Tissue and Organ Procurement
Conditions
Keywords
designated organ donor, college students
Brief summary
Taking advantage of college students' frequent use of online technology, including social networking sites (e.g., Instagram a social media site /Facebook a social networking site) and social media sites (e.g., YouTube), the investigators will create an online intervention that leverages this technology to engage and educate Asian, Native Hawaiian, Pacific Islanders (ANHPI)students about a range of topics related to organ donation following death.
Detailed description
Over 56% of the 120,000 critically ill Americans waiting on transplant waiting lists are ethnic minorities. The proportion of ethnic minorities, including Asian, Native Hawaiian, Pacific Islanders (ANHPI), on waiting lists exceeds their representation in the general population. However, few ANHPI adults are designated organ donors (DOD) on their driver's licenses or in a donor registry. ANHPI college students (aged 18-29) also have low DOD rates, particularly Filipinos. Individuals are typically asked about becoming a DOD when renewing a driver's license; but most never think about OD outside of the short-lived Department of Motor Vehicles (DMV) transaction. Knowing someone's status as a DOD on their license can be an influential factor in solidifying a family's feelings about donating a relative's organs after his/her death, if their consent is necessary. Of those who choose DOD status on a license, most will remain one for life. Intervening with drivers before the date of their license renewal can be difficult to arrange; however, opportunities arise when college students turn 21 and want to renew their license in order to remove formatting / colors signifying that the license belongs to an underage minor (\< 21 years old). Taking advantage of college students' frequent use of online technology, including social networking sites (e.g., Instagram a social media site /Facebook a social networking site) and social media sites (e.g., YouTube), the investigators created an online intervention that leveraged this technology to engage and educate ANHPI students about a range of topics related to organ donation (OD). It will also provide culturally sensitive messages tailored to their interest in or wariness of organ donation and reframe students' attitudes about OD and becoming a DOD. Previous internet interventions to encourage college students to become DODs have not included culturally sensitive approaches for ANHPI, who have unique barriers to OD. The cross-sectional design will test the impact of introducing, sequentially, an online intervention tailored to college students at three universities (UH-Manoa, UH-Hilo, and Hawaii Pacific University). The sequence of when the a university received the intervention was randomly determined; thus, the study's design was a cross-sectional design. The goal was to increase DOD rates in college students, particularly ANHPI and encouraging peer discussions/interactions/advocacy about OD. Effectiveness will be measured by a change over time in the percentage of students who report being a DOD on their license/donor registry (250 students per university measured across 6 time points; thus, the total sample = 4,500). The investigators anticipate a 12% increase in DOD rate in students who are exposed to the intervention. Increases in DOD status will also be tracked via an increase (over normal rates) in the number of new donors aged 18-29 who register as a donor on Hawaii's online donor registry. To make the study website relevant to college students the investigators will include resources useful for assignments in courses (e.g., both in required general education courses- including one on writing skills, and courses on ethics, religion, sociology, and culture/ ethnic studies, etc.) Students and student organizations will participate in contests to win prizes (e.g., for the best 1-minute DOD focused-YouTube video/ Instagram picture, creating a caption for a photo on Instagram, and student organizations who compete for group awards). A goal of the intervention will be to reframe OD by engaging altruistic attitudes based on college students' commitment to green sustainability efforts (e.g., go green, recycle yourself). Innovative culturally sensitive strategies that can engage, educate, and reframe DOD for college students, including those who find it unappealing (i.e., the ick factor) are clearly needed. The online intervention will saturate online venues (i.e., YouTube, Instagram) visited frequently by college students, and the investigators will use the new concept of gamification to turn college students' learning and advocacy ideas surrounding OD/DOD into a game or contest with their peers. This project builds upon Drs. Albright and Feeley's (consultant - Univ. of Buffalo, Dept. of Communications) previous work to encourage adolescents and young adults to become a DOD; thus, the investigators feel well-suited to design, implement, and evaluate the proposed project. The intervention will increase DOD rates in ANHPI students, and thus, increase the number of ethnic minorities who become deceased organ donors now and for years to come.
Interventions
interactive website using social media and gamification
Sponsors
Study design
Masking description
Students did not know the schedule for rolling out the intervention by university.
Intervention model description
Online educational intervention of choice to be an organ donor was provided to undergraduate students at three universities. The intervention launch at the universities were sequentially initiated, in random order. The design included cross-sectional assessments (unique respondents at each site over time ) as well as longitudinal assessments (same students repeatedly assessed over time).
Eligibility
Inclusion criteria
* Must be registered undergraduate student at University of Hawaii at Manoa, University of Hawaii at Hilo, or Hawaii Pacific University * Must be over the age of 18yrs
Exclusion criteria
* Not an undergraduate college student at one of the participating university sites
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Donor Status | 2 years | number of subjects who are designated organ donor on license |
| Talk to Peers/Family | 2 years | number of subjects who report talking to family or peers about choice be organ donor |
Countries
United States
Participant flow
Recruitment details
Cross-sectional samples of undergraduate students were recruited for every survey; thus, numbers that completed a baseline or a post-treatment survey differed by site. Surveys prior to the intervention served as baseline data and surveys after initiation served as intervention results. For example, one site (UHM -Manoa) received only one baseline survey; but 6 post-intervention surveys.Thus, it had small baseline sample; but, large post-test sample.
Participants by arm
| Arm | Count |
|---|---|
| First Initiation Site University randomized to receive intervention after 1 baseline assessment. Duration of intervention was 3 semesters. This was University of Hawaii at Manoa (UHM). | 1,483 |
| Second Initiation Site University randomized to receive intervention after 3 baseline assessment. Duration of intervention was 2 semesters. This was University of Hawaii at Hilo (UHH). | 1,412 |
| Third Initiation Site University randomized to receive intervention after 5 baseline assessment. Duration of intervention was 2 semesters. This was Hawaii Pacific University (HPU). | 1,932 |
| Total | 4,827 |
Baseline characteristics
| Characteristic | First Initiation Site | Total | Third Initiation Site | Second Initiation Site |
|---|---|---|---|---|
| Age, Continuous | 21.78 years STANDARD_DEVIATION 0.37 | 22.43 years STANDARD_DEVIATION 0.57 | 22.68 years STANDARD_DEVIATION 0.27 | 22.77 years STANDARD_DEVIATION 0.36 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 161 Participants | 684 Participants | 306 Participants | 217 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 1313 Participants | 4075 Participants | 1597 Participants | 1165 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 9 Participants | 68 Participants | 29 Participants | 30 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 38 Participants | 187 Participants | 79 Participants | 70 Participants |
| Race (NIH/OMB) Asian | 757 Participants | 1786 Participants | 671 Participants | 358 Participants |
| Race (NIH/OMB) Black or African American | 21 Participants | 128 Participants | 82 Participants | 25 Participants |
| Race (NIH/OMB) More than one race | 169 Participants | 467 Participants | 146 Participants | 152 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 206 Participants | 779 Participants | 199 Participants | 374 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 28 Participants | 146 Participants | 73 Participants | 45 Participants |
| Race (NIH/OMB) White | 264 Participants | 1334 Participants | 682 Participants | 388 Participants |
| Region of Enrollment United States | 1483 Participants | 4827 Participants | 1932 Participants | 1412 Participants |
| Sex: Female, Male Female | 1120 Participants | 3627 Participants | 1578 Participants | 929 Participants |
| Sex: Female, Male Male | 363 Participants | 1200 Participants | 354 Participants | 483 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk |
|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 1,483 | 0 / 1,412 | 0 / 1,932 |
| other Total, other adverse events | 0 / 1,483 | 0 / 1,412 | 0 / 1,932 |
| serious Total, serious adverse events | 0 / 1,483 | 0 / 1,412 | 0 / 1,932 |
Outcome results
Donor Status
number of subjects who are designated organ donor on license
Time frame: 2 years
Population: Undergraduate students who completed surveys.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| First Initiation Site | Donor Status | 748 Participants |
| Second Initiation Site | Donor Status | 715 Participants |
| Third Initiation Site | Donor Status | 1030 Participants |
Talk to Peers/Family
number of subjects who report talking to family or peers about choice be organ donor
Time frame: 2 years
Population: Undergraduate students who completed surveys.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| First Initiation Site | Talk to Peers/Family | 555 Participants |
| Second Initiation Site | Talk to Peers/Family | 563 Participants |
| Third Initiation Site | Talk to Peers/Family | 846 Participants |