Are organ donation communication decisions reasoned or reactive? A test of the utility of an augmented theory of planned behaviour with the prototype/willingness model.
OBJECTIVE
To explore whether people's organ donation consent decisions occur via a reasoned and/or social reaction pathway.


METHODS
We examined prospectively students' and community members' decisions to register consent on a donor register and discuss organ donation wishes with family.


METHODS
Participants completed items assessing theory of planned behaviour (TPB; attitude, subjective norm, perceived behavioural control (PBC)), prototype/willingness model (PWM; donor prototype favourability/similarity, past behaviour), and proposed additional influences (moral norm, self-identity, recipient prototypes) for registering (N=339) and discussing (N=315) intentions/willingness. Participants self-reported their registering (N=177) and discussing (N=166) behaviour 1 month later. The utility of the (1) TPB, (2) PWM, (3) augmented TPB with PWM, and (4) augmented TPB with PWM and extensions was tested using structural equation modelling for registering and discussing intentions/willingness, and logistic regression for behaviour.


RESULTS
While the TPB proved a more parsimonious model, fit indices suggested that the other proposed models offered viable options, explaining greater variance in communication intentions/willingness. The TPB, augmented TPB with PWM, and extended augmented TPB with PWM best explained registering and discussing decisions. The proposed and revised PWM also proved an adequate fit for discussing decisions. Respondents with stronger intentions (and PBC for registering) had a higher likelihood of registering and discussing.


CONCLUSIONS
People's decisions to communicate donation wishes may be better explained via a reasoned pathway (especially for registering); however, discussing involves more reactive elements. The role of moral norm, self-identity, and prototypes as influences predicting communication decisions were highlighted also.
Hyde
Melissa K
MK
School of Psychology and Counselling, Queensland University of Technology, Brisbane, Queensland, Australia. mk.hyde@qut.edu.au
White
Katherine M
KM
D000293:Adolescent; D000328:Adult; D000368:Aged; D003142:Communication; D003657:Decision Making; D005260:Female; D006801:Humans; D007258:Informed Consent / Q000523:psychology*; D033182:Intention; D007389:Internal-External Control; D008297:Male; D008875:Middle Aged; D028681:Moral Obligations; D009042:Motivation; D011446:Prospective Studies; D011793:Queensland; D012042:Registries; D012945:Social Values; D013334:Students / Q000523:psychology; D014019:Tissue Donors / Q000523:psychology*; D055815:Young Adult