Eusebio M. Alvaro

Intentions of Becoming a Living Organ Donor Among Hispanics: A Theory-Based Approach Exploring Differences Between Living and Nonliving Organ Donation

This research examines perceptions concerning living (n = 1,253) and nonliving (n = 1,259) organ donation among Hispanic adults, a group considerably less likely than the general population to become donors. Measures are derived from the Theory of Planned Behavior (Ajzen, 1991) and Vested Interest Theory (Crano, 1983 1997). A substantial percentage of respondents reported positive attitudes and high personal stake concerning organ donation. Mean differences in norms, attitudes, intentions, and assumed immediacy of payoff were found between living and nonliving donor groups, suggesting that these two donation formats are dissimilar and should be examined independently. Accordingly, separate hierarchical multiple regression models were estimated for living and nonliving donation. Analyses supported both theoretical frameworks: Constructs associated with Planned Behavior and Vested Interest independently contributed to donor intentions. The implications of these results, and our recommendations for future health campaigns, are presented in light of these theoretical models.

Living kidney donation among Hispanics: a qualitative examination of barriers and opportunities

Context Despite their increasing need for kidneys and low nonliving donation rates, minimal research has been conducted to ascertain the perceptions of Hispanic Americans about living organ donation and the process of asking for such a donation. Objective To examine perceptions of Hispanics regarding barriers to and benefits of living donation as well as the process of asking someone to be a living donor. Design A qualitative study consisting of 10 focus groups conducted in 2 series. Participants Adult Spanish-language-dominant Hispanic members of the general population of Tucson, Arizona. Results The main barriers to living organ donation were a lack of knowledge or information and fear of the donation process. Knowing that one has helped save or improve anothers life was the central benefit. Most participants reported being willing to ask a relative to be a living donor if they were ever in need. Two main responses typified these individuals: no concern about asking because of a strong desire to fight for ones health and for ones family, or asking despite difficulties and concerns about the process. A significant minority of participants indicated they would not ask for a donation, because of either a desire to avoid harming others or the expectation that a relative would initiate an offer.

Organ Donor Registration Preferences Among Hispanic Populations: Which Modes of Registration Have the Greatest Promise?

There is little debate over Hispanics’ need for viable organs. Although organ donor registries can potentially assist in alleviating this need, the U.S. Department of Health and Human Services (DHHS) has called on researchers to investigate methods to maximize such potential. This research effort answers the aforementioned call by surveying Hispanics, both those who prefer to use Spanish (SP, n = 239) and those who prefer not to use Spanish (NSP, n = 364) about the methods of donor registration that they would most likely utilize. When provided with different options for organ donor registration, signing up by applying for a driver’s license, through a place of worship, or through a doctor’s office were among the most popular methods; over the telephone, tax forms, or through the use of home computer were among the least popular. Furthermore, the DHHS-suggested idea of registering via organ donor kiosks was very well received.

A Mass Mediated Intervention on Hispanic Live Kidney Donation

This research examines the impact of a Spanish language mass media campaign on living organ donation attitudes and behavioral intentions among Spanish dominant Hispanics in Tucson, Arizona. Impact was assessed via a pretest/posttest control group quasiexperimental design with Tucson, Arizona, as the intervention community and Phoenix, Arizona, as the control. Preintervention focus groups provided qualitative data to guide intervention development, while telephone surveys in both communities provided quantitative data to assess campaign impact. Analyses reveal pretest/posttest differences in the intervention community such that posttest intentions regarding living organ donation behaviors increased from pretest. No such differences were observed in the control community. Subsequent analyses revealed differences between respondents in the intervention community exposed to the campaign vs. those in the same community not exposed to the campaign. Exposed respondents reported more positive living organ donation behavioral intentions than nonexposed respondents. Implications for research and practice are discussed.

A quasi-experimental investigation of message appeal variations on organ donor registration rates.

OBJECTIVE Approximately 6,000 Americans die every year awaiting an organ transplant. Health promotion interventions may alleviate the shortage of viable organs by increasing the number of registered organ donors. This study is the first to evaluate the differential effectiveness of various organ donor messages in naturalistic settings. DESIGN A 4 (Appeal)x4 (Exemplar)x4 (Location) counterbalanced quasi-experimental design was implemented. MAIN OUTCOME MEASURE The behavioral outcome measure was the number of individuals who registered to be organ donors at computer kiosks. RESULTS A number of significant main effects and interactions emerged. Most notably, of the 4 different appeals (counterargument, emotional, motivating action, dissonance), counterargument was by far the most efficacious, especially in academic-type settings (library, university, community college); the emotional appeal was most successful in hospitals. CONCLUSIONS The findings from this study have implications for both organ donor investigations and health campaign research in general. Statistical interactions highlight the importance of evaluating multiple exemplars in multiple locations for each type of appeal when conducting health campaign research.

Passive-positive organ donor registration behavior: a mixed method assessment of the IIFF Model.

When it comes to organ donation, the majority of American non-donors are passive-positives – they support organ donation but have yet to register as donors. A quasi-experimental, four-city, pretest/posttest study was conducted to assess the utility of the IIFF Model as a means of increasing registration among these individuals. Focus groups were used as the intervention context. In support of the models utility, 46.6% of focus group participants signed donor cards at the end of the intervention. Extrapolated to the general population, such a finding could result in millions of new registrants. Retrospective analyses of reasons for non-registration provided before the start of the focus groups reveal that passive-positives placing culpability for non-registration on lack of knowledge or opportunity register signed-up at a rate of 63.6%. Passive-positives claiming to have put off registering because of their discomfort with thoughts of death or fear that organ donors are allowed to die so their organs can be harvested registered at a rate of 5.8%.

Depression and help seeking among Mexican-Americans: the mediating role of familism.

Increased depression symptomatology results in a reduced willingness to seek help from family. Focusing on Mexican–Americans, the current study hypothesized that the a reduction in favorable perceptions of familial relations could be partially to blame for limited help seeking among people with depression. Data were collected from 84 Mexican–Americans. Measures assessed depression symptomatology, familism, perceptions of help seeking from family, and demographics. As predicted: (1) depression symptomatology was negatively associated with perceptions of help seeking from family; (2) familism was positively associated with perceptions of help seeking from family; and, (3) depression symptomatology was negatively associated with familism. Further, familism partially mediated the relationship between depression symptomatology and help seeking comfort, as well as between depression symptomatology and the perceived utility of familial help seeking. The results indicate a reduction in familistic values may be partially responsible for reduced help seeking among Mexican–Americans with depression.

Can you spare an organ?: exploring Hispanic Americans' willingness to discuss living organ donation with loved ones.

Living organ donation offers a means of overcoming the shortage of viable organs available for transplant: a shortage particularly problematic among Hispanics. One barrier standing between those in need of a kidney and a successful transplant operation is an inability, and often lack of desire, to talk to loved ones about the need for a living donation. With an eye on future intervention approaches, and guided in part by the theory of planned behavior, this research effort sought to explore the factors associated with a willingness to engage in a conversation about a living donation with loved ones. Study 1, a phone survey of Hispanic Americans drawn from a Hispanic surname list, reveals that while upward of 90% of respondents would be willing to offer a kidney to a family member in need, and a similar percentage would be willing to accept a living donation if offered, only about half of respondents would feel comfortable initiating a conversation with family members if the respondent was in need of a living donation. Study 2, a survey of Hispanic American patients currently in need of a living kidney donation, revealed that perceived behavioral control accounted for 60% of the variance in future intentions to initiate a conversation among those who have yet to speak to a family member about becoming a living donor. Moreover, perceived behavioral control mediated the relationship between perceived asking appropriateness and future intentions to initiate a conversation. Lastly, recipient outcome expectations, asking appropriateness, and subjective norms were revealed to be predictive of perceived behavioral control. Implications for future living donor interventions focusing on increasing recipient-initiated conversations are discussed.

“…you would probably want to do it. Cause that's what made them popular”: Exploring Perceptions of Inhalant Utility Among Young Adolescent Nonusers and Occasional Users

With an eye toward future primary prevention efforts, this study explores perceptions of inhalant utility among young adolescents in the United States. The study makes use of data gathered via nine focus groups conducted in Tucson, Arizona in 2004 (N = 47, mean age = 13.2 years). Three main themes emerged concerning the perceived utility of inhalant use: (1) Inhalant use as a means of mental escape, (2) Inhalant use as a social tool, and (3) Inhalant use as a parental relations tool. Additionally, participants discussed an interaction hypothesis regarding inhalant use and popularity. Implications for future research are suggested and limitations described.

Increasing organ donor registration rates by providing an immediate and complete registration opportunity: An experimental assessment of the IIFF model

The IIFF model of organ donation holds that the simultaneous presence of four factors directly influence donor registration: (1) immediate and complete registration opportunity (ICRO), (2) information, (3) focused engagement, and (4) favorable activation. Two field experiments examined the impact of an ICRO on organ donation registration. In Study 1, participants were at town halls where they knew organ donation was to be discussed. Registration cards were distributed and then collected at the end of the session in half of the town halls. For the other half, participants were asked to mail in completed cards. In three US cities, participants given an ICRO registered at a significantly greater rate (z = 4.865, p < 0.05). Study 2, targeting Hispanics at a swap meet, differed in that the registration impact of awareness of the availability of an ICRO was investigated. Participants made aware of an ICRO registered at a significantly greater rate (z = 4.1, p = 0.000).