Health Information Sources of Individuals With Cancer and Their Family Members

Researchers and practitioners who have sought to understand public reluctance to donating organs in spite of favorable attitudes toward organ donation have long thought that belief in myths about donation contribute to the problem. How these myths emerged and more important, why they have persisted in spite of national education campaigns is not clear. In the absence of direct personal experience with organ donation or transplantation, we believe that most people receive their information about donation through the media. In this study, we identify all entertainment television shows with organ donation storylines or subplots broadcast on ABC, NBC, CBS, and FOX from 2004–2005. Frame analysis reveals 2 competing metaframes: the moral corruption of the powerful and organ donors are good people. In addition to the metaframes, 4 secondary frames, and 6 tertiary frames are identified. Organ donation is framed in mostly negative terms, with a few notable exceptions. Recommendations for how to address negative framing of organ donation in the media are offered.     

Beyond the organ donor card: the effect of knowledge, attitudes, and values on willingness to communicate about organ donation to family members

Although numerous studies have examined many of the predictors of signing an organ donor card, including knowledge, attitudes, values, and demographic variables, very few have examined the factors associated with individuals' willingness to communicate about organ donation with family members. Because organ donation does not take place without the permission of a person's next-of-kin, government agencies and organ procurement organizations have targeted communication with family members as a primary objective of organ donation campaigns. This study reports the results of a survey of a stratified random sample of adults at 2 local sites of a national employer. Results indicate that knowledge, attitude, and altruism are significantly related to 2 measures of willingness to communicate: past behavior (whether respondents had already discussed organ donation with family members) and a scale measuring willingness to communicate about organ donation in the future. Because the quality of discussions between the potential donor and his or her family will depend on how well the donor is able to address vital issues regarding donation, it is concluded that campaigns seeking to promote communication between family members about organ donation must simultaneously seek to increase knowledge, debunk myths, and bolster positive attitudes about donation.     

Beyond the Organ Donor Card: The Effect of Knowledge,Attitudes, and Values on Willingness to Communicate About Organ Donation to Family Members

Although numerous studies have examined many of the predictors of signing an organ donor card, including knowledge, attitudes, values, and demographic variables, very few have examined the factors associated with individuals' willingness to communicate about organ donation with family members. Because organ donation does not take place without the permission of a person's next-of-kin, government agencies and organ procurement organizations have targeted communication with family members as a primary objective of organ donation campaigns. This study reports the results of a survey of a stratified random sample of adults at 2 local sites of a national employer. Results indicate that knowledge, attitude, and altruism are significantly related to 2 measures of willingness to communicate: past behavior (whether respondents had already discussed organ donation with family members) and a scale measuring willingness to communicate about organ donation in the future. Because the quality of discussions between the potential donor and his or her family will depend on how well the donor is able to address vital issues regarding donation, it is concluded that campaigns seeking to promote communication between family members about organ donation must simultaneously seek to increase knowledge, debunk myths, and bolster positive attitudes about donation.     

The Challenges of Social Marketing of Organ Donation: News and Entertainment Coverage of Donation and Transplantation

While great strides have been made in persuading the public to become potential organ donors, actual behavior has not yet caught up with the nearly universally favorable attitudes the public expresses toward donation. This paper explores the issue by situating the social marketing of organ donation against a broader backdrop of entertainment and news media coverage of organ donation. Organ donation storylines are featured on broadcast television in medical and legal dramas, soap operas, and other television serials approximately four times per month (not including most cable networks), and feature storylines that promote myths and fears of the organ donation process. National news and other non-fictionalized coverage of organ donation are even more common, with stories appearing over twenty times a month on average. These stories tend to be one-dimensional and highly sensationalized in their coverage. The marketing of organ donation for entertainment essentially creates a counter-campaign to organ donation, with greater resources and reach than social marketers have access to. Understanding the broader environmental context of organ donation messages highlights the issues faced by social marketing campaigns in persuading the public to become potential donors.     

The challenges of social marketing of organ donation: news and entertainment coverage of donation and transplantation

While great strides have been made in persuading the public to become potential organ donors, actual behavior has not yet caught up with the nearly universally favorable attitudes the public expresses toward donation. This paper explores the issue by situating the social marketing of organ donation against a broader backdrop of entertainment and news media coverage of organ donation. Organ donation storylines are featured on broadcast television in medical and legal dramas, soap operas, and other television serials approximately four times per month (not including most cable networks), and feature storylines that promote myths and fears of the organ donation process. National news and other non-fictionalized coverage of organ donation are even more common, with stories appearing over twenty times a month on average. These stories tend to be one-dimensional and highly sensationalized in their coverage. The marketing of organ donation for entertainment essentially creates a counter-campaign to organ donation, with greater resources and reach than social marketers have access to. Understanding the broader environmental context of organ donation messages highlights the issues faced by social marketing campaigns in persuading the public to become potential donors.     

Transparency and accountability in mass media campaigns about organ donation: a response to Morgan and Feeley

We respond to Morgan and Feeley’s critique on our article “Mass Media in Organ Donation: Managing Conflicting Messages and Interests.” We noted that Morgan and Feeley agree with the position that the primary aims of media campaigns are: “to educate the general public about organ donation process” and “help individuals make informed decisions” about organ donation. For those reasons, the educational messages in media campaigns should not be restricted to “information from pilot work or focus groups” but should include evidence-based facts resulting from a comprehensive literature research. We consider the controversial aspects about organ donation to be relevant, if not necessary, educational materials that must be disclosed in media campaigns to comply with the legal and moral requirements of informed consent. With that perspective in mind, we address the validity of Morgan and Feeley’s claim that media campaigns have no need for informing the public about the controversial nature of death determination in organ donation. Scientific evidence has proven that the criteria for death determination are inconsistent with the Uniform Determination of Death Act and therefore potentially harmful to donors. The decision by campaign designers to use the statutory definition of death without disclosing the current controversies surrounding that definition does not contribute to improved informed decision making. We argue that if Morgan and Feeley accept the important role of media campaigns to enhance informed decision making, then critical controversies should be disclosed. In support of that premise, we will outline: (1) the wide-spread scientific challenges to brain death as a concept of death; (2) the influence of the donor registry and team-huddling on the medical care of potential donors; (3) the use of authorization rather than informed consent for donor registration; (4) the contemporary religious controversy; and (5) the effects of training desk clerks as organ requestors at the Department of Motor Vehicles offices. We conclude that organ donation is a medical procedure subject to all the ethical obligations that the medical profession must uphold including that of transparency and truthfulness.     

Organ Donation on Web 2.0: Content and Audience Analysis of Organ Donation Videos on YouTube

This study examines the content of and audience response to organ donation videos on YouTube, a Web 2.0 platform, with framing theory. Positive frames were identified in both video content and audience comments. Analysis revealed a reciprocity relationship between media frames and audience frames. Videos covered content categories such as kidney, liver, organ donation registration process, and youth. Videos were favorably rated. No significant differences were found between videos produced by organizations and individuals in the United States and those produced in other countries. The findings provide insight into how new communication technologies are shaping health communication in ways that differ from traditional media. The implications of Web 2.0, characterized by user-generated content and interactivity, for health communication and health campaign practice are discussed.     

Knowledge, attitudes and behavior regarding organ transplantation: the impact of the first transplantation from a brain-dead donor under the organ transplantation act

OBJECTIVE: To investigate knowledge, attitudes and behavior regarding organ transplantation, and to estimate the impact of the first organ transplantation from a brain-dead donor under the Organ Transplantation Act. SUBJECTS AND METHODS: A telephone survey was made using the Random Digit Dialing method in May 1999. People living in the Tokyo Metropolitan area ages 20 years or over were asked about their knowledge, attitudes and behavior regarding organ transplantation, and their opinions on the first organ transplantation conduced in February 1999. The results were compared with an opinion poll made 7 months previously to estimate the impact of this first case. RESULTS: The number of respondents was 489 (response rate: 46.0%). 1) Knowledge of organ transplantation: most people knew that organ donation from brain-dead donors was possible under the act, and that written consent on a form and family member's agreement were necessary before donating. More people knew about donor cards. 2) Organ transplantation: more people were willing to donate their organs when they die, and to agree to donation when a family member died who had wanted to donate his/her organs on their death. In the poll 7 months before, fewer people were willing to donate their organs or to agree to donate their family member's organs after brain death compared with after heart arrest. However, no such difference between brain death and heart arrest was found in this later study, suggesting that the distinction between the two was no longer considered to be so important. 3) Respondents themselves having donor cards constituted 15.2%, showing a marked increase from 7 months earlier. Another 39.7% wished to carry a donor card; the most common reason for not carrying one was they did not know how to acquire it. 4) The first transplantation was considered to have contributed to the increase in knowledge, and a favorable change in attitudes and behavior toward organ transplantation. 5) Respondents who agreed to that organ donation from children aged under 15 should be possible constituted 46.4%, of the to be this not being allowed at the present time. 6) The majority of respondents considered that the brain death was diagnosed properly in the first case and that the donation was made voluntarily, concluding that the transplantation was made fairly. 7) Respondents who considered that the privacy of the donor and the recipients was violated were 46.2% and 36.1%, respectively. The attitude of the mass media toward the first transplantation was criticized by 56.9% of the respondents. 8) Respondents who had a favorable impression of the organ transplantation were 61.9%. Such people are likely to donate their organs, to agree to a family member's donation, and to have a donor card than people who had not gained a favorable impression. The two groups exhibited no difference in their knowledge concerning organ transplantation. CONCLUSIONS: An increase in knowledge and a favorable change in attitudes and behavior regarding organ transplantation was confirmed in this survey, as compared with results 7 months earlier, probably because the first transplantation took place. The majority of the respondents considered that the first transplantation was made fairly, although they criticized the attitude of the mass media invading the privacy of the donor and the recipients. Further studies should be made to facilitate effective delivery of donor cards to people who want to carry them, and to change the rules on organ donation from children.     

A Profile of Australian Adults Who Have Discussed Their Posthumous Organ Donation Wishes With Family Members

Next of kin who are aware of the deceased's organ donation wishes usually will honor those wishes, while next of kin who are unaware of these wishes typically withhold consent for posthumous donation. Encouraging individuals to communicate or register their organ donation wishes is therefore important. Using a sample of 409 participants, the current study sought to develop a profile of Australian adults who had communicated their organ donation wishes to family members. Christian participants and those who had a higher income were more likely to have communicated their donation wishes. Conversely, participants were less likely to have communicated their donation wishes if they were unregistered and undecided/opposed to organ donation, unregistered but willing to donate, or fearful of death. Finally, whether participants had communicated, registered, or communicated and registered their donation wishes was associated with their age, religion, attitude toward organ donation, and recall of media content about organ donation. Messages encouraging the communication of organ donation wishes to family members should therefore be targeted toward those individuals who are most likely to be receptive toward enacting this behavior.     

How organ donation is represented in newspaper articles in the United States

A media agenda setting study was conducted to examine how newspaper stories frame the topic of organ and tissue donation. Seven hundred fifteen stories on organ and tissue donation from 20 newspapers dated 2002 or 2003 were content-analyzed for valence (i.e., positive, negative, or neutral toward organ donation) and topic (e.g., living donation, transplant process, celebrity donor/recipient). The 20 newspapers were chosen by circulation and electronic access of database. Four of the top 5 and 13 of the top 20 circulating newspapers were included and several combinations of search terms were used to identify relevant articles. Results indicate that the majority of articles were either positive (57%) or neutral (29%) regarding the topic of organ donation. The 4 most common topics covered in news articles included: (a) posttransplantation health and welfare, (b) information on the shortage of organ donors, (c) living donation, and (d) information about the transplantation process. Kidneys (n = 204) and hearts (n = 120) were the 2 most commonly mentioned organs in the sample of articles. Results are discussed and how news articles may shape laypersons' attitudes and intentions regarding organ donation is considered.     

Knowledge and Attitude of Iranian Medical University Students about Organ Donation and Transplantation: A Cross-Sectional Study

BackgroundMedical professionals'' knowledge of and attitudes toward organ donation and transplantation have positive impact on donation rates. The aim of this study was to determine the knowledge and attitude of medical university students in Iran about organ donation and transplantation.MethodsThis cross-sectional study was carried out on 1078 undergraduate students in Golestan University of Medical Sciences, Gorgan, Iran, from January to June 2019. All eligible students were recruited using convenient sampling. Data were gathered using knowledge and attitude toward organ donation and transplantation questionnaire. The higher scores of both subscales, the knowledge subscale (range from 0 to 13) and the attitude subscale (range from 13 to 65), indicate the better knowledge and attitude toward organ donation and transplantation.ResultsThe mean age of students was 22.24±5.16 years. Finding showed that the mean score of students'' knowledge and attitude toward organ donation and organ transplantation were 8.48±1.71 and 48.55±8.11 respectively. Also, the mean score of students'' knowledges in females (P<0.001), married (P=0.001) and who had organ donation card (P<0.001) was significantly higher. Nearly all of the students had heard about organ donation (98.3%) and organ transplantation (98.4%). Majority of them pointed that their source of information about organ donation and transplantation was television (TV) program (47.1%). Most of the students (73.8%) reported that they agree to donate their organs but most of them (67.5%) did not know how to obtain organ donation card and only 9.6% of them had the organ donor card as a volunteer donor.ConclusionAccording to finding, despite the awareness and favorable attitude about organ donation and transplantation among medical students, the number of registered donors was low. In addition to promoting college students'' awareness about organ donation for increasing registered donors, it is needed to aware and pursue lay people through social media.     

A Theory of Planned Behavior Study of College Students' Intention to Register as Organ Donors in Japan,Korea, and the United States

This study investigated willingness of Americans, Koreans, and Japanese to register as organ donors using the theory of planned behavior. Although previous research showed that attitude toward donation and communication with family predicted organ donation behaviors for respondents in the United States, these variables were also significant for respondents in Japan and Korea. Perceived behavioral control predicted intention to register for Japanese participants whereas knowledge about organ donation was associated with reluctance to register for Koreans. Spiritual connection and concern were shown to be causal factors underlying attitude in all 3 countries. In spite of positive attitudes toward organ donation and comparable knowledge with Americans and Japanese, most Korean participants declined to take an application to register as a donor. Implications of these findings for future research are discussed.     

A theory of planned behavior study of college students' intention to register as organ donors in Japan, Korea, and the United States

This study investigated willingness of Americans, Koreans, and Japanese to register as organ donors using the theory of planned behavior. Although previous research showed that attitude toward donation and communication with family predicted organ donation behaviors for respondents in the United States, these variables were also significant for respondents in Japan and Korea. Perceived behavioral control predicted intention to register for Japanese participants whereas knowledge about organ donation was associated with reluctance to register for Koreans. Spiritual connection and concern were shown to be causal factors underlying attitude in all 3 countries. In spite of positive attitudes toward organ donation and comparable knowledge with Americans and Japanese, most Korean participants declined to take an application to register as a donor. Implications of these findings for future research are discussed.     

Encouraging family discussion on the decision to donate organs: the role of the willingness to communicate scale

Family discussion of organ donation has been found to double rates of family consent regarding organ donation. Therefore, family discussion is an important communication process to study in the effort to get more people to become organ donors. This investigation concerns the willingness to communicate about organ donation and its relationship to other variables and processes related to family discussion of organ donation. Previous research on willingness to communicate examined the antecedent variables of knowledge, attitude toward organ donation, and altruism. This research found that being willing to communicate about organ donation with one's family is related to prior thought and intent to sign an organ donor card, to perceiving organ donation messages as credible, and to feeling relatively low anxiety after reading organ donation messages. One week after being presented with the messages, willingness to communicate was found to be positively associated with worrying about the lack of donors, engaging in family discussion about organ donation, and having an organ donor card witnessed. It was negatively related to feeling personally uneasy about organ donation during the past week.     

How Organ Donation Is Represented in Newspaper Articles in the United States

A media agenda setting study was conducted to examine how newspaper stories frame the topic of organ and tissue donation. Seven hundred fifteen stories on organ and tissue donation from 20 newspapers dated 2002 or 2003 were content-analyzed for valence (i.e., positive, negative, or neutral toward organ donation) and topic (e.g., living donation, transplant process, celebrity donor/recipient). The 20 newspapers were chosen by circulation and electronic access of database. Four of the top 5 and 13 of the top 20 circulating newspapers were included and several combinations of search terms were used to identify relevant articles. Results indicate that the majority of articles were either positive (57%) or neutral (29%) regarding the topic of organ donation. The 4 most common topics covered in news articles included: (a) posttransplantation health and welfare, (b) information on the shortage of organ donors, (c) living donation, and (d) information about the transplantation process. Kidneys (n?=?204) and hearts (n?=?120) were the 2 most commonly mentioned organs in the sample of articles. Results are discussed and how news articles may shape laypersons' attitudes and intentions regarding organ donation is considered.     

Media content analysis of the introduction of a “soft opt‐out” system of organ donation in Wales 2015‐17

In an attempt to improve organ donation rates, some countries are considering moving from “opt‐in” systems where citizens must express their willingness to be an organ donor, to “opt‐out” systems where consent is presumed unless individuals have expressed their wishes otherwise, by, for example, joining an “opt‐out” register. In Wales—a part of the United Kingdom—the devolved government recently legislated for an “opt‐out” system. For the change to be effective, a public awareness campaign was critical to the policy's success. Using quantitative and qualitative content analysis, we explored media coverage of the change to better understand the relationship between the state, policy actors, media and the public when such policy changes take place. Our findings illustrate how a state communication campaign can effectively set the media agenda within which we saw a degree of interdependency created with the state using the media to promote policy, and the media relying on the state for credible information. Yet we also found that the media is not uncritical and observed how it uses its autonomy to influence policy setting. Over the period of study, we found that a change in tone and view towards deemed consent organ donation has taken place in the media. However, while this may influence or reflect public attitudes, it is yet to be seen whether the media campaign translates into behavioural change that will result in increases in organ donations.     

Encouraging Family Discussion on the Decision to Donate Organs: The Role of the Willingness to Communicate Scale

Family discussion of organ donation has been found to double rates of family consent regarding organ donation. Therefore, family discussion is an important communication process to study in the effort to get more people to become organ donors. This investigation concerns the willingness to communicate about organ donation and its relationship to other variables and processes related to family discussion of organ donation. Previous research on willingness to communicate examined the antecedent variables of knowledge, attitude toward organ donation, and altruism. This research found that being willing to communicate about organ donation with one's family is related to prior thought and intent to sign an organ donor card, to perceiving organ donation messages as credible, and to feeling relatively low anxiety after reading organ donation messages. One week after being presented with the messages, willingness to communicate was found to be positively associated with worrying about the lack of donors, engaging in family discussion about organ donation, and having an organ donor card witnessed. It was negatively related to feeling personally uneasy about organ donation during the past week.     

Family practice residents' attitudes toward organ donation

Shortage of organs for transplantation has been attributed in part to negative attitudes of medical personnel. As the demand for organ donations increases, it is likely that family physicians may encounter with increasing frequency situations in which they are in some way involved with the families of potential donors. This study was designed to assess residents' attitudes toward organ donation Overall attitudes were positive, with a mean attitude score of 1.275 (SD 1.415) where 0 = very favorable and 9 = very unfavorable. At the same time, however, concerns regarding premature declaration of death, feelings of the potential donor's family, and cost or benefit of organ donation were identified as well. Nearly one half the residents thought they had little knowledge about organ donation or transplant. Residents' feelings about donating their own organs were most predictive of their opinion of organ donation in general. Only 25 percent of residents had signed an organ donor card and had it witnessed. How much residents knew about organ donation and how they thought their own families felt were the best predictors of whether they had signed the donor form.     

Perceptions about organ donation among African American, Hispanic, and white high school students

We applied the Health Belief Model (HBM) to better understand perceptions of organ donation among African American, Hispanic, and White high school students. We conducted 14 focus groups with 18-year-old students to identify strategies to reach this audience when promoting the First-Person Consent Registry (FPCR) for organ donation. We found that African American, Hispanic, and White high school students are largely unaware of the need for organ donors, and are unfamiliar with how to join the FPCR. Participants identified more barriers to joining the FPCR than benefits. Two aspects of self-efficacy emerged related to joining the FPCR: decisional and task efficacy. Overall, few differences were found with respect to organ donation myths across the three ethnic groups. The results are discussed, with an emphasis on how the findings compare and contrast with previous organ donation research. We focus on message design and dissemination strategies for practitioners targeting 18-year-old high school students with organ donation promotional materials.