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.
- Circulation 02/2013; 127(12). DOI:10.1161/CIR.0b013e318288b4dd · 14.95 Impact Factor
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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. DOI:10.1136/bmjopen-2013-003453 · 2.06 Impact Factor
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ABSTRACT: Obesity-associated chronic diseases persist in Samoan populations in the United States. Samoans and African Americans share cultural similarities such as church affiliation, perceptions of weight and body size, and obesity-related health risks. Adapting an effective energy balance intervention originally designed for African Americans-Body and Soul-might be useful in reducing obesity among U.S. Samoans. To determine potential attractiveness and adaptations, we used aspects of grounded theory to analyze key-informant and focus group interviews with 31 purposively selected Samoans in Hawaii. We incorporated participatory features into the research with Samoan community members conducting parts of the study. From interview narratives, we identified relevant themes from Samoan culture, such as fa'aSamoa or the Samoan way, and specific energy balance activities to include in an obesity and cancer prevention intervention for U.S.-dwelling Samoans. Our findings describe methods to address health disparities by incorporating culturally appropriate health concepts into existing evidence-based interventions.Qualitative Health Research 09/2014; 24(12). DOI:10.1177/1049732314549021 · 2.19 Impact Factor