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Keywords:

  • Donation;
  • organ and tissue donation;
  • psychosocial issues;
  • qualitative research;
  • shortage of donor organs;
  • survey

Abstract

  1. Top of page
  2. Abstract
  3. Introduction
  4. Materials and Methods
  5. Results
  6. Discussion
  7. Conclusions
  8. Acknowledgments
  9. Disclosure
  10. References
  11. Supporting Information

This study investigates how college students can be social support catalysts for organ donation and how social, cognitive and attitudinal dimensions impact organ donor registration. A total of 317 people participated in the exploratory portion of the project and a total of 1800 responses were obtained from an online survey to members of a national student organization. The findings show that perceptions of the benefits of organ donation and altruistic motives had the greatest impact on the support for organ donation while respondents' knowledge about how to register to be an organ donor was the dominant dimension for donor registration status. Social-based communications had the next greatest impact for both support and donor registration. Based on the findings, an 18-month social media campaign was launched with the student organization that had 20 421 website visitors, 4473 Facebook members, 1189 YouTube video submissions with 164 000 views, motivated 19 623 people to go to a state's organ donor registration page, and had 9000 documented organ donor registrations. Within the student organization, organ donor registration increased by 28%. On the basis of these project results, Donate Life America and other sponsors have provided funding for two additional years.


Abbreviations: 
CAMA

Collegiate American Marketing Association

H

hypothesis

ns

not significant

Std

standardized

Introduction

  1. Top of page
  2. Abstract
  3. Introduction
  4. Materials and Methods
  5. Results
  6. Discussion
  7. Conclusions
  8. Acknowledgments
  9. Disclosure
  10. References
  11. Supporting Information

Recently, the strategic shift by health care professionals and researchers toward the application of social marketing principles has placed greater emphasis on finding ways to involve community members in promoting organ donation registration by university students (1). Unfortunately, college-age students have underparticipated in organ donor registration, a surprising fact given that college students tend to support social causes they believe in (2,3). Despite this underparticipation, communication initiatives targeting college students have a strong likelihood of success for motivating them to register to be an organ donor and to serve as opinion leaders (4–9). Although literature investigating college students' awareness, perceptions, beliefs and behaviors is sparse, research evidence exists that multimedia and peer-to-peer communication campaigns may increase the engagement levels of this large and important age group (8,9). This interest is motivated in part by an increased focus by consumers to participate in the “cocreation” of health services enabled by new information and communication technologies such as online health communities, blogs, social media networks and Web 2.0 (10).

College students have been especially active in the use of interpersonal media and have a greater likelihood of using social media such as online videos, text-messaging, instant messaging and other user-generated content to communicate with members of their social communities (11). Although this emergent area of inquiry has added to our knowledge, little research has examined comprehensive frameworks that investigate the joint impact that social and personal communication-based factors have on the support for organ donor registration by college students. Even less is understood about whether the variables that impact support for organ donation are similar or dissimilar to those that explain students' actual organ donor registration. Donor research targeting college students that increases our understanding of important determinant variables from awareness through registration is thus, warranted (3,12,13).

This study, which was funded by a 2-year grant from the US Department of Health and Human Services Administration, addresses this void through insight into how college students in student organizations may serve as social media catalysts for communications designed to motivate others to learn about the need of organ donation and to become organ donors. The results from this study were used to develop an 18-month US-wide social media and interpersonal communication project in conjunction with a large student organization to raise awareness and support for organ donor registration. We thus attempt to answer the following research questions: What psychosocial factors, including interpersonal, social and personal communications, (1) most impact the support for organ donation by college students, (2) most distinguish organ donor registrants from nonregistrants and (3) whether the relative impact of these psychosocial factors are the same for organ donation support and actual registration behavior? Our model and hypotheses that we test are presented in Figure 1.

image

Figure 1. Organ donation support and registration behavior framework.

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Materials and Methods

  1. Top of page
  2. Abstract
  3. Introduction
  4. Materials and Methods
  5. Results
  6. Discussion
  7. Conclusions
  8. Acknowledgments
  9. Disclosure
  10. References
  11. Supporting Information

Sample

The Collegiate American Marketing Association (CAMA) agreed to participate in the 2-year grant project, including a qualitative research stage, a quantitative research stage and an organ donor registration campaign. The CAMA is a professional marketing association with approximately 10 000 members and 300+ chapters in the United States, Canada and Puerto Rico. The CAMA offered researchers access to its member base and agreed to participate in the organ donor registration campaign upon completion of the research stage of the project.

Questionnaire design

An exploratory research stage and a review of the literature were used to construct the questionnaire to test the stated hypotheses. The exploratory research initiated with 150 key informant interviews with CAMA students to uncover potential barriers to organ donor registration, how social and interpersonal media may hinder/assist the information dissemination process, and other questions relevant to the research project and organ donor registration campaign. Upon completion of these interviews, focus groups with 96 participants were conducted with CAMA leaders at the University of Wisconsin-Whitewater, University of Nevada-Las Vegas, University of Pennsylvania Wharton School and Texas State-San Marcos. All of the focus groups were moderated by experienced research professionals indentified in the grant proposal. Based on these interviews and focus groups, the final questionnaire contained a variety of questions that fell into seven cognitive, attitudinal and social dimensions relevant to explaining organ donation support and registration: (1) Awareness/knowledge about organ donation, (2) acknowledgement of an organ and tissue demand-supply gap, (3) concerns/fears with organ donation, (4) altruism and benefits, (5) social support, (6) social relevance/impact and (7) viral support of social causes. Except for viral support of social causes, the statements used within each dimension used a five-point Likert scale ranging from 1 = strongly disagree to 5 = strongly agree. Two measures were used to identify respondent's likelihood of engaging in viral support of social causes (1 = very unlikely to 5 = very likely). The questionnaire was approved by the University of Wisconsin institutional review board (IRB) and staff at the CAMA headquarters. As shown in Figure 1, these seven dimensions were then used as independent variables in two separate regression models. The dependent variables in the regression models are (1) overall support for organ donation (I support organ donation, five-point agreement scale) and (2) registered to be an organ donor (0 = no, 1 = yes).

Approximately 8500 current CAMA members with an email address were sent an online survey link via email asking for participation in the study. After three waves, a total of 1802 student organization members responded to the survey. The average open rate was 30%, resulting in a 70.6% response rate for those who read the email message (1802/2550). The overall response rate regardless of open rate was 21.2% (1802/8500). These response rates compare favorably for a national online survey of college students (14). The profile of respondents is provided in Table 1. The gender, age and class standing findings match the overall demographic profile from the CAMA's annual conference membership survey. As with many professional student organizations, most members are juniors and seniors.

Table 1.  Profile of respondents
 Profile (%)
Gender
 Female69
 Male31
Age
 184.6
 198.4
 2019.7
 2127.4
 2215.6
 236.7
 241.9
 252.3
 26+13.4
Class standing
 Freshman6.7
 Sophomore8.7
 Junior28.0
 Senior44.4
 Graduate student6.7
 Other5.1
Length as organization member
 1 semester or less55.2
 2 semesters15.1
 3 semesters13.9
 4 semesters6.7
 5+ semesters9.1
Major
 Marketing76.6
 Business (nonmarketing)17.0
 Nonbusiness6.4

Campaign development

An organ donor registration campaign was implemented that used the CAMA as the initiator of a viral communication process designed to spread the word about organ donation, motivate others to participate in the social spreading of information and importantly, to get organization members, other university students, friends and family to become organ donors. A project website was developed that (1) presented videos to introduce the program and to provide testimonials, (2) contained organ donation statistics, (3) conveyed step-by-step instructions for implementing effective communication campaigns, (4) spotlighted what chapters were doing, (5) provided a direct means of registering by state and (6) offered varied social media opportunities including Facebook, Twitter, project blog and YouTube.

Results

  1. Top of page
  2. Abstract
  3. Introduction
  4. Materials and Methods
  5. Results
  6. Discussion
  7. Conclusions
  8. Acknowledgments
  9. Disclosure
  10. References
  11. Supporting Information

Scale dimensionality and reliability

Initially, the items representing the seven theoretical constructs were subjected to an exploratory principle component factor analysis to assess dimensionality and scale reliability. Items with low and/or multiple factor correlations were dropped from the assessment. Items of each construct were carefully examined to make sure that all items were loaded based on theory. Next, the remaining items were subjected to an item to total correlation analysis. Items with low item to total correlations were eliminated. The coefficient alpha for each of the measures was computed to estimate the reliability. As shown in Table 2, the cognitive, attitudinal and social dimensions loaded as expected. Except for social relevance/impact, all of the dimensions had acceptable coefficient alpha reliability scores for exploratory research. The coefficient alpha score for the social relevance/impact dimension is low for two reasons. First, unlike the other statements that used a five-point Likert scale, this dimension used a two-point know/did not know scale (0 = no, 1 = yes). Second, only 25.1% of the respondents indicated that they know someone who died and had their organs donated to others, 18.3% have had a friend who needed a transplant, 18.1% have a family member who needed a transplant and 6.9% knew someone who died while on a transplant waiting list. These low yes frequencies contributed to the lower coefficient alpha score as well. We, thus allowed this dimension to remain in the test of organ donor support and registration.

Table 2.  Factor analysis
 Fears/Benefits/Social Viral Social
 ConcernsAltruismsupportKnowledgesupportNeedimpact
Wealthy patients are moved up the waiting list faster than lower income patients0.669      
Donated organs often go to undeserving people0.669      
Minorities have a lower chance of being selected to receive a donated organ0.654      
The family of the organ donor ends up paying extra medical bills0.653      
Doctors do not try as hard to save someone's life if they know they are an organ donor0.631      
Many people on the waiting list are there because they did not take care of themselves0.613      
The system for allocating organs to wait list patients is unfair0.587      
Elderly people cannot become an organ donor because of their age0.553      
An organ donor cannot have a regular funeral/an open casket because of the surgery0.509      
College students are too young to think about dying and organ donation0.491      
Signing up to become an organ donor is the right thing to do 0.739     
After someone dies, it makes sense to let others use their organs 0.710     
Getting more people to sign up to be an organ donor will save countless lives 0.697     
Signing up to become an organ donor is an easy way to help others in need 0.684     
Organ donation gives purpose to one's death 0.647     
More people would sign up to be an organ donor if they knew more about it 0.552     
Most people have family members or friends who will need an organ transplant 0.458     
My friends are supportive of organ donation  0.699    
If asked by a friend, a person is likely to sign up to become an organ donor  0.679    
If asked by their son/daughter, parents are likely to sign up to be an organ donor  0.656    
My fellow university students are supportive of organ donation  0.645    
My family is supportive of organ donation  0.563    
I have had discussions with others about being an organ donor  0.437    
I am familiar with how to sign up to be an organ donor   0.858   
My family is familiar with how to sign up to be an organ donor   0.855   
My friends are familiar with how to sign up to be an organ donor   0.805   
I have read/viewed/listened to information on how to be an organ donor   0.607   
Become a fan/friend/follower of a “Cause” you support    0.883  
Send an invite to someone to become a fan/friend/follower of a “Cause” you support    0.872  
Many people on the transplant waiting list die while waiting for an organ     0.728 
Only a small percent of the US population is a registered organ donor     0.668 
The demand for organ transplants far exceeds the available supply of organs     0.659 
I knew someone who died while on the transplant waiting list      0.681
I have friends who have needed an organ transplant      0.680
I have family (parents, aunts, uncles, etc.) who have needed an organ transplant      0.646
I knew someone who died and had their organs donated to others      0.418
Total variance explained = 52.09%11.089.679.188.064.874.684.55
Coefficient alphas0.810.800.770.850.820.640.49

Statistical methods

Independent sample t-tests were used to compare responses for organ donor registrants and nondonor registrants. Multiple regression was used to assess the impact of each dimension on the support for organ donation registration. Binary logistic regression was used for evaluating the impact of the dimensions on organ donor registration status.

Descriptive findings

Although women outnumber men in the organization, few meaningful and significant differences were found across gender and suggest that our findings can be generalized to men and women. A cross tabulation of responses comparing the first and the second 50% of respondents uncovered few meaningful differences, thus reducing nonresponse bias. A summary of key findings is shown in Table 3.

Table 3.  Descriptive findings
DimensionStatement% Agree% Neutral% Disagree
  1. Scale ranged from 1 = strongly disagree to 5 = strongly agree; except for viral support of social causes (1 = very unlikely to 5 = very likely) and social relevance/impact (yes/no).

Fears and concernsWealthy patients are often moved up the waiting list faster than lower income patients34.831.134.0
 The system for allocating organs to wait list patients is unfair17.756.925.4
 Elderly people cannot become an organ donor because of their age16.735.947.4
 Minorities have a lower chance of being selected to receive a donated organ15.834.649.6
 The family of the organ donor ends up paying extra medical bills9.246.744.1
 Doctors do not try as hard to save someone's life if they know they are an organ donor17.720.661.8
 Many people on the waiting list are there because they did not take care of themselves13.820.565.8
 Donated organs often go to undeserving people8.927.263.9
 An organ donor cannot have a regular funeral/an open casket because of the surgery9.822.068.3
 College students are too young to think about dying and organ donation14.611.074.5
Donation benefits/altruismGetting more people to sign up to become an organ donor will save countless lives92.95.71.4
 Signing up to become an organ donor is an easy way to help others in need87.78.24.1
 After someone dies, it makes sense to let others use their organs82.613.53.9
 Signing up to become an organ donor is the right thing to do76.920.13.1
 More people would sign up to be an organ donor if they knew more about it79.713.66.7
 Organ donation gives purpose to one's death60.621.218.2
 Most people have family members or friends who will need an organ transplant57.230.911.8
Social interactions/supportMy family is supportive of organ donation70.022.47.6
 My friends are supportive of organ donation58.737.83.4
 If asked by their son or daughter, parents are likely to sign up to become an organ donor64.327.28.5
 If asked by a friend, a person is likely to sign up to become an organ donor56.131.712.2
 I have had discussions with others about being an organ donor60.115.124.7
 My fellow university students are supportive of organ donation42.654.23.2
Awareness and knowledge about organ donationI am familiar with how to sign up to be an organ donor70.08.721.4
 My family is familiar with how to sign up to be an organ donor65.914.519.6
 I have read/viewed/listened to information on how to be an organ donor53.217.529.2
 My friends are familiar with how to sign up to be an organ donor48.226.625.2
Viral support of social causesBecome a fan/friend/follower of a “cause” you support (likely/neutral/unlikely%)79.611.39.1
 Send an invite to someone to become a fan/friend/follower of a “cause” you support (likely/neutral/unlikely%)57.121.121.8
Need acknowledgementThe demand for organ transplants far exceeds the available supply of organs93.05.91.1
 Many people on the transplant waiting list die while waiting for an available organ88.010.21.9
 Only a small percent of the US population is a registered organ donor70.521.18.4
Social relevance/impactI knew someone who died and had their organs donated to others (yes%)(25.1%)
 I have friends who have needed an organ transplant (yes%)(18.3%)
 I have family who have needed an organ transplant (yes%)(18.1%)
 I knew someone who died while on the transplant waiting list (yes%)(6.9%)

Organ donors versus nondonors Just over one-half (52.9%) are registered as an organ donor. A comparison of respondents using cross tabulations shows that students who are registered organ donors generally are (1) more knowledgeable about the need for organ donation and the registration process, (2) more likely to have positive attitudes and perceptions of the impact organ donation has on others' lives, (3) more knowledgeable that many of the common myths about organ donation are incorrect and (4) more likely to agree that they and others in their contact network are supportive of organ donation (Table 4).

Table 4.  Comparisons of registered donor versus nondonor on agree versus neutral/disagree
  % Agree 
  Registered donorNondonorPearson
DimensionStatement(n = 953)(n = 849)chi-square
  1. Scale ranged from 1 = strongly disagree to 5 = strongly agree; except for viral support of social causes (1 = very unlikely to 5 = very likely) and social relevance/impact (yes/no).

Fears and oncernsDoctors don't try as hard to save someone's life if they know they are an organ donor11.224.3.001
 An organ donor can't have a regular funeral/an open casket because of the surgery6.812.6.01
 The family of the organ donor ends up paying extra medical bills6.511.50.01
 Elderly people can't become an organ donor because of their age13.320.70.01
 Wealthy patients are often moved up the waiting list faster than lower income patients29.340.90.001
 Minorities have a lower chance of being selected to receive a donated organ14.417.0ns
 Donated organs often go to undeserving people8.49.1ns
 The system for allocating organs to wait list patients is unfair13.721.30.01
 Many people on the waiting list are there because they did not take care of themselves13.314.1ns
 College students are too young to think about dying and organ donation12.017.60.05
Donation benefits/altruismSigning up to become an organ donor is an easy way to help others in need95.180.00.001
 Organ donation gives purpose to one's death68.452.20.001
 Signing up to become an organ donor is the right thing to do90.962.20.001
 Getting more people to sign up to become an organ donor will save countless lives95.889.60.001
 More people would sign up to be an organ donor if they knew more about it84.675.20.001
 Most people have family members or friends who will need an organ transplant61.454.10.05
 After someone dies, it makes sense to let others use their organs92.473.30.001
Social interaction/supportMy family is supportive of organ donation86.551.10.001
 My friends are supportive of organ donation72.443.00.001
 If asked by their son or daughter, parents are likely to sign up to become an organ donor72.455.00.001
 I have had discussions with others about being an organ donor72.446.10.001
 If asked by a friend, a person is likely to sign up to become an organ donor66.743.90.001
 My fellow university students are supportive of organ donation51.132.80.001
Knowledge about need for organ donationI am familiar with how to sign up to be an organ donor89.949.10.001
 My family is familiar with how to sign up to be an organ donor83.146.10.001
 My friends are familiar with how to sign up to be an organ donor59.733.50.001
 I have read/viewed/listened to information on how to be an organ donor71.532.40.001
Viral support of causesBecome a fan/friend/follower of a “Cause” you support (likely%)79.579.7ns
 Send an invite to someone to become a fan/friend/follower of a “Cause” you support (likely%)55.359.2ns
Need acknowledgementOnly a small percent of the US population is a registered organ donor69.073.7ns
 The demand for organ transplants far exceeds the available supply of organs95.192.2ns
 Many people on the transplant waiting list die while waiting for an organ92.886.10.001
Experience and support issuesI have family who have needed an organ transplant (yes%)19.017.0ns
 I have friends who have needed an organ transplant (yes%)21.314.80.01
 I knew someone who died while on the transplant waiting list (yes%)8.65.00.05
 I knew someone who died and had their organs donated to others (yes%)32.516.50.001

An extensive range of other intergroup analyses were run including gender, personal experiences with organ donation, age, class standing and major. Few significant differences surfaced except for those noted for donor registrant versus nonregistrants.

Hypothesis testing findings

Overall support for organ donor registration Multiple regression was used to assess the relative impact each of the seven dimensions had on respondents' overall support for organ donation. Factor scores were used as the independent variables and respondent gender and class standing were used as control variables. As Table 5 shows, all seven of the cognitive, attitudinal and social variables had a significant impact and in the hypothesized direction (R2= 0.495, F = 106, p < 0.001). Neither gender nor class standing had a significant impact on college students' support for organ donation. In terms of their relative impact, donation benefits and altruism had the greatest influence on support for organ donation, followed by social interactions/support, fears and concerns, knowledge about organ donation, social relevance/impact, need cknowledgement and participation in viral social causes.

Table 5.  Overall support for organ donation
Organ donation support   
dimensionsStd Betat-valuep-Value
  1. R2= 0.495, F = 106, p < 0.001.

Donation benefits/altruism0.51022.450.001
Social interactions/support0.39217.270.001
Fears and concerns−0.243−10.690.001
Awareness and knowledge about organ donation0.1114.890.001
Social relevance/impact0.0703.080.01
Need acknowledgement0.0682.980.01
Viral social causes support0.0602.650.01

Donor registration status Binary logistic regression was used to assess the impact each of the dimensions had on predicting donor registration status. As for organ donation support, the factor scores for each of the seven dimensions were used as independent variables and gender and class standing were used as control variables (Table 6). Six of the seven cognitive, attitudinal and social variables had a significant impact predicting donor registration status and explain a high percent of the variation in responses (Nagelkerke R2= 0.488, χ2= 138, p < 0.001). Neither gender nor class standing had a significant impact. Regarding their relative influence on predicting donor status, knowledge about organ donation had the greatest impact, followed by social interactions/support, donation benefits and altruism, fears and concerns, participation in viral social causes and social relevance/impact.

Table 6.  Donor registration status
Organ donation support   
dimensionsBetaWaldSig
  1. Nagelkerke R2= 0.488, χ2= 138, p < 0.001.

Awareness and knowledge about organ donation1.235160.790.001
Social interactions/support0.81183.600.001
Donation benefits/altruism0.77379.750.001
Fears and concerns−0.514−36.970.001
Viral social causes support0.36718.540.001
Social relevance/impact2.338.080.010
Need acknowledgement−0.0340.083ns

Comparison of organ donation support and registration status A primary objective of this research was to indentify the cognitive, attitudinal and social dimensions on both the support of organ donation and actual registration behavior. The acceptable coefficient alpha levels for all but one dimension and the high variance explained provide support for scale reliability and validity. We were also interested in determining whether the relative importance of these dimensions varied depending on whether support or behavior was evaluated. In Table 7 we present test statistics for organ donation support (t-test) and donor registration status (Wald statistic), along with the rank ordering of importance of the independent variables. Table 7 shows that the most critical element for generating support for organ donor registration differs dramatically when compared to increasing the likelihood of actually registering to be an organ donor. Specifically, perceptions of the benefits of organ donation and altruistic motives had the greatest impact on the support for organ donation while respondents' knowledge about how to register to be an organ donor was the dominant dimension for donor registration status. Second and important given the greater opportunity to generate social-based communications in personal and electronic forms, Social Interactions/Support had the next greatest impact for both support and donor registration. Third, except for need acknowledgement, there is a relatively high level of consistency across the two regressions on the remaining dimensions.

Table 7.  Comparison of organ donation support and donor registration status
Organ donation support  
dimensionsSupportRegistration
Donation benefits/altruism22.45 (1)79.75 (3)
Social interactions/support17.27 (2)83.60 (2)
Fears and concerns−10.69 (3)−0.36.97 (4)
Awareness and knowledge about organ donation4.89 (4)160.79 (1)
Social relevance/impact3.08 (5)8.08 (6)
Need acknowledgement2.98 (6)ns
Viral social causes support2.65 (7)18.54 (5)

Campaign results

Using Google Analytics, video viewing metrics and other social media assessment tools, to date AMASavesLives has 20 421 website visitors, 4473 Facebook members, 1189 submitted YouTube videos generating 164 000 views, 713 blog posts/comments and has had 1800 tweets. In terms of student involvement, 83 different organ donation registration events were held in the past 12 months. From a behavioral perspective, the project motivated 19 623 people to go to a state's organ donor registration page and to date has lead to over 9000 registrations. Based on the posttest survey, organ donation knowledge and support statistically increased on ten items, misperceptions significantly decreased on seven items, and most importantly, organ donator registration increased by 28% among CAMA members. Because of these project results, Donate Life America and other sponsors have provided ongoing funding for the 2011–2012 and 2012–2013 school years.

Discussion

  1. Top of page
  2. Abstract
  3. Introduction
  4. Materials and Methods
  5. Results
  6. Discussion
  7. Conclusions
  8. Acknowledgments
  9. Disclosure
  10. References
  11. Supporting Information

Our multimodel investigation of college students underscores the fact that organ donor registration is a multidimensional and complex process, one that changes as you move from cognition through participation. The donor registration process for college students is multidimensional because the regression findings from both models provide evidence that three different types of psychosocial constructs, namely cognitive, attitudinal and social, independently and jointly impact both the support for organ donor registration and actual donor registration. The donor registration process is complex in that the rank ordering of what most impacts psychological support for organ donor registration is not the same as what most differentiates donor registrants from nonregistrants.

The qualitative and descriptive research findings, along with the regression findings from both models spotlight the growing importance of social-based communication components (1,11,15). The findings are consistent with research which shows that if made aware of the need college students will communicate with others about organ donation, many of whom would spread the word virally (4,16). The fact that social interactions/support (13,17–19) social relevance/impact (20–22) and the viral support of social causes were all significant in both the support and donor status models provides clear evidence that the use of social media of all types, including social networking, email, video viewing and uploading, personal presentations and the like, should receive increased focus in both the academic and health education communities (11). Providing students with knowledge about organ donation and organ donor registration, reasons to become a donor, how donor registration helps others, and information for overcoming organ donation myths and perceived inequities should all be part of social-based communication efforts (4,7,8,18,19,23).

Our findings also support the view that the organ donor registration process is hierarchical and that transitioning college students from exposure to participation might be more complex than originally thought. For example, while increasing knowledge about the organ donation process is clearly important (3,13,16,20,24), communication efforts designed to build upon more altruistic motives will likely have their greatest impact early on in the decision process and will serve as useful talking points in the virally disseminated information (4,7,8,17–19,23). Because social interactions/support was the second most important dimension in both the support and donor status model, getting students to speak with others about organ donation, its benefits and how donor registration benefits those in need are likely to be the impetus for growing the viral communication network. The qualitative, descriptive and empirical findings suggest that those most impacted by organ donation will likely serve as the initial champions in the social media process (3,4,15,20–22). In that student organizations were viewed as strong change agents in the qualitative study, and that those impacted by organ donation had higher donor registration support and participation. Identifying these organ donor champions and providing them with useful information should pay strong dividends.

Conclusions

  1. Top of page
  2. Abstract
  3. Introduction
  4. Materials and Methods
  5. Results
  6. Discussion
  7. Conclusions
  8. Acknowledgments
  9. Disclosure
  10. References
  11. Supporting Information

Our study is one of the most extensive to date that develops a comprehensive model on the relative importance of cognitive, attitudinal and social dimensions on the organ donor registration process. It is also the first study that we are aware of which compares the influence of these dimensions on two key elements of the donor registration process—psychological support and donor registration behavior. In that the findings showed that the organ donor registration process has both unique and differential effects on support and donor status, additional research is needed that proposes and tests hierarchical/sequential models, and particularly, the ordering of relationships that best represents the stages college students go through when deciding to sign up to be an organ donor. A limitation is that although our study focused on one national student organization with an already high self-reported organ donor registration rate, additional research is needed that broadens the types of student organizations investigated.

Our study showed that efforts to educate college students of the need for organ donation, the impact donors can have on saving lives and that dispel myths may lead to increased support for donation and more registered organ donors. Importantly, those who are registered organ donors are more likely to serve as advocates for organ donation and help increase awareness and knowledge of others. Students have a very high usage of social media and self reported a strong likelihood to use personal and electronic communication to access information about social causes and the willingness to distribute user-generated content in support of a cause. User-generated videos, social websites and photo-sharing in combination with personal communications should be particularly effective. To this end, it will be critical to generate an engaged community of advocates to serve as organ donor advocates at the chapter level. The qualitative findings suggest that students need easy to access information about organ donation, step-by-step guidance on how to successfully launch and implement a viral campaign and readily available examples that they can use with limited effort (i.e. sample emails, press releases, publication relations articles, etc.).

This study offered insight into key areas of study within the realm of social media organ donation campaigns and student organizations. Although much was learned with regard to potential opportunities and barriers, linking viral media to social causes, effective communication strategies and an array of psychosocial issues pertinent to organ donation and college students and organization members, there is as of yet a wealth of potential research needs. Specifically more research is needed to find ways to effectively merge personal and social media campaigns. Research is also needed that assesses the individual and joint impact different communication channels, messaging strategies and Internet-based tools have on student engagement. Although our study is one of the largest to date, the fact that data collection was limited to only one national student organization suggests that research targeting different types of student organizations and college students in general is also warranted.

Acknowledgments

  1. Top of page
  2. Abstract
  3. Introduction
  4. Materials and Methods
  5. Results
  6. Discussion
  7. Conclusions
  8. Acknowledgments
  9. Disclosure
  10. References
  11. Supporting Information

The authors would like to thank the US Department of Health and Human Services, Health Resources and Services Administration, for project funding.

Disclosure

  1. Top of page
  2. Abstract
  3. Introduction
  4. Materials and Methods
  5. Results
  6. Discussion
  7. Conclusions
  8. Acknowledgments
  9. Disclosure
  10. References
  11. Supporting Information

Funding for the project was made by the US Department of Health and Human Services, Health Resources and Services Administration. Dr. D'Alessandro was the principle investigator on the grant and Dr. Peltier was principle research evaluator. In addition to being a Professor of Marketing, UW-Whitewater, Dr. Peltier is also President of Applied PhD Research. The authors of this manuscript have no conflicts of interest to disclose as described by the American Journal of Transplantation.

References

  1. Top of page
  2. Abstract
  3. Introduction
  4. Materials and Methods
  5. Results
  6. Discussion
  7. Conclusions
  8. Acknowledgments
  9. Disclosure
  10. References
  11. Supporting Information
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Supporting Information

  1. Top of page
  2. Abstract
  3. Introduction
  4. Materials and Methods
  5. Results
  6. Discussion
  7. Conclusions
  8. Acknowledgments
  9. Disclosure
  10. References
  11. Supporting Information

Table S1: Participants and exploratory data collection methods.

Table S2: Operational definitions.

FilenameFormatSizeDescription
AJT_3783_sm_suppmat.pdf66KSupporting info item

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