Increasing donor designation through black churches: results of a randomized trial.
ABSTRACT African Americans are disproportionately represented among those awaiting a transplant, but many are reluctant to donate their organs.
To test the effectiveness of using lay health advisors to increase organ donation among church members.
Churches were pair-matched by average estimated income and size and then randomized to 1 of 2 interventions: one addressing organ donation and the other addressing increasing consumption of fruits and vegetables.
Twenty-two African American churches in Southeast Michigan.
Church members were trained to serve as lay health advisors (called peer leaders).
Peer leaders conducted organ donation discussions with church groups and showed a DVD created for this program that was tailored to African American churches.
The primary outcome was verified registration in the state's donor registry. Participants also completed pre/post questionnaires regarding their attitudes about organ donation.
Once clustering, baseline value, and demographics were adjusted for, the intervention and comparison groups did not differ on any of the 3 attitude scales on the posttest. In logistic regression analysis, with baseline donation status, demographics, and church clustering controlled for, the odds of self-reported enrollment at 1-year posttest did not differ by condition (odds ratio, 1.23; 95% CI, 0.87-1.72). A total of 211 enrollments in the state registry from participating churches were verified. Of these, 163 were from intervention churches and 48 were from comparison churches.
Use of lay health advisors through black churches can increase minority enrollment in a donor registry even absent change in attitudes.
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ABSTRACT: To identify effective interventions to increase organ donor registration and improve knowledge about organ donation among ethnic minorities in North America and the UK. Systematic review. MEDLINE, EMBASE, PsycINFO, CINAHL and Cochrane Central searched up to November 2012, together with four trials databases and the grey literature. A systematic search followed by assessment of eligibility and quality. An interpretive and thematic approach to synthesis was undertaken. This examined the nature and delivery of interventions in relation to a range of outcomes: verified registration, changing knowledge and a measured shift towards greater readiness. 18 studies were included in the review, comprising educational and mass media interventions. Mass media interventions alone reported no significant change in the intention or willingness to register. Educational interventions either alone or combined with mass media approaches were more effective in increasing registration rates, with a strong interpersonal component and an immediate opportunity to register identified as important characteristics in successful change. Effective interventions need to be matched to the populations' stage of readiness to register. Measured outcomes should include registration and shifts along the pathway towards this behavioural outcome.BMJ Open 12/2013; 3(12):e003453. · 2.06 Impact Factor
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ABSTRACT: Historically, African Americans have been underrepresented in clinical trials (CTs) compared to whites. A growing number of research institutions have created CT registries to match volunteers with appropriate studies. In a sample of 745 African Americans from 16 churches, we tested the impact of a culturally tailored intervention aimed at increasing enrollment in a university-based CT registry. Half of the churches received a culturally tailored CT education program (intervention) and half of the churches received a program about healthy eating (comparison). The main outcomes were the odds of post-test self-reported enrollment and verified enrollment. Using linear regression, post-test willingness to participate in a CT was also assessed. Odds of verified enrollment were higher in the intervention than comparison group (OR=2.95, 95% CI: 1.33-6.5, p=0.01). Post-test self-reported enrollment in the registry was also higher among the intervention group than comparison group members (OR=1.94, 95% CI: 1.08-3.47, p=0.03). Willingness to participate in a future CT was higher in the intervention group (β=0.74, p=0.02). A culturally tailored education program about CTs can increase enrollment of African Americans in a university-based clinical trials registry. Community engagement and health education workshops may improve minority CT enrollment over time. Copyright © 2014. Published by Elsevier Ireland Ltd.Patient Education and Counseling 11/2014; 98(2). · 2.60 Impact Factor