Online Intervention for ANHPI College Students
Condition: Tissue and Organ Procurement
Study type: Interventional

Summary: 
      Taking advantage of college students' frequent use of online technology, including social
      networking sites (e.g., Instagram a social media site /Facebook a social networking site) and
      social media sites (e.g., YouTube), the investigators will create an online intervention that
      leverages this technology to engage and educate Asian, Native Hawaiian, Pacific Islanders
      (ANHPI)students about a range of topics related to organ donation following death.
    

Detailed description: 
      Over 56% of the 120,000 critically ill Americans waiting on transplant waiting lists are
      ethnic minorities. The proportion of ethnic minorities, including Asian, Native Hawaiian,
      Pacific Islanders (ANHPI), on waiting lists exceeds their representation in the general
      population. However, few ANHPI adults are designated organ donors (DOD) on their driver's
      licenses or in a donor registry. ANHPI college students (aged 18-29) also have low DOD rates,
      particularly Filipinos. Individuals are typically asked about becoming a DOD when renewing a
      driver's license; but most never think about OD outside of the short-lived Department of
      Motor Vehicles (DMV) transaction. Knowing someone's status as a DOD on their license can be
      an influential factor in solidifying a family's feelings about donating a relative's organs
      after his/her death, if their consent is necessary. Of those who choose DOD status on a
      license, most will remain one for life. Intervening with drivers before the date of their
      license renewal can be difficult to arrange; however, opportunities arise when college
      students turn 21 and want to renew their license in order to remove formatting / colors
      signifying that the license belongs to an underage minor (< 21 years old).

      Taking advantage of college students' frequent use of online technology, including social
      networking sites (e.g., Instagram a social media site /Facebook a social networking site) and
      social media sites (e.g., YouTube), the investigators created an online intervention that
      leveraged this technology to engage and educate ANHPI students about a range of topics
      related to organ donation (OD). It will also provide culturally sensitive messages tailored
      to their interest in or wariness of organ donation and reframe students' attitudes about OD
      and becoming a DOD. Previous internet interventions to encourage college students to become
      DODs have not included culturally sensitive approaches for ANHPI, who have unique barriers to
      OD. The cross-sectional design will test the impact of introducing, sequentially, an online
      intervention tailored to college students at three universities (UH-Manoa, UH-Hilo, and
      Hawaii Pacific University). The sequence of when the a university received the intervention
      was randomly determined; thus, the study's design was a cross-sectional design. The goal was
      to increase DOD rates in college students, particularly ANHPI and encouraging peer
      discussions/interactions/advocacy about OD.

      Effectiveness will be measured by a change over time in the percentage of students who report
      being a DOD on their license/donor registry (250 students per university measured across 6
      time points; thus, the total sample = 4,500). The investigators anticipate a 12% increase in
      DOD rate in students who are exposed to the intervention. Increases in DOD status will also
      be tracked via an increase (over normal rates) in the number of new donors aged 18-29 who
      register as a donor on Hawaii's online donor registry. To make the study website relevant to
      college students the investigators will include resources useful for assignments in courses
      (e.g., both in required "general education" courses- including one on "writing skills", and
      courses on ethics, religion, sociology, and culture/ ethnic studies, etc.) Students and
      student organizations will participate in contests to win prizes (e.g., for the best 1-minute
      DOD focused-YouTube video/ Instagram picture, creating a "caption" for a photo on Instagram,
      and student organizations who compete for group awards). A goal of the intervention will be
      to reframe OD by engaging altruistic attitudes based on college students' commitment to
      "green" sustainability efforts (e.g., "go green, recycle yourself"). Innovative culturally
      sensitive strategies that can engage, educate, and reframe DOD for college students,
      including those who find it unappealing (i.e., the "ick factor") are clearly needed. The
      online intervention will saturate online venues (i.e., YouTube, Instagram) visited frequently
      by college students, and the investigators will use the new concept of "gamification" to turn
      college students' learning and advocacy ideas surrounding OD/DOD into a game or contest with
      their peers. This project builds upon Drs. Albright and Feeley's (consultant - Univ. of
      Buffalo, Dept. of Communications) previous work to encourage adolescents and young adults to
      become a DOD; thus, the investigators feel well-suited to design, implement, and evaluate the
      proposed project. The intervention will increase DOD rates in ANHPI students, and thus,
      increase the number of ethnic minorities who become deceased organ donors now and for years
      to come.
    

Intervention name(s): Web intervention
Intervention type(s): Behavioral
Intervention description(s): interactive website using social media and gamification
Other intervention name(s): iDecide Hawaii
Allocation: Randomized
Intervention model: Sequential Assignment
Intervention model description: Online educational intervention of choice to be an organ donor was provided to undergraduate students at three universities. The intervention launch at the universities were sequentially initiated, in random order. The design included cross-sectional assessments (unique respondents at each site over time ) as well as longitudinal assessments (same students repeatedly assessed over time).
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: designated organ donor, college students