Human Organ Donation: Does Knowledge Correlate with Intention?

Abstract

One increasing form of social distress in the USA today is the increasing number of ill Americans who die while awaiting a life-saving organ (Satel, 2008). While organ donation is a life saving practice supported by 95 per cent of Americans, only half of the U.S. population is registered to donate organs. To explore this discrepancy between attitudes and behaviors relating to organ donation, 135 New Yorkers completed an anonymous 25-item survey to assess individuals' accurate knowledge of organ donation and their organ donor practices. Results support the researchers' two hypotheses: (a) individuals who possess more accurate information about organ donation practices are more likely to be organ donors (r=.225, p<.01) and (b) are more likely to have had experience with organ donation, either directly or indirectly (r =.247, p <.01). These findings have implications for the organ donation community, specifically the focus of campaigns that seek to increase the number of registered organ donors.     

Cultures of the soul: spiritual beliefs about organ donation in China and the United States

Spiritual beliefs shape ideas about the meaning of life, the moment of death, and the care that must be taken to deliver the body of the loved one to the spiritual realm. This study investigated spiritual beliefs about organ donation for participants in China (n = 364) and the United States (n = 384). Results showed that spiritual connection with the transplant recipient, spiritual concern about removing organs, and attitudes toward organ donation significantly predicted willingness to become an organ donor for participants in both countries. Americans reported being significantly more religious compared to Chinese. However, altruism and religiosity were not significant predictors of willingness to donate organs. Chinese participants showed significantly higher levels of spiritual connection with the potential recipient of transplanted organs. Even so, Chinese participants exhibited more reluctance to become organ donors compared to Americans. Gender differences in organ donation behaviors are also reported. The study discusses the implications of the findings for structuring organ procurement campaigns that will address spiritual beliefs about organ donation.     

Reducing Public Misinformation About Organ Donation: An Experimental Intervention

Abstract

The shortage of life-saving human organs for transplantation today is a growing and international problem. A recent survey in this Journal found that people with “more accurate information about organ donation practices are more likely to be organ donors (r= .225, p< .01)” (Nickols, Stack, Viviano, & Whitney, 2008, p. 240). How much can a factual 20-minute message about organ donation significantly increase people's knowledge and pro-donation behavior? In this field experiment, 101 students in two urban colleges completed a one-page survey before and after an expert's 20-minute message. The survey assessed participants' knowledge about organ donation from 0 (low) to 40 (high), biodata, self-reported experiences, and behavior in the past (registered organ donor) and future (consider becoming a donor). As hypothesized: (1) Pre-message knowledge about organ donation was moderate (mean = 21.8 on the 0-40 scale), and rose significantly after the message (mean = 28.6, p < .01). (2) This knowledge positively correlated with consideration to register in the future as an organ donor (r = +.41; p < .001 post-presentation). (3) However, there was no significant correlation of prior donor registration with knowledge prior to the message (r = +.08) or after the message (r = +.04). From these findings, it seems a brief FAQ fact-sheet or DVD would be highly useful to increase people's accurate knowledge about donations.     

Organ donation and reciprocity

The willingness to donate organs post-mortem varies considerably both across and within countries. Linking these differences to personal characteristics is an important focus of research investigating the supply of donor organs. Anecdotal evidence and previous findings indirectly suggest that the desire to reciprocate others’ (un)willingness to donate organs plays an important role in the decision to become an organ donor. We use individual measures of reciprocity in a large, representative survey in Germany and relate these to organ donation attitudes and behavior. Higher positive reciprocity is associated with a higher general willingness to donate organs, but it does not correlate with donor card possession. Individuals with higher negative reciprocity have a lower general willingness to donate organs and are less likely to have a donor card. Our findings open up the possibility of a double dividend of measures that increase organ donations. These could yield an additional increase of organ donations via a feedback loop through reciprocity.     

The Effect of Social Information on Giving from Lapsed Donors: Evidence from a Field Experiment

Using data from an experiment carried out by a large nonprofit organization, this paper finds that lapsed donors who received a solicitation letter referencing a relatively high donation made by another donor (high social information) were more generous in giving, but overall less likely to make a donation, relative to the baseline (low social information) group. After using the propensity score matching to correct for pretreatment differences in the two experimental groups, the estimated effect of high social information on the average donation amount is an increase of $14.95 (45 %). However, high social information is also found to reduce the probability a lapsed donor will give by 4.1 %. Thus, high social information can have potentially offsetting effects when applied to lapsed donors. Nonprofits should consider this trade-off when employing social information fundraising techniques to solicit donations from lapsed donors.     

Changing college student perceptions and participation in organ donation: A classroom and service learning intervention

Each day an average of 18 people die from the lack of available organs for transplantation and the demand for organ, eye and tissue donation continues to vastly exceed the number of available donors. The single most effective method in addressing this issue remains programmatic efforts to encourage and support organ donation. The purpose of this article is to introduce a creative and comprehensive approach to enhance awareness, participation and organ donor registry among young adults. The programmatic intervention utilized a service learning model within a Freshman Year Seminar course focused on organ donation. The partnership between classroom-based curriculum and experiential learning served to increase knowledge and enhance positive attitudes toward organ donation, as measured by pre-post tests and student reflections in portfolio assessments. The number of organ donor registrants was increased as a result of student outreach activities. Results are discussed in terms of implications for increasing donation.     

Majority size and conformity behavior in charitable giving: Field evidence from a donation-based crowdfunding platform in Japan

A charitable donor typically imitates the majority contribution of other donors. This study examines the relationships between majority size and this so-called donor’s conformity behavior, by empirically investigating the impacts of multiple earlier donations on the donation of a subsequent donor to JapanGiving, a donation-based crowdfunding platform in Japan. This analysis is possible because the platform’s webpage displays the previous donation amounts in chronological order, thus allowing us to examine the modal amount of more recent donations. By using data on 9989 actual donations, our dynamic panel analysis suggests that when the number of most recent continuous modal donations increases, the likelihood that a subsequent donor matches the modal amount increases. This result supports the notion that a donor’s conformity behavior is more likely to occur when a greater proportion of other donors give a similar amount. Furthermore, the effects of continuous modal donations are strongly observed for low monetary ranges. We interpret that initiating further cooperation among a large number of less cooperative other donors would become harder, or individuals would obtain an excuse for less cooperation due to the others’ behaviors. Finally, we discuss how our findings connect economic studies of charity and social psychology studies of conformity and could help improve the effectiveness of fundraising by charities.     

How Sunday, price, and social norms influence donation behaviour

We describe a natural field experiment investigating donation behaviour. The setting was an art gallery where donations could be deposited into a transparent box in the foyer. Two aspects of the donation environment were manipulated: signs on the donation box and the initial contents of the box. We used three sign treatments: a control with no sign, a sign that thanked donors, and a sign that indicated donations would be matched. We used two initial contents treatments: one with relatively little money ($50) and one with four times as much. The average donation per donor was significantly larger in the $200 treatments but this was offset by a decrease in the propensity to donate. In the matching treatments donations were significantly larger both at the per donor and per visitor level. A control variable turned out to have the largest influence on donation behaviour: the day of the week. The average donation per visitor was 51% higher on Sundays, when compared to every other day of the week.     

Profiling Donors of Blood,Money, and Time

Understanding donor profiles is crucial for donor relationship management. Whereas previous research has focused on profiling blood, money, or time donor segments separately, we define seven donor profiles based on their former donation behavior for blood, money, and time donation and compare them to non‐donors. Relying on representative data from the German Socio Economic Panel, we use an extensive set of characteristics that include sociodemographic, psychographic, health‐related, and geographical measures and simultaneously investigate profiles of donors for single and multiple donation forms and non‐donors by means of a multinomial logistic model. Our results reveal valuable insights for donor acquisition and retention strategies of nonprofit organizations along the identified profiling characteristics of donor segments. By this, our findings help nonprofit organization managers to better target single and multiple donors across three donation forms.     

African American Migration to the North: New Evidence for the 1910s

The years between 1910 and 1920 witnessed the first wave of the "Great Migration" of African Americans to the North. This article uses new census data from the Integrated Public Use Microdata Series project to study self‐selection patterns in African American migration during this important decade. The results indicate that, contrary to contemporary accounts, migration rates rose at least as much among the literate as among the illiterate (and perhaps more), and migration increased more for married African Americans than for the unmarried.     

THE EFFECT OF CADAVERIC KIDNEY DONATIONS ON LIVING KIDNEY DONATIONS: AN INSTRUMENTAL VARIABLES APPROACH

Transplantation is notable for the degree to which resources are allocated via administrative rather than market mechanisms. However, non‐monetary incentives still permeate the system. Using instrumental variable regression, we estimate the substitution patterns between cadaveric and living kidney donations in the United States from 1988 to 2008. On average, a decrease of two to five cadaveric donations causes living kidney donations to increase by one. Disaggregating living donors into blood‐related and non‐blood‐related donors, the strongest effect is found among non‐blood‐related donors known to the organ recipient. A 1% increase of cadaveric donations decreases living donations from this group by 1.54%. (JEL D62, D64, I1)     

Public Attitudes Toward the Ethics of Organ Donation

Abstract

This study expanded on previous investigations exploring public attitudes toward the human rights issues involved in organ donation practices and personal support for these practices. Participants included college and graduate students, and senior citizens (N = 99). Attitudes were assessed prior to and following the presentation of a brief informational DVD on major organ donation practices. Results indicated that participants were largely divided in their attitudes toward human rights issues, as well as in personal support for donation practices. Registration status was correlated with education, r = .47, p < .001. Support for donation incentive programs varied. Registered donors showed a change in attitudes toward human rights issues, t(22) = 2.18, p = .04. For non-registered donors, personal support for donation practices decreased after viewing the DVD, t(51) = - 3.06, p = .004. Results are discussed in terms of implications for increasing donation.     

Willingness to Participate in Organ Donation Among Black Seventh-Day Adventist College Students

Objective and Participants: The authors studied a group of black and white Seventh-Day Adventist (SDA) college students (N = 334) to compare the power of religious socialization with racial socialization. Methods: The authors compared the levels of willingness to donate organs between black and nonblack students in an availability sample. Results: Black SDA college students were significantly more likely than white SDA students or SDA students of other races to perceive racism in the healthcare system and to believe that doctors would not make heroic efforts to save their lives if they knew they were organ donors; they were 66.9% less likely to donate organs than were white SDA students or SDA students of other races. Conclusions: Despite a common religion with a purposive indoctrination, the racial socialization of black SDA students exerted a stronger influence on willingness to participate in organ donation than did that of white students and students of other races within this religion.     

Organ Donation and Transplantation in India: An Inquiry in Kerala

Until recently, financial incentive was the prime motivation in transplantation of kidneys from nonrelated living donors in India. Prior to the Human Organ Transplantation Act of 1994, it was legal in all states of India to purchase and merchandise organs, eliminating the opportunity for black markets currently created by the enormous demand for organs. Eight years later, the question remains on how if at all The Act has changed the way organ donation is viewed and conducted in India. This study reveals attitudes and beliefs about organ donation in India from the perspectives of the doctors and the public. Interviewees expressed concerns and fears over the implementation of The Act. Mistrust of the medical profession and concerns about illegal buying and selling of organs were some major issues brought forth by the public. Additional issues were the need for public education, advertisement, and role models to promote organ donation in India. All interviewees had prior knowledge of organ donation and did not require explanation of the concept. No one interviewed was opposed to organ donation. Many participants were aware of organ donation through Ashwaria Roy, a former Miss World who does advertising campaigns promoting cornea donation in India.     

Effects of Donor Priority Strategy on Relationship Fundraising Outcomes

Nonprofit organizations commonly implement donor priority strategies, yet little research has explored the effects of this relationship strategy. Whereas previous research highlighted the positive effects of benefit segmentation and analyzed donor motives to choose a specific donation level, this study investigates the effects of priority benefit perception on relationship factors such as donor satisfaction, donor loyalty, upgrade/downgrade intentions, and voluntary behavior. Based on data from the German cultural sector—804 donors of a friend circle that differentiates two donation levels—the results of the partial least squares path analysis show that donors' perception of priority benefits positively affects donor satisfaction and donor loyalty. The study also shows that a priority strategy negatively influences intentions to downgrade among higher‐prioritized donors and positively enhances intentions to upgrade among lower‐prioritized donors. Applying multigroup comparison the authors find that most relationship effects do not differ significantly across higher‐ and lower‐prioritized donors. This study thereby supports the implementation of donor priority strategy among cultural organizations because of its advantages for developing strong relationships with donors of all levels. Several managerial recommendations are given; for example, managers should better implement only a few instead of a large number of donor levels, should determine carefully which benefits to offer at the different levels, and analyze the donor base in order to identify donors with strong potential for upgrading.     

FUNDRAISING INTERMEDIARIES INHIBIT QUALITY‐DRIVEN CHARITABLE DONATIONS

Charitable donations are frequently raised by an intermediary, which accepts donations and subsequently sends the proceeds to the chairty—for example, a workplace campaign for United Way, a 5‐km walk for Susan G. Komen, or buying cookies from a local troop for the Girl Scouts. These fundraisers can greatly increase donations received by a given charity, but how do they affect what types of charities we support? This article shows intermediary fundraisers can make donors insensitive to differences in charity quality: Unattractive charities can receive the same financial support as an attractive charity. In a series of across‐subject experiments, when donations are framed as going directly to the charity, unattractive charities receive fewer and smaller contributions relative to attractive charities; however, when donations for the same charities are collected by (meaningless) intermediary fundraising campaigns, donations become indistinguishable across charities. The fundraising campaign does not affect donor recall of charity identity or evaluation of charity quality; it simply precludes donors from using these data in the donation decision. Follow‐up experiments suggest the results are driven by information overload. (JEL A13, C91, C93, D61, D64, H41)     

Motivational crowding out effects in charitable giving: Experimental evidence

This paper tests motivational crowding out in the domain of charitable giving. A novelty is that our experiment isolates alternative explanations for the decline of giving, such as strategic considerations of decision-makers. Moreover, preference elicitation allows us to focus on the reaction of donors characterized by different degrees of intrinsic motivation. In the charitable-giving setting subjects donate money to the German “Red Cross” in two consecutive donations. The first dictator game is modified, i.e., donors face with equal probability an ex post reimbursement or a subsequent payment. The second game is a standard dictator game. We find that after an ex post change in the price of giving of the first donation, substantially more donors with a high degree of intrinsic motivation decrease donations than subjects with a low degree of intrinsic motivation and donors who did not experience a price effect. In a replication study we find support for these results for subjects who have previously participated in at least one economic experiment.     

HIV/AIDS Prevention in the African American Community:

The high rate of AIDS cases among African Americans, especially women, suggests that HIV risk reduction behavior change programs and messages have not been highly successful in preventing HIV transmission among this population. This paper recommends that the situational and environmental context of African Americans' lives, and their responses to HIV/AIDS be addressed and incorporated into HIV prevention programs in an effort to make these programs more relevant to high risk African Americans. A multilevel system intervention approach grounded in an ecosystem perspective which focuses on the community as the primary target level of intervention is proposed to increase the effectiveness of HIV prevention efforts among African Americans.     

African Americans,U.S. Poverty,and International Law

ABSTRACT

Statistical rates of poverty among African Americans often hide the cultural and historical nature of their intended consequences. Unfavorable outcomes for social change can occur when viewing poverty among African Americans in isolation from their unique historical and cultural experiences and U.S. social, political, and capitalistic influences. While pressures to subordinate African Americans continue, African Americans also exert pressure (e.g., social movements) as human agents in their efforts toward self-determination. In order to understand and/or ameliorate poverty in the US, policy makers, researchers, and educators must first deal with the cultural hegemony undergirding it.