Optimizing Educational Video Designs to Improve Minority Organ Donor Registration

摘要 美国器官捐献系统一直处于危机状态。美国有超过115，000名患者 等待器官移植，等待名单每年增加数千人，尽管超过10，000人 死亡或病得太重而无法接受移植。拉丁美洲人受到器官危机的严重影响 这是因为他们的糖尿病和终末期肾病发病率较高，无法获得充分的治疗。 在115，000名等待中，超过95，000人需要肾脏，其中19.2%是拉丁裔，尽管拉丁裔 仅占美国人口的16.7%。拉丁裔也占15.8%的受助人，但只有13.1%的 捐助者。这些比率仍然远远低于不成比例的需求，因为器官最匹配时，捐赠者和 获奖者的种族相似。我们将研究改善拉丁美洲人器官捐献者登记的方法 使用关于循环死亡后不受控制的捐赠（uDCDD）的教育视频， 与我们的拉丁裔理发店和美容院网络合作分发。uDCDD程序 考虑捐赠的候选人，无论死亡的时间或地点，只要考虑毕竟发生 维持生命的努力已经耗尽。视频内容将包括西班牙uDCDD项目的现场镜头， 与美国相比，这显著提高了肾移植率。如果成功，我们估计， uDCDD计划每年可以在美国提供22，000多个捐赠机会。 模型将告知我们的uDCDD视频的设计，以测试如何流派（专家推荐，纪录片， 现场uDCDD镜头）和结束选择（令人振奋的，负面的后果，未解决的）影响立即 注册后查看我们的建议是一个3阶段的定性和定量研究设计，包括 一个干预发展阶段，使用定性访谈，以获得和提供文化上的具体 视频内容（目标1）;一项2x3随机对照试验，我们将随机选择客户， 收到iPad提供的六个视频之一，之后将立即提供器官捐赠机会。 通过在线注册或邮件申请提供（目标2）;以及失败分析，我们将 采访了一些随机试验的参与者，他们在一个月后没有注册， 教育会议，以确定其原因（目标3）。本研究将为今后的研究提供一个模型， 我们将根据我们的研究结果修改我们的视频， 理发店和美容院使用大屏幕电视或互动亭。通过这项工作，我们希望 通过增加拉丁美洲人的登记来减少器官移植的差异， 对肾脏移植的需求更大。 !

Abstract The U.S. organ donation system remains in a perpetual state of crisis. Over 115,000 patients in the U.S. are waiting for organ transplants, and the waitlist increases by several thousand annually despite over 10,000 dying or becoming too sick to receive a transplant. Latinos are disproportionally affected by this organ crisis due to their higher prevalence of diabetes and end-stage renal disease from inadequate access to treatment. Of the 115,000 waiting, over 95,000 require kidneys, and of these, 19.2% are Latino despite Latinos comprising only 16.7% of the U.S. population. Latinos also comprise 15.8% of recipients but only 13.1% of donors. These rates remain well below the disproportionate need since organs best match when donors and recipients are of similar race. We will investigate means for improving organ donor registration among Latinos using educational videos about uncontrolled donation after circulatory death (uDCDD) produced and distributed in partnership with our network of Latino owned barbershops and beauty parlors. uDCDD programs consider candidates for donation no matter timing or location of death, so long as consideration occurs after all life sustaining efforts are exhausted. Video content will include live footage from uDCDD programs in Spain, which has markedly improved rates of kidney transplantation compared to the U.S. If successful, we estimate that uDCDD programs could provide 22,000 more donation opportunities annually in the U.S. Educational models will inform the design of our uDCDD videos to test how genre (expert testimonials, documentary with live uDCDD footage) and ending choices (uplifting, negative consequences, unresolved) impact immediate registration after viewing. Our proposal is a 3-phase qualitative and quantitative research design that includes an intervention development phase using qualitative interviewing to both derive and provide culturally specific content for the videos (Aim 1); a 2x3 randomized controlled trial, in which we will randomize customers to receive one of six videos delivered with iPads, after which an immediate organ donation opportunity will be offered through registration online or with a mail application (Aim 2); and a failure analysis whereby we will interview some of the participants from the randomized trial who failed to register one month after their educational session to ascertain their reasons (Aim 3). This research will provide a model for future studies, in which we will modify our videos based on our research findings and distribute them in Latino-owned barbershops and beauty parlors using large screen TVs or interactive kiosks. Through this work, we hope to reduce organ transplantation disparities through increased registration among Latinos who comprise a group having a disproportionally greater need for kidney transplants. !