36 Culturally Targeted and Individually Tailored Videos Improve Organ Donation Willingness Among Black Men After Viewing

Abstract

Black men have disproportionally greatest need for kidney transplants due to higher prevalence of hypertension and diabetes and inadequate access to treatment. Black men also are least likely to donate organs. The ED is the portal of entry for potential organ donors with more opportunities arising from new programs that consider donation after failed resuscitation. These programs are reliant on patients being registered donors. We assessed whether generic, culturally targeted, or individually tailored videos differentially impact donation willingness among black men. Videos were produced with clients, barbers, and owners of black-owned barbershops (BOBs) throughout NYC. Content was informed from individual qualitative interviews with clients. Beliefs mapped into religion, culture/knowledge, altruism, and normative constructs. Videos were evaluated with a single blinded RCT. Clients viewed videos with iPads and noise cancelling headphones, after which registration was offered. The control video showed a white mother who met the recipient of her daughter’s heart (a white man). The targeted video conveyed information with testimonials from black transplant specialists, barbers, and a black man who is awaiting a kidney transplant. Content debunked myths about organ donation with equal length segments devoted to the belief constructs. Tailoring consisted of 16 video variations based on the targeted video. Pre-intervention organ donation beliefs were assessed with an index validated with multidimensional Rasch models. If a participant scored < 0.6 logits in a domain, that content was included. The primary outcome was proportion of participants who registered. Secondary outcomes included taking an informational pamphlet and change in pre/post organ donation willingness scores (ODWS) assessed with a 5-item scale informed by stages of change theory. We modeled registration with multi-level logistic regression using video group as the primary regressor and BOB location as a random effect. Ordinal logistic regression was used to model post-viewing ODWS as the dependent variable, video group as the primary regressor adjusting for baseline ODWS. Outcomes were assessed with intention to treat (ITT) and treatment effects. 3,746 men were approached in 40 BOBs. Of these, 1,440 were enrolled and 1,353 completed the study. Mean age was 34 years. Randomization yielded approximately equal groups based on age, sex, education, religion, and baseline ODWS. Outcomes are presented in the table below. Tailored and targeted videos did not impact registration differentially compared to generic content, but these production choices improved taking pamphlets and willingness among black men. There were no significant differences between the tailored and targeted groups. Distributing culturally targeted videos without individually tailoring content in community settings may be effective means for improving organ donor willingness among black men.