Community Based Research to Improve Organ Donor Registration among Black Men

描述(申请人提供)：美国的器官捐赠制度一直处于危机状态。超过115,000名患者正在等待移植，而等待名单每年增加数千人，尽管超过6,500人死亡，3,500人病情严重，无法接受移植。黑人男性不成比例地受到这场危机的影响，原因是高血压和糖尿病控制不力的患病率较高，治疗机会不足，导致终末期肾脏疾病的患病率最高，对肾脏移植的需求也更大。虽然黑人只占美国总人口的13%，但他们占等待肾脏移植的9.3万名患者的34%。黑人男性占等待名单的19%，而黑人女性占15%，这也表明了性别差异。联邦政府支持的干预措施增加了黑人捐赠者的数量，使捐赠率现在与他们的人口百分比成正比，但他们仍然远远低于不成比例的需求，因为当捐赠者和接受者的种族相似时，器官最佳匹配。在这项申请中，我们将研究如何使用与我们在纽约拥有的黑人理发店网络合作制作和分发的教育视频节目来改善黑人男性的器官捐赠者登记。我们将使用娱乐教育视频，并确定为不同受众制作的内容(通用的多元文化内容，针对理发店的黑人男性，以及根据单身观众先前的器官捐赠信念为他们量身定做)如何影响器官捐赠者注册。我们的应用是一个包括三个阶段的定性和定量研究设计，其中包括使用数字视频访谈来派生和提供视频的特定文化内容的干预开发阶段(目标1)；3个ARM 随机对照试验阶段：随机对照试验阶段，客户将被随机分成随iPad一起提供的通用的、有针对性的或量身定制的视频节目，之后将通过在线注册或通过申请邮寄提供即时的器官捐赠机会(目标2)；以及失败分析，即我们将采访一些在随机试验中注册但在教育课程结束后一个月未注册的参与者，以确定节目的影响(目标3)。未来的研究将涉及根据这项研究的发现修改这一视频节目，通过在大屏幕电视上播放通用或有针对性的视频的被动消息，或使用互动售货亭的定制节目，来促进黑人理发店的器官捐赠。通过这项工作，我们希望通过增加黑人男性的登记来减少器官移植的差异，黑人男性构成了一个不成比例地更需要肾脏移植的群体。

DESCRIPTION (provided by applicant): The U.S. organ donation system is in a perpetual state of crisis. Over 115,000 patients are waiting for transplants while the waitlist increases by several thousand annually despite over 6,500 dying and 3,500 becoming too sick to receive a transplant. Black men are disproportionally affected by this crisis, due to higher prevalence of poorly controlled hypertension and diabetes and inadequate access to treatment, leading to the highest prevalence of end-stage renal disease and a greater need for kidney transplantation. While Blacks comprise only 13 percent of the total U.S. population, they comprise 34 percent of the 93,000 patients waiting for kidney transplants. Black men comprise 19 percent of the waitlist compared to black women comprising 15 percent, indicating a gender disparity as well. Federally supported interventions have increased the number of black donors such that rates are now proportional to their population percentages, but they remain well below the disproportionate need since organs best match when donors and recipients are of similar race. In this application, we will investigate means for improving organ donor registration among black men using educational video programming produced and distributed in partnership with our network of black owned barbershops in NYC. We will use entertainment education videos and determine how content produced for different audiences (generic multicultural, targeted for black men in our barbershops, and tailored for single viewers based on their prior organ donation beliefs) influences organ donor registration. Our application is a 3- phase qualitative and quantitative research design that includes an intervention development phase using digital video interviewing to both derive and provide culturally specific content for the videos (Aim 1); a 3 arm randomized controlled trial phase, in which customers will be randomized to receive the generic, targeted, or tailored video programming delivered with iPads, after which an immediate organ donation opportunity will be offered through registration online or with a mailed in application (Aim 2); and a failure analysis whereby we will interview some of the participants from the randomized trial who registered and failed to register one month after their educational session to ascertain the influence of the programming (Aim 3). Future studies will involve modifying this video programming based on findings from this research to promote organ donation in black owned barbershops through passive messaging with generic or targeted videos shown on large screen TVs, or with tailored programs using interactive kiosks. Through this work, we hope to reduce organ transplantation disparities through increased registration among black men who comprise a group having a disproportionally greater need for kidney transplants.