Culturally competent methods to promote organ donation rates among African-Americans using venues of the Bureau of Motor Vehicles

BACKGROUND

The diversity of the nation is one of society's greatest assets, but this feature is overshadowed by the disproportionate burden of disease that exists among America's minorities. Evidence of the disparate health status has been documented in low life expectancy, cancer, diabetes, cardiovascular, and kidney disease as well as a plethora of disorders that necessitate organ transplantation. Many minorities have been reluctant to register to become organ donors. This circumstance can be alleviated by educating the public regarding the necessity of organ transplantation. We have developed a "unique" collaborative outreach program designed to promote acceptance of organ donation in African-Americans (AAs). Our outreach curriculum at Bureau of Motor Vehicles (BMV) has resulted in increased registrations and awareness regarding the need and positive perceptions toward donation.

METHODS

We developed a culturally sensitive outreach program: cultural sensitivity indicates how culture has the ability to influence communication between patients and health providers. An "Outreach Promotional Contest" was strategically targeted toward 28 Ohio BMVs to promote and assist in an outreach educational program regarding organ donation/registry.

RESULTS

The consequence/results has been an increase of 3.4% in the BMV locations. The one BMV, with the highest increase was attended predominantly by AAs which moreover, won first place in the contest (6.425%; P < .05).

CONCLUSION

To increase the number of people willing to register, we believe that both community education regarding the need and importance, as well as culturally sensitive promotion of organ donation, is the best way to increase organ donor registries particularly among minority populations.

The UNOS OPTN waiting list from 1988 to 1993

Based on data from the OPTN Waiting List and the Scientific Registry between 1988 and 1992: 1. On October 31, 1993 the combined waiting list for a solid organ transplant contained 32,603 registrations. This represents more than a 100% increase since 1988. Specifically, registrations for a lung transplant grew by more than 1600% and registrations for a liver transplant increased by 356% during the period. The intestine waiting list contained 900 registrations on October 31, 1993. 2. The distribution of patient characteristics on the waiting list snapshot as of October 31, 1993 was not markedly different from that on previous snapshots. Slight increases in the percentage of older (65 years) kidney, liver, and heart registrants were apparent. A slight decrease in the percentage of highly sensitized (PRA > or = 80%) kidney registrants was observed. 3. In general, median waiting times to transplant have increased each year between 1988 and 1992. During this period, the most significant increases were observed for kidney-pancreas registrants (277% increase) and lung registrants (205% increase). 4. For all waiting lists except heart-lung, registrants with blood type O waited substantially longer for a transplant than registrants with blood type A. This was especially true for kidney registrants. Other notable differences in waiting times on the kidney waiting list occurred between Blacks and Whites and between adults and pediatric registrants. Males waited on the heart waiting list for a transplant over twice as long as females. 5. The overall percentage of registrants who died while waiting for a transplant in 1992 was 5.8%, compared with 5.5% in 1988. The highest death rates occurred for thoracic registrants (13.1%, 16.2%, and 12.7% for heart, heart-lung, and lung, respectively). The lowest death rates occurred for kidney (3.5%) and kidney-pancreas registrants (1.2%). The death rate for pancreas registrants (9.4%) was greater than the death rate for liver registrants (8.5%). The number who died while waiting increased each year between 1988 and 1992, but the rate of increase may be declining.