title: Regional Differences in Communication Process and Outcomes of Requests for Solid Organ Donation.
abstract: Although federal mandate prohibits the allocation of solid organs for transplantation based on "accidents of geography," geographic variation of transplantable organs is well documented. This study explores regional differences in communication in requests for organ donation. Administrative data from nine partnering organ procurement organizations and interview data from 1339 family decision makers (FDMs) were compared across eight geographically distinct US donor service areas (DSAs). Authorization for organ donation ranged from 60.4% to 98.1% across DSAs. FDMs from the three regions with the lowest authorization rates reported the lowest levels of satisfaction with the time spent discussing donation and with the request process, discussion of the least donation-related topics, the highest levels of pressure to donate, and the least comfort with the donation decision. Organ procurement organization region predicted authorization (odds ratios ranged from 8.14 to 0.24), as did time spent discussing donation (OR = 2.11), the number of donation-related topics discussed (OR = 1.14), and requesters' communication skill (OR = 1.14). Standardized training for organ donation request staff is needed to ensure the highest quality communication during requests, optimize rates of family authorization to donation in all regions, and increase the supply of organs available for transplantation.
authors.affiliation: Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA.
authors.forename: H M
authors.initials: HM
authors.lastname: Traino
authors.affiliation: Department of Health Behavior & Policy, Virginia Commonwealth University, Richmond, VA.
authors.forename: A J
authors.initials: AJ
authors.lastname: Molisani
authors.affiliation: College of Public Health, Temple University, Philadelphia, PA.
authors.forename: L A
authors.initials: LA
authors.lastname: Siminoff
mesh_terms: D000328:Adult; D003142:Communication; D003657:Decision Making; D005190:Family / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D016377:Organ Transplantation; D011379:Prognosis; D014019:Tissue Donors / Q000523:psychology*; D009927:Tissue and Organ Procurement / Q000379:methods*
keywords: donors and donation; health services and outcomes research; organ procurement organization; social sciences