Multivariate analysis of factors associated with willingness to be an organ donor - a basis for organ donation advocacy/awareness

Background. Success in solid organ transplantation is limited by lack of donor organs more than any other factor. Previous reports show myths and knowledge deficiencies surrounding organ donation (OD) and transplantation are associated with unwillingness to be an organ donor. Our aim was to further clarify these associations to allow targeting of negative predictive variables in an advocacy campaign for OD. Methods. Data were collected from an internet-accessible survey; no specific population segment was targeted. Survey questions were designed to ascertain willingness to donate (3 choices: yes, no, unsure) and knowledge of and attitudes toward OD and transplantation. Those unsure of willingness to donate were prospectively defined as unwilling. Univariate (t-test, chi-square) and multivariate (logistic regression) analyses were performed. There were 419 respondents. Results. 318 (75.9%) were female; 378 (90.2%) were Caucasian; 318/417 (76.3%) had a 4-year college degree or higher. 353/417 (84.7%) were willing to be a donor; 64 (15.5%) were unwilling. Univariate factors associated (p<0.05) with unwillingness included: non-Caucasian; concern that inadequate emergency medical care would be provided to a designated donor; believing famous persons get transplant waiting list priority; not having discussed OD with family; not having seen information on OD within 30 days; believing donor families should be paid. Multivariate analyses showed concern of inadequate emergency care (odds ratio, 0.24, p=0.0003) and believing famous persons get transplant priority (OR 0.48, p=0.015) independently predict unwillingness to donate. 398/411 (96.8%) would honor a family's previously stated wish to donate; 323/416 (77.6%) would honor a family member's wish to not donate. 135/417 (32.4%) reported having seen the “DonateLife” symbol; 220/415 (53.0%) reported they were aware the symbol is intended to increase OD; of those unaware (150/415, 36.1%) or unsure (n=45, 10.8%) of its intent, 37 (19.1%) reported it increased their willingness to donate. Neither working in the medical/public health field nor education level achieved was associated with willingness to donate. Conclusions. Increased OD is necessary to maximize the potential of transplantation. Most respondents to our survey were willing to be an organ donor and would honor a family member's previously stated desire. Our survey is not a random sample of the population; this notwithstanding, both factors independently associated with unwillingness to donate are subject to modification through educational efforts and are logical target variables in an OD advocacy/awareness campaign. It is unclear whether the current “DonateLife” symbol has the indended consequences; modifying it for enhanced effect should be considered.