mapping the processes and patterns of family organ donation discussions: Conversational styles and strategies in live discourse. Health Commun. 2009;24(5):413–425.

13.

Rykhoff

Coupland

Dionne

. A clinical group's attempt to raise awareness of organ and tissue donation. Prog Transplant. 2010;20(1):33–39.

14.

Albright

Wong

Cruz

Sagayadoro

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. Prog Transplant. 2010;20(4):392–400.

15.

D'Alessandro

Peltier

Dahl

. The impact of social, cognitive and attitudinal dimensions on college students' support for organ donation. Am J Transplant. 2011;12(1):152–161.

16.

D'Alessandro

Peltier

Dahl

. The use of social media by university students to increase support for organ donation. Prog Transplant. In press.

17.

Siegel

Alvaro

Hohman

. A dawning recognition of factors for increasing donor registration. In: Siegel

Alvaro

, eds. Understanding Organ Donation Applied Behavioral Science Perspectives. Chichester, UK: John Wiley & Sons; 2010:313–330.

18.

Prochaska

DiClemente

Norcross

. In search of how people change: Applications to addictive behaviors. Am Psychol. 1992;47(9):1102–1114.

19.

Fishbein

Ajzen

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

20.

Ajzen

The theory of planned behavior. Organ Behav Hum Decis Process. 1991;50:179–211.

21.

Rios

Cascales

Martinez

. Emigration from the British Isles to southeastern Spain: A study of attitudes toward organ donation. Am J Transplant. 2007;7(8):2020–2030.

22.

Feeley

Tamburlin

Vincent

. An educational intervention on organ and tissue donation for first-year medical students. Prog Transplant. 2008;18(2):103–108.

23.

Mostafa

. Altruistic, cognitive, and attitudinal determinants of organ donation intention in Egypt: A social marketing perspective. Health Mark Q. 2010;27(1):97–115.

24.

Feeley

Anker

Watkins

Rivera

Tag

Volpe

A peer-to-peer campaign to promote organ donation among racially diverse college students in New York City. J Natl Med Assoc. 2009;101(11):1154–1162.

25.

Sonmez

Zengin

Ongel

Kisioglu

Ozturk

Attitude and behavior related to organ donation and affecting factors: A study of last-term students at a university. Transplant Proc. 2010;42(5):1449–1452.

26.

Wakefield

Watts

Homewood

Meiser

Siminoff

. Attitudes toward organ donation and donor behavior: A review of the international literature. Prog Transplant. 2010; 20(4):380–391.

27.

Rodrigue

Cornell

Howard

. Relationship of exposure to organ donation information to attitudes, beliefs, and donation decisions of next of kin. Prog Transplant. 2009;19(2): 173–179.

28.

Siegel

Alvaro

Crano

Gonzalez

Tang

Jones

. Passive-positive organ donor registration behavior: A mixed method assessment of the IIFF Model. Psychol Health Med. 2010;15(2):198–209.

29.

Siegel

Alvaro

. Where have we been and where to next: A review and synthesis of organ donation media campaigns. In: Siegel

Alvaro

, eds. Understanding Organ Donation Applied Behavioral Science Perspectives. Chichester, UK: John Wiley & Sons; 2010:43–63.

30.

Peltier

Scovotti

Pointer

The role the collegiate American Marketing Association plays in professional and entrepreneurial skill development. J Mark Educ. 2008;30(1):47–56.

31.

National Center for Education Statistics. Fast Facts. http://nces.ed.gov/fastfacts/display.asp?id=98. Accessed January 17, 2012.

32.

Nunnally

Psychometric Theory. 2nd ed. New York, NY: McGraw-Hill; 1978.

33.

Churchill

. A paradigm for developing better measures of marketing constructs. J Mark Res. 1979;16:64–73.

34.

Peltier

D'Alessandro

Hsu

Schibrowsky

. A hierarchical communication model of the antecedents of health care professionals' support for donations after cardiac death. Am J Transplant. 2011;11(3):591–598.

35.

Anker

Feeley

. Asking the difficult questions: Message strategies used by organ procurement coordinators in requesting familial consent to organ donation. J Health Commun. 2011;16(6):643–659.