This multisite, qualitative study of 78 family-pair dyads provides rich data on the reasons people cite for (not) wanting to sign an organ donor card in the context of family conversations. In this study, dyads were videotaped as they discussed 8 questions pertaining to their views on organ donation, beginning with the most general opinions and progressing to more detailed questions. Analysis of the transcribed data revealed that the most common reasons for wanting to donate organs were based on religion or a desire to help other people in need. The most common reasons cited for not wanting to donate organs were mistrust (of doctors, hospitals, and the organ allocation system), a belief in a black market for organs in the United States, and deservingness issues (that one's organs would go to someone who brought on his or her own illness, or who could be a "bad person"). One of the most surprising findings is that religion is offered far more often as a rationale for wanting to help sick people through organ donation than it was for not wanting to donate organs. These findings both support and contradict past studies based on quantitative survey data. Implications for the construction of more effective future organ donor campaigns are discussed.

Researchers are already aware that decision making about health issues is not necessarily driven by rational or cognitive-based decision-making processes. This appears to be especially true for the decision to donate organs. Although hints about what is actually driving the decision-making process are scattered throughout the literature, noncognitive factors have not been tested systematically. Structural equation modeling of data gathered from 4426 participants at six different geographic locations in the United States demonstrates that cognitive-based factors (such as knowledge about donation) are less influential on the decision to donate than noncognitive variables such as the desire to maintain bodily integrity, worries that signing a donor card might 'jinx' a person, and medical mistrust.

Researchers and practitioners who have sought to understand public reluctance to donating organs in spite of favorable attitudes toward organ donation have long thought that belief in myths about donation contribute to the problem. How these myths emerged and more important, why they have persisted in spite of national education campaigns is not clear. In the absence of direct personal experience with organ donation or transplantation, we believe that most people receive their information about donation through the media. In this study, we identify all entertainment television shows with organ donation storylines or subplots broadcast on ABC, NBC, CBS, and FOX from 2004-2005. Frame analysis reveals 2 competing metaframes: the moral corruption of the powerful and organ donors are good people. In addition to the metaframes, 4 secondary frames, and 6 tertiary frames are identified. Organ donation is framed in mostly negative terms, with a few notable exceptions. Recommendations for how to address negative framing of organ donation in the media are offered.

In this study, 78 family pair dyads (spouses, parent-child pairs, or siblings) were brought into an interaction laboratory set up like a living room. After being briefed on the study, family members discussed a series of eight questions about their thoughts and opinions about organ donation. Thematic analysis of the thousands of pages of transcripts revealed that family members believe that they receive important information about organ donation through the media. Unfortunately, the most influential information came from sensationalistic, negative media portrayals. The myths that seem to be the most actively referenced by the media include premature declaration of death, the transference of personality traits from donor to recipient, a US black market for organs, corruption in the medical community, and corruption in the organ allocation system (which allows celebrities to get transplants first). Although these are not the only myths that the generally public holds to be true, the media is a powerful source of support for these particular myths. Therefore, such myths must be countered effectively if greater consent for organ donation is to be attained.

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African Americans are disproportionately represented on the national waiting list for organ transplantation. Promoting organ donor registries is one way to improve the possibility that those on the waiting list can receive a life saving transplant. Driver licensing bureaus have been suggested as an efficient site for campaigns aimed at increasing state-based registry sign-ups. Previous research has suggested these campaigns work well for Caucasian populations, but there is less evidence supporting this approach in more diverse populations. To determine whether more diverse populations demonstrate similar sign-up rates when receiving a driver licensing bureau campaign, the present study used a previously successful strategy as the basis for designing and disseminating materials that would appeal to African Americans and Caucasians in two diverse counties in the state of Michigan (Wayne and Oakland Counties). Communication design and media priming served as the theoretical foundations of a three-prong campaign that used mass media, point-of-decision, and interpersonal components. Results from countywide and zip code data indicate that the campaign greatly increased sign-ups among African American residents (700% increase above baseline). Although more Caucasians still signed up than did African Americans, the inclusion of an interpersonal component resulted in similar numbers of registry sign-ups during 2 intervention months. The study provides evidence supporting the use of driver licensing bureau campaigns to promote organ donation registries to diverse audiences.

This article examines the influence of religiosity, religious norms, subjective norms, and bodily integrity (the extent to which people think the body should remain unaltered after death) on intent to donate organs postmortem. A total of 4,426 participants from 6 universities completed surveys for this study. The results indicate that religiosity and religious norms had a nonsignificant effect on willingness to donate. In addition, attitudes toward donation had a weak positive relationship on intent to donate, whereas subjective norms exerted a modest positive relationship on intent to donate. Finally, the results reveal a strong direct and indirect effect of bodily integrity on intent to donate.

Training DMV clerks is an effective way to increase knowledge, attitudes, and beliefs for gatekeepers of organ donor registries and may increase donor registration rates among the public.