Physician Peer Minority Organ Donation Education Model

描述（由申请人提供）： 少数民族的潜在尸体捐赠者的同意率比白人低40-50%。密歇根州移植协会（密歇根州器官采购组织[OPO]）服务领域的同意过程的持续方案评估表明，占少数尸体器官捐赠者转介的93%的10个设施偏离了利用训练有素的和指定的捐赠专家管理捐赠请求过程的高收益方法。我们假设，医生的行为变化，使文化敏感和适当培训的捐赠专家承担主要/主要角色的捐赠请求将产生更高的捐赠率在少数器官捐赠者转介。我们建议：（B）设计一个2小时的医生同侪教育计划，由指定的医生领导人向在少数人器官捐赠者转介最集中的设施执业的选定专科医生的目标受众提供。此医师同侪少数民族器官捐献教育模式（PMODEM）的目的是：（1）利用八位医师领导者作为指导者/榜样，为经常遇到脑死亡的选定专业的医师提供指导，从而成为潜在的尸体器官捐献者（急诊医学，神经外科和创伤）;（2）为10个指定少数族裔转诊机构的80名执业医生提供2小时的“最佳捐赠管理实践”继续医学教育课程;（3）收集和管理OPO所有设施的捐赠管理流程的预期数据;以及（4）对PMODEM对以下方面的影响进行统计分析：（a）使用经过培训的指定请求者;（B）少数族裔的近亲同意率;（c）密歇根州东南部的少数族裔捐赠率。样本量计算表明，如果80名医生接受2小时的教育课程，则有90%的把握度可以检测到少数捐赠者同意率增加20%。使用受过训练的指定请求者，在获得近亲同意方面具有专业知识，这对增加少数民族捐赠者的尸体器官捐赠具有最大的直接潜力，其中约50%的人目前拒绝给予同意。

DESCRIPTION (provided by applicant): The consent rate in potential cadaveric donors among racial minorities is 40-50% lower than in Whites. Ongoing programmatic evaluation of the consent process in the service area of the Transplantation Society of Michigan (the Organ Procurement Organization [OPO] for the State of Michigan) indicates that ten facilities accounting for 93% of minority cadaveric organ donor referrals deviate from the high yield approach of utilizing trained and designated donation specialists in the management of the donation request process. We hypothesize that physician behavioral change enabling a culturally sensitive and appropriately trained donation specialist to assume the primary/principal role in the donation request would yield a higher donation rate in minority organ donor referrals. We propose to: (a) develop a 4-hour professional focus group on donation management with eight specialty physician leaders; and (b) design a 2-hour Physician Peer Educational Program to be delivered by the designated physician leaders to a target audience of physicians in selected specialties who practice in the facilities with the highest concentration of minority organ donor referrals. The aims of this Physician Peer Minority Organ Donation Education Model (PMODEM) are: (1) to utilize the eight physician leaders as instructors/role models for physicians in selected specialties who regularly encounter brain death and thus, potential cadaveric organ donors (Emergency Medicine, Neurosurgery and Trauma); (2) to deliver a 2-hour "best donation management practice" CME program to 80 practicing physicians in the ten specified minority referral facilities; (3) to collect and manage prospective data on the donation management process in all facilities in the OPO; and (4) to conduct statistical analysis of the impact of the PMODEM on: (a) the use of trained designated requestor; (b) the next-of-kin consent rate among minorities; and (c) the minority donation rate in southeastern Michigan. Sample size calculations indicate a 90% power to detect a 20% increase in minority donor consent rate if 80 physicians undergo the 2-hour educational session. The use of trained designated requestor with expertise in obtaining consent from the next-of-kin has the greatest immediate potential to increase cadaveric organ donation in the racial minorities donors among whom approximately 50% currently refuse to give consent.