Optimizing Educational Video Designs to Improve Minority Organ Donor Registration

描述(申请人提供)：美国的器官捐赠制度仍然处于永久的危机状态。美国有超过11.5万名患者在等待器官移植， 尽管有1万多人死亡或病情严重，无法接受移植，但等待名单仍以每年数千人的速度增长。拉美裔人受到这一器官危机的不成比例的影响，因为他们的糖尿病和终末期肾脏疾病的患病率较高，因为获得治疗的机会不足。在等待的11.5万人中，超过9.5万人需要肾脏，其中19.2%是拉丁裔，尽管拉丁裔只占美国人口的16.7%。拉丁裔也占受赠者的15.8%，但只占捐赠者的13.1%。这些比率仍然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，器官最匹配。我们将利用与我们的拉丁裔理发店和美容院网络合作制作和分发的关于循环死亡后不受控制的捐赠(UDCDD)的教育视频，研究改善拉丁裔器官捐赠者注册的方法。UDCDD项目无论死亡时间或地点，只要在所有维持生命的努力耗尽后考虑捐赠者。视频内容将包括西班牙uDCDD项目的实况镜头，与美国相比，西班牙的uDCDD项目显著提高了肾脏移植的比率。如果成功，我们估计uDCDD项目每年可以在美国提供22,000个捐赠机会。教育模式将为我们的uDCDD视频的设计提供信息，以测试流派(专家证词、带有uDCDD现场视频的纪录片)和结束选择(振奋人心、负面后果、未解决)如何影响观看后立即注册。我们的应用是一个三阶段的定性和定量研究设计，其中包括干预开发阶段，使用定性访谈来为视频派生并提供特定于文化的内容(目标1)；2x3随机对照试验，在该试验中，我们将随机让客户接收随iPad提供的六个视频中的一个，之后将通过在线注册或通过邮件应用程序提供即时的器官捐赠机会(目标2)；以及失败分析，我们将采访随机试验中一些在教育课程后一个月未能注册的参与者，以确定他们的原因(目标3)。这项研究将为未来的研究提供一个模型，我们将根据研究结果修改我们的视频，并使用大屏幕电视或互动售货亭在拉丁裔拥有的理发店和美容院分发它们。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距，这些人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 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 percent are Latino despite Latinos comprising only 16.7 percent of the U.S. population. Latinos also comprise 15.8 percent of recipients but only 13.1 percent 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 application 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.