Effect of an iPod Video Intervention on Consent to Donate Organs A Randomized Trial

Annals of Internal Medicine

J. Daryl Thornton, MD, MPH;
Marilyn Alejandro-Rodriguez;
Janeen B. León, MS, RD, LD;
Jeffrey M. Albert, PhD;
Evelyn L. Baldeon;
Liza M. De Jesus, BA;
Ana Gallardo;
Sabina Hossain;
Elba Adriana Perez;
Jovana Y. Martin, MD;
Susan Lasalvia, RN, BSN;
Kristine A. Wong, MJ, MPH;
Margaret D. Allen, MD, DrSC(Hon);
Mark Robinson, MA;
Charles Heald;
Gordon Bowen, MS; and
Ashwini R. Sehgal, MD

Abstract
Background: The gap between the supply of organs available for transplantation and demand is growing, especially among ethnic groups.

Objective: To evaluate the effect of a video designed to address concerns of ethnic groups about organ donation.

Design: Cluster randomized, controlled trial. Randomization was performed by using a random-number table with centralized allocation concealment. Participants and investigators assessing outcomes were not blinded to group assignment. (ClinicalTrials.gov registration number: NCT00870506)

Setting: Twelve branches of the Ohio Bureau of Motor Vehicles in northeastern Ohio.

Participants: 952 participants aged 15 to 66 years.

Intervention: Video (intervention; n = 443) or usual Bureau of Motor Vehicles license practices (control;n = 509).

Measurements: The primary outcome was the proportion of participants who provided consent for organ donation on a newly acquired driver's license, learner's permit, or state identification card. Secondary outcomes included willingness to make a living kidney donation to a family member in need and personal beliefs about donation.

Results: More participants who viewed the video consented to donate organs than control participants (84% vs. 72%; difference, 12 percentage points [95% CI, 6 to 17 percentage points]). The video was effective among black participants (76% vs. 54%; difference, 22 percentage points [CI, 9 to 35 percentage points]) and white participants (88% vs. 77%; difference, 11 percentage points [CI, 5 to 15 percentage points]). At the end of the trial, fewer intervention than control participants reported having insufficient information about organ donation (34% vs. 44%; difference, −10 percentage points [CI, −16 to −4 percentage points]), wanting to be buried with all of their organs (14% vs. 25%; difference, −11 percentage points [CI, −16 to −6 percentage points]), and having conflicts with organ donation (7% vs. 11%; difference, −4 percentage points [CI, −8 to −2 percentage points]).

Limitation: How the observed increases in consent to donate organs might translate into a greater organ supply in the region is unclear.

Conclusion: Exposure to a brief video addressing concerns that ethnic groups have about organ donation just before obtaining a license, permit, or identification card increased consent to donate organs among white and black participants.

Primary Funding Source: National Institutes of Health and the Robert Wood Johnson Foundation.
Article link: http://www.annals.org/content/156/7/483.abstract?aimhp