Health Promoters and Organ Donation
Condition: Organ Donation; Donor Designation/Registration
Study type: Interventional

Summary: 
      Older Hispanics (age 50+ years) are disproportionately overrepresented on the transplant
      waitlist, but underrepresented as deceased donors and transplant recipients. This application
      proposes the formative research to design and empirically test an eLearning module,
      Promotoras de Donación, to train community health workers (i.e., Promotoras), who already
      provide culturally and linguistically sensitive services to their communities, to discuss and
      promote organ donation with older Hispanic women in 3 geographically distinct communities
      across the U.S. The proposed intervention leverages the established and evidence-based
      Promotoras program to increase rates of donor designation within Hispanic communities across
      the U.S. and reduce disparities in access to transplantation for this population.
    

Detailed description: 
      Despite consistently positive attitudes toward organ donation, increasing the number of
      registered organ donors in the US continues to challenge the professional and research
      communities. Improving rates of donor designation among ethnic minorities is of particular
      importance given the need to match donated organs to recipients on blood type and human
      leukocyte antigens - the best matches are found when the donor and recipient are of the same
      ethnic background. In Hispanic communities, lay health educators (i.e., Promotoras) are
      trained to promote behaviors that empower and enable constituents to prevent disease, and
      increase control over and improve their health. In partnership with leadership of four
      Promotoras organizations in geographically diverse areas of the U.S. (PA, IL, TX)
      representing the largest subgroups of the Hispanic population, this pilot study proposes to
      leverage the preexisting network of lay health educators to advocate for organ donation and
      promote donor registration (first person consent) among female Hispanics over the age of 50.
      Specifically, this study will collect the formative data needed to design an educational and
      behavioral communication eLearning module for Promotoras and test the impact of the training
      on Promotoras' knowledge of organ donation, confidence discussing and promoting donor
      registration, and efficacy increasing rates of donor registration among mature and older
      Hispanic women. Focus group interviews with Hispanic women and Promotoras will identify the
      information needs and concerns about organ donation registration of these two groups;
      interviews with lay educators will also gauge interactivity preferences as well as content
      and design issues for the resulting web-based training (Aim 1). These data will be used to
      develop an eLearning module to educate Promotoras about organ donation and train them to
      discuss donation and promote donor registration (Aim 2). A brief quantitative survey will
      assess the impact of the module on knowledge of organ donation and confidence (communication
      self-efficacy) discussing donation and promoting donor designation. We will evaluate
      Promotoras' efficacy promoting organ donation by assessing the number of Hispanic women age
      50 and over who register as posthumous organ donors as a proportion of all women attending
      small group sessions led by trained Promotoras (Aim 3). If effective, the eLearning module
      could easily be disseminated nationally to train Promotoras to discuss and promote organ
      donation. Ultimately, this 'train-the-trainer' study has the potential to increase rates of
      donor registration among Hispanic communities in the U.S. and help to reduce disparities in
      access to transplantation for this population.
    

Intervention name(s): Health Promoters and Organ Donation
Intervention type(s): Behavioral
Intervention description(s): Promotoras de Donación is a highly engaging and interactive online learning experience, that accommodates multiple learning styles by incorporating a variety of pedagogic approaches. The module consists of two components: a didactic educational component and a skills-based communication component. The didactic component provides basic information about organ donation and transplantation and the need for donors in the Hispanic community, and addresses concerns about donation commonly held by older Latina. The skills-based component provides instruction on the key communication skills needed to effectively engage small groups in discussions about organ donation. This component is intended to build communication self-efficacy or confidence opening the discussion about donation, addressing concerns raised by mature and older women participating in the small group sessions, and promoting the act of donor registration using persuasive, but non-coercive language.
Other intervention name(s): Promotoras de Donación (PdD)
Intervention model: Single Group Assignment
Intervention model description: The study includes focus group interviews with mature Latina and Promotora to inform the development of a web-based educational and communication intervention, as well as an evaluation of the intervention using a nonrandomized, quasi-experimental pragmatic design, pre-post only with no control group to test the impact of the eLearning module on lay health educators' knowledge of organ donation and confidence holding discussions about and promoting organ donation. Additionally, we will examine the impact of the Promotoras de Donación intervention, which will engage trained lay health educators to lead small group sessions with mature Latina, on the women's attitudes about organ donation and donor registration, and rates of donor registration.
Masking: None (Open Label)
Primary purpose: Other
Keywords: Organ donation; Donor designation/registration; Train-the-trainer; Promotora; Community health worker; Lay health educator; Program development; Program evaluation