Original Clinical Science-GeneralBackground. There are 20 million living US armed forces veterans; however, the organ donation attitudes of veterans have not been examined. Methods. Over a 17-month period, a convenience sample of 1517 veterans in New England completed a survey to assess attitudes about organ, tissue, and vascularized composite allograft (VCA) donation. Results. Most veterans (96%) supported the donation of organs and tissue for transplantation, and 59% were registered as an organ and tissue donor. Being younger (adjusted odds ratio [aOR]: 0.96 0.97 0.98 ; P = 0.01), female (aOR: 1.06 1.46 2.03 ; P = 0.02), non-Hispanic white (aOR: 1.30 2.07 3.30 ; P = 0.01), Hispanic (aOR: 1.28 2.43 4.61 ; P = 0.01), and having more trust that the transplant process is fair and equal (aOR: 1.19 1.40 1.65 ; P = 0.01) were predictive of donor registration. Also, most veterans were willing to donate their face (57%), hands/arms (81%), legs (81%), penis (men: 61%), and uterus (women: 76%) at time of death; donation willingness was higher for upper and lower limbs than for face or genitourinary organs (P < 0.001). Those unwilling to donate VCA organs expressed concerns about identity loss, psychological discomfort of self and others, body integrity, funeral presentation, and religious beliefs. Most (54%) felt that VCA donation should require permission of legal next-of-kin at the time of one's death, even if the decedent was a registered donor. Conclusions. There is a high level of support for organ, tissue, and VCA transplantation and donation among veterans, despite limited educational campaigns targeting this population. There is high potential among veterans to further increase donor registry enrollment and raise awareness about VCA benefits for severely injured service members.
Personal sensing may improve digital therapeutics for mental health care by facilitating early screening, symptom monitoring, risk prediction, and personalized/adaptive interventions. However, further development and use of personal sensing first requires better understanding of its acceptability to people targeted for these mental health applications. We assessed the acceptability of both active and passive personal sensing methods in a sample of people with moderate to severe alcohol use disorder using both behavioral and self-report measures. Participants (N = 154; 50% female; mean age = 41; 87% White, 97% Non-Hispanic) in early recovery (1 – 8 weeks of abstinence) from alcohol use disorder were recruited from the Madison, WI area to participate in a 3-month longitudinal study. Participants engaged with active (ecological momentary assessment; EMA, audio check-in, and sleep quality) and passive (geolocation, cellular communication logs, and text message content) personal sensing methods. We assessed 3 behavioral indicators of acceptability: participants’ choices about their participation in the study at various stages in the study procedure, their choice to opt-in to provide data for each personal sensing method, and their compliance for a subset of the active methods (EMA, audio check-in). We also assessed 3 self-report measures of acceptability (interference, dislike, and willingness to use for 1 year) for each method. All but 1 of the individuals who were eligible to participate consented to the personal sensing procedures. Most of these individuals (88%) also returned 1 week later to formally enroll in the study and begin to provide these data. All participants (100%) opted-in to provide data for EMA, sleep quality, and all passive methods (geolocation, cellular communication logs, text message content). Three participants (2%) did not provide any audio check-ins while on study. The average completion rate for all requested EMAs (4X daily) was 81% for 4x daily and 94% for 1x daily. The completion rate for the daily audio check-in was 55%. Aggregate participant ratings indicated all personal sensing methods to be significantly more acceptable (all P’s < .05) compared to neutral across subjective measures of interference, dislike, and willingness to use for 1 year. Participants did not significantly differ in their dislike of active compared to passive methods (P = .23). However, participants reported a higher willingness to use passive methods for 1 year compared to active methods (P = .04). The results of our study suggest that both active and passive personal sensing methods are generally acceptable to people with alcohol use disorder over a longer period than has previously been assessed. This was true even for data streams that contained potentially more sensitive information (e.g., geolocation, cellular communications). Important individual differences were observed both across people and methods which indicate opportunities for future improvements.
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