A test of three interventions to promote people's communication of their consent for organ donation

Abstract

People's decision to join an organ donor registry and have a discussion with family about their organ donation preference increases the likelihood that their family will consent to donation of their organs. This study explores the effectiveness of three interventions compared to a control condition to increase individual consent (registering and discussing donation wishes) for organ donation. Australian residents who had not previously communicated their consent (N = 177) were randomly allocated to complete an online survey representing either an extended theory of planned behaviour motivational intervention (strengthening intention via attitudes, subjective norms, control, moral norms and identity), a volitional intervention using constructs from the health action process approach (strengthening the translation of intentions into action using action plans and coping plans), a combined motivational and volitional intervention, or a control condition. Registering, but not discussing, intentions increased in the motivational compared to non-motivational conditions. For joining the organ donor registry, the combination of strengthening intentions (motivational) as well as forming specific action (when, where, how, and with whom for discussing) and coping (listing potential obstacles and how these may be overcome) plans (volitional) resulted in significantly higher rates of self-reported behaviour. There was no evidence for this effect on discussion.

Investigating and Promoting the Decision towards Signing an Organ Donation Card

“…Our results corroborate previous findings [12] [19] that merely encouraging the decision by stimulating a behavior plan can be an effective intervention to increase organ donation behavior. This type of intervention would at least be useful for single behaviors.…”

“…Contrarily, a non-linear trend is indicated in general by significant differences between pairs of adjacent means in some variables, but not in others. Such a result pattern would support a stage model [12] [27]. Based on the HAPA's assumptions, mean discontinuity pattern hypotheses suggest that means of positive outcome expectancies should differ between the non-intentional and intentional stage (higher in intenders), but not between the intentional and action stage (hypothesis 2).…”

“…Furthermore, it includes past behavior (in terms of the stage variable), but no future behavior, no planning and no experimental manipulation. An experimental test is imperative for testing stages [12]. Thus, in the subsequent Study 2, the HAPA assumptions were tested experimentally, by adding a planning intervention and a preparatory behavior measure.…”

“…By contrast, individuals in the non-intentional stage first have to set a goal (i.e. increase their goals to donate) [8] [12]. For this group, a pure planning intervention is mismatched.…”

“…Firstly (in Study 1), we tested the stage-specific predictions of goal setting towards an altruistic, single behavior-donating an organ postmortem. The main innovation was to complement previous findings based on pure linear continuous assumptions in which the HAPA was chosen as a theoretical backdrop [12]. Subsequently (in Study 2), to validate the HAPA assumptions experimentally we tested the efficacy of a planning intervention introduced at a single meeting, and its stage-specific effects on the unique behavior of postmortem organ donation.…”