An evaluation of the license to save lives program to promote organ, eye, and tissue donation among teenagers.

As the number of designated organ donors continues to lag behind the number of waiting list patients, teenagers remain a promising demographic of potential organ donors. The current study enlisted Michigan and Ohio driver education students to participate in an online digital learning intervention, License to Save Lives (LTSL). Students were randomly assigned to either an interactive or noninteractive LTSL intervention. Across both states, the pretest-posttest design revealed greater knowledge among students following exposure to either the interactive or noninteractive LTSL program. No attitudinal or behavioral differences emerged between the interactive and noninteractive conditions. Michigan (39.82%) and Ohio (58.10%) students registered to be organ donors at a respectable rate. The results are discussed with an emphasis on feasibility and sustainability as well as the promise for digital games to promote organ donation knowledge, attitude, and registration among teenagers.

Can Happiness and Sadness Overcome Organ Donation Barriers Following Exposure to Radio Ads?

Concerns related to bodily integrity, medical mistrust, superstition, and disgust with respect to organ transplantation remain commonly cited barriers among African American, Caucasian, and Hispanic non-donors. The current study examined two narrative strategies for mitigating these barriers by eliciting feelings of happiness or sadness. African American, Caucasian, and Hispanic non-donors (N = 576) were randomly assigned to a radio ad that communicated either a recipient narrative or a waiting list narrative. As expected, the recipient narrative elicited greater feelings of happiness whereas the waiting list narrative aroused greater feelings of sadness. Moderated mediation analyses revealed models in which happiness, not sadness, was the mediator, such that the narrative frame was associated with ad persuasiveness. Additionally, only medical mistrust interacted with happiness to predict ad persuasiveness The results are discussed with an emphasis on message design strategies to employ among reluctant adult African American, Caucasian, and Hispanic potential donors.

An Investigation into the Portrayal of Organ Donation on Grey's Anatomy Seasons 1 Through 15.

The current project sought to extend prior research examining organ donation portrayals on Grey's Anatomy by examining the first fifteen seasons. Guided by the health belief model, content analysis revealed more attention was given to benefits of donation than barriers. Contrary to previous research, more attention was given to refuting rather than promoting commonly cited myths. The results also address attention to the health threat as well as Grey's Anatomy's representation of self-efficacy in registering to be an organ donor. Finally, proportion tests revealed significant differences between the types of organs transplanted on Grey's Anatomy compared to organs transplanted in the United States. The results are discussed with an emphasis on portrayal trends throughout Season 1 through 15 as well as the theoretical and practical implications of our findings.

A Reasoned Action Approach to Limiting Excessive Social Media Usage Among Adults.

The literature on social media suggests a link between use and negative mental health consequences. Numerous theoretical perspectives have attempted to explain the underlying mechanisms for this relationship but are lacking a clear explanation for why some individuals may be negatively impacted by their social media use. Despite a plethora of research on this relationship, minimal research has examined the act of limiting social media use as a promotional behavior. This study takes a fresh approach by investigating attitudinal components that predict intentions to limit social media use via the reasoned action approach. US adults (N = 298) participated in an online survey on excessive social media use. Attitudes, perceived norms, and perceived behavioral control were significant predictors of intentions to limit social media use. In addition, perceived behavioral control was hypothesized to moderate both the attitude to intention and norm to intention relationships in that these associations would be stronger for those with higher control beliefs. Results showed that strong control beliefs strengthened the attitudes to intentions relationship but weakened the norm to intention relationship. Future practical and research directions are discussed to promote limiting social media use and further investigate the negative mental health outcomes of excessive social media.

Raising Concussion Awareness among Amateur Athletes: An Examination of the Centers for Disease Control and Prevention's (CDC) Heads Up Campaign.

Attention to concussion prevention and management has grown in recent years due to the potentially long-term, debilitating effects a head injury can have on an individual. Although multiple campaigns have been designed to target this issue, there remains a need to evaluate the persuasive principles used to advocate for safety measures and protocols, specifically within youth sports. With this in mind, we applied the health belief model (HBM) in our content analysis of the Centers for Disease Control and Prevention's (CDC) Heads Up concussion awareness campaign. Campaign videos (N = 35) were coded for threat severity, threat susceptibility, benefits, barriers, self-efficacy, and cues to action. The majority of videos communicated the seriousness of concussions and attempts to communicate concussion susceptibility were driven by personal stories, rather than facts and statistics demonstrating concussion prevalence. Less than half of the videos communicated the benefits of following concussion protocols and only a third of the messages described barriers to following recommended protocols. The majority of videos aimed to elevate self-efficacy among athletes and parents, but not coaches, by focusing on identifying symptoms and concussion avoidance. The implications for concussion prevention and management among athletes, parents, and coaches are discussed.

A Test of Autonomy Restoration Postscripts to Mitigate Psychological Reactance to an Opt-Out Organ Donor Registry in the United States.

The organ shortage continues to present problems around the world including the United States. In response, some countries have switched from an opt-in organ donor registry to an opt-out registry. The United States currently utilizes an opt-in registry where an individual is not considered an organ donor until they register their intentions. In the current study, U.S. adults were randomly assigned to a 2 (message valence: promotional, refutational) x 2 (autonomy restoration postscript: present, not present) x 2 (social proof: high likes, low likes) posttest only control group design evaluating social media message regarding an opt-out organ donor registry for implementation in the U.S. Results revealed an interaction between message valence and autonomy on freedom threat perceptions toward the message. Consistent with psychological reactance theory, freedom threat perceptions were positively associated with reactance, which in turn was positively associated with an intention to sign a petition and call a representative to voice disapproval of the opt-out organ donor registry. The discussion is focused on pragmatic recommendations for organ donor practitioners and advocates as well as the theoretical contributions to reactance theory.

Psychological Reactance Theory and COVID-19 Vaccine Mandates: The Roles of Threat Magnitude and Direction of Threat.

The current study examines psychological reactance theory (PRT), focusing on the role of threat directness and threat magnitude in the context of a COVID-19 vaccine mandate. Students on two college campuses in the United States (N = 374) were informed that their university or the other university (i.e., threat directness manipulation) was considering a vaccinate mandate for the following semester that would or would not include sanctions for noncompliance (i.e., threat magnitude manipulation). Participants experienced significantly greater freedom threat perceptions when the mandate included sanctions compared to when it did not, but freedom threat perception did not differ when the mandate was on their own campus as to the other campus. An interaction effect was also observed in which perceived freedom threat and reactance was greatest among participants receiving an indirect (as opposed to direct) threat with sanctions. Findings are discussed with an emphasis on the theoretical contribution to PRT along with the practical implications for vaccine mandates.

An examination of teenagers' beliefs toward organ donor registration.

Teenagers represent a promising target population for organ donor registration efforts, as in the US teenagers age 15-17 may register their intent for organ donation, which later translates to consent at age 18. However, teenagers constitute a relatively understudied population in the organ donation literature. A sample of teenagers (N = 466) ranging in age from 13 to 19 was recruited from driver's education schools in Ohio and Michigan in order to learn more about their perceived reasons for and against registering as an organ donor. A coding scheme was developed, and responses were coded by two trained coders. In line with previous work in adult samples, our results revealed the three most common reasons for registering were prosocial benefits, rational arguments, and personal experience. In contrast to previous work among adults, the two most common reasons for not registering were bodily integrity and religious reasons. Several novel beliefs among teenagers that were both supportive and non-supportive of organ donor registration were identified. Findings from the current study are discussed with an emphasis on implications for practitioners working to promote organ donor registration among teenage audiences.

An evaluation of a motor vehicle facility campaign with an established statewide donor registry: A test of sustainable, evidence-based intervention strategies.

Increasing organ donor registration enrollment inside motor vehicle facilities (MVF) is a common approach in the United States. From this research, a formula for what works has emerged within the literature including the presence of an interpersonal component, video messages, and point-of-decision materials. These intervention components have demonstrated effectiveness at increasing registrations in relatively new statewide registries; however, their effectiveness in MVFs with a mature registry remains understudied. The current study examined the effectiveness of an online MVF clerk intervention and the other examined the effectiveness of a multi-message, phase MVF intervention aimed at increasing organ donation registrations. The results revealed that MVF clerks garnered increased knowledge and greater comfort in communicating about organ donation with patrons after the intervention. Moreover, the intervention revealed that clerk talk effectiveness was positively associated with organ donation registration among MVF customers. Against expectations, recall of video messages was negatively associated with new registrations. Exposure to the brochure, counter mat, and poster donation messages was not associated with organ donation registration. An emphasis on the strengths and shortcomings of using MVFs as intervention sites for organ donation registration promotion are discussed.

An Application of the Reasoned Action Approach to Bystander Intervention for Sexual Assault.

The high prevalence of sexual assault in US college campuses has led to a widespread implementation of bystander intervention programs aimed at preventing sexual assault. The current study examines predictors of college students' intentions to engage in bystander intervention through the theoretical lens of the reasoned action approach. An online survey with college students (N = 186) was conducted at a large Midwestern university. Our results indicated experiential attitudes, instrumental attitudes, descriptive norms, autonomy, and capacity, each positively associated with participants' intentions to intervene to stop a sexual assault. Against expectations, injunctive norms were unrelated to bystander intervention intentions. Finally, in addition to these main effects, an experiential attitude by autonomy interaction was also observed. The results are discussed with a focus on the theoretical and practical implications of our findings.

Examining Mechanisms Underlying Fear-Control in the Extended Parallel Process Model.

This investigation sought to advance the extended parallel process model in important ways by testing associations among the strengths of efficacy and threat appeals with fear as well as two outcomes of fear-control processing, psychological reactance and message minimization. Within the context of print ads admonishing against noise-induced hearing loss (NIHL) and the fictitious Trepidosis virus, partial support was found for the additive model with no support for the multiplicative model. High efficacy appeals mitigated freedom threat perceptions across both contexts. Fear was positively associated with both freedom threat perceptions within the NIHL context and favorable attitudes for both NIHL and Trepidosis virus contexts. In line with psychological reactance theory, a freedom threat was positively associated with psychological reactance. Reactance, in turn, was positively associated with message minimization. The models supported reactance preceding message minimization across both message contexts. Both the theoretical and practical implications are discussed with an emphasis on future research opportunities within the fear-appeal literature.

Using direct mail to promote organ donor registration: Two campaigns and a meta-analysis.

BACKGROUND: Two direct mail campaigns were undertaken in Rochester and Buffalo, New York, with the goal of enrolling adults aged 50-64 years into the state organ and tissue donation electronic registry. Meta-analytic methods were used to summarize the body of research on the effects of direct mail marketing to promote organ donation registration. METHODS: In the first study, 40 000 mailers were sent to targeted adults in Rochester, New York, and varied by brochure-only, letter-only, and letter plus brochure mailing conditions. A follow-up mailer using letter-only was sent to 20 000 individuals in Buffalo, New York area. In a second study, campaign results were combined with previously published direct mail campaigns in a random-effects meta-analysis. RESULTS: The overall registration rates were 1.6% and 4.6% for the Rochester and Buffalo campaigns, and the letter-only condition outperformed the brochure-only and letter plus brochure conditions in the Rochester area campaigns. Meta-analysis indicated a 3.3% registration rates across 15 campaigns and 329 137 targeted individuals. Registration rates were higher when targeting 18-year-olds and when direct mail letters were authored by officials affiliated with state departments. CONCLUSION: Use of direct mail to promote organ donor registration is an inexpensive method to increase enrollments in state registries.

An investigation into mature adults' attitudinal reluctance to register as organ donors.

BACKGROUND: Mature adults (age 50-64) make up a large proportion of organ transplant recipients, and waiting list candidates yet are underrepresented in terms of actual donors. Understanding the reasons why mature adults fail to register as deceased organ donors is critical in achieving the goal of increasing the actionable supply of organs available for transplant. Conceptual models propose certain factors such as bodily integrity, ick (i.e., disgust), jinx (i.e., superstition), medical mistrust, salience, self-efficacy, and stake are associated with organ donation registration attitudes. Moreover, the age myth, or the belief that one's age prevents them from becoming an organ donor, was examined among mature adults between the ages of 50-64. METHOD: An online survey was disseminated to mature adults (N=709). RESULTS: Results indicated jinx, salience, self-efficacy, and stake each predicted organ donation attitudes among mature adults. Moreover, results indicated that age myth accounted for attitudes toward registering as an organ donor among non-registered mature adults after controlling for non-cognitive and vested interest constructs. CONCLUSION: This study demonstrates the age myth is negatively associated with attitudes toward registering as organ donors. The results are discussed with an emphasis on both the theoretical and practical implications of study findings.

Community College Students' Health Insurance Enrollment, Maintenance, and Talking With Parents Intentions: An Application of the Reasoned Action Approach.

A primary objective of health care reform is to provide affordable and quality health insurance to individuals. Currently, promotional efforts have been moderately successful in registering older, more mature adults yet comparatively less successful in registering younger adults. With this challenge in mind, we conducted extensive formative research to better understand the attitudes, subjective norms, and perceived behavioral control of community college students. More specifically, we examined how each relates to their intentions to enroll in a health insurance plan, maintain their current health insurance plan, and talk with their parents about their parents having health insurance. In doing so, we relied on the revised reasoned action approach advanced by Fishbein and his associates (Fishbein & Ajzen, 2010; Yzer, 2012, 2013). Results showed that the constructs predicted intentions to enroll in health insurance for those with no insurance and for those with government-sponsored insurance and intentions to maintain insurance for those currently insured. Our study demonstrates the applicability of the revised reasoned action framework within this context and is discussed with an emphasis on the practical and theoretical contributions.

An examination of three theoretical models to explain the organ donation attitude--registration discrepancy among mature adults.

An inconsistency in the research indicates positive attitudes toward organ donation do not map reliably onto organ donor registrations. Various models have sought to explain this inconsistency and the current analysis formally compared three models: the Bystander Intervention Model (BIM), the Organ Donor Model (ODM), and Vested Interest Theory (VIT). Mature (N = 688) adults between the ages of 50 to 64 years completed surveys related to organ donation. Results revealed that VIT accounted for the most variance in organ donation registrations followed by the BIM and ODM. The discussion emphasizes the importance of employing theories to explain a phenomenon as well as the practical implications of the findings.

Does Donor Status, Race, and Biological Sex Predict Organ Donor Registration Barriers?

PURPOSE: The purpose of the current study was to examine differences among bodily integrity, disgust, medical mistrust, and superstition among African Americans, Caucasians, and Latinos; females and males; and registered organ donors and non-registered potential donors. METHODS: A random digit dialing phone survey was utilized to garner information pertaining to organ donation beliefs among African American (n = 200), Caucasian (n = 200), and Latino (n = 200) Chicago residents. More specifically, participants responded to measures of bodily integrity, disgust, medical mistrust, and superstition, organ donor registration status, among others. RESULTS: The results indicated that African American and Latino participants were less likely to be registered organ donors than Caucasians (p < .001). In general, females maintained fewer barriers than males with respect to bodily integrity (p < .05), disgust (p = .01), and superstition (p = .01). With respect to organ donation barriers, bodily integrity (p < .0001) emerged as a central concern among those surveyed. CONCLUSION: This study highlights the significance of audience segmentation when promoting posthumous organ and tissue donation. Specifically, the results stress the importance of constructing distinct messages to non-registered potential donors compared to messages delivered to registered donors. Moreover, different barriers surfaced among females and males as well as among African American, Caucasian, and Latino residents. It is clear that a one size fits all approach will likely not work when promoting organ and tissue donation.

Source and Message Framing Considerations for Recruiting Mature Adults as Organ Donors Through Direct Mail Campaigns.

CONTEXT: Mature adults represent an important audience segment for organ donation practitioners. Despite their potential impact as organ donors, compared to other age demographics, their registration rates are much lower. OBJECTIVE: The objective of the current campaign was to determine the most effective source and message strategy to promote organ and tissue donation among mature adults. METHODS: A 2 (states: Illinois and Iowa) by 2 (sources: government agency and organ procurement organization [OPO]) by 3 (taglines: Any age is the right age to share the gift of life, Don't rule yourself out, and Don't rule yourself out: Any age is the right age to share the gift of life) between-subjects design was used to test the effectiveness of direct mailings promoting organ donation to mature adults. RESULTS: Across both Illinois and Iowa, the results revealed that greater organ donation registration rates emerged following exposure to direct mail authored by a state official such as the Illinois Secretary of State or the Iowa Department of Public Health compared to local OPOs. CONCLUSIONS: Overall, the findings speak to the effectiveness of direct mail marketing campaign's ability to register potential organ donors. Moreover, the results reveal that it is more important who sends the message as opposed to what the message states.

You've got mail! An examination of a statewide direct-mail marketing campaign to promote deceased organ donor registrations.

BACKGROUND: This study extends previous direct-mail campaigns by evaluating the effectiveness of a marketing campaign promoting organ donation message strategies from the vantage point of organ donors, organ recipients, individuals on the waiting list, or a combination of these three frames. METHODS: Illinois residents were randomly assigned to one of four organ donation brochures disseminated via U.S. postal mail. Registrations occurred via the Internet and U.S. postal mail. RESULTS: Individuals register at a greater rate following exposure to the combination framed message compared to organ donor, organ recipient, and waiting list narratives. The campaign revealed that individuals are more likely to register via U.S. postal mail than the Internet. CONCLUSION: Direct-mail marketing efforts were shown to be an effective approach to promote organ and tissue donation registrations. The results demonstrated a preference for the combination framed brochure. The results are discussed with an emphasis on the practical implications of utilizing direct-mail marketing efforts to promote organ donation among young adults.

An examination of the relationship between health information use and health orientation in Korean mothers: focusing on the type of health information.

The present study explores the relationship between mothers' health information use and health orientation regarding their children's health. Given that the online mothering community (i.e., parenting websites) is currently an important source of parenting information for mothers of young children, the present study distinguishes between informal online health information provided by mothering communities and formal online health information provided by health-related websites to test for differences. An online survey of 533 Korean mothers of children between the ages of 0 and 3 years revealed that the frequency of health-related website use (i.e., formal information) was associated with mothers' health consciousness and their health information orientation toward their children's health. The frequency of mothering community use (i.e., informal information) was associated with health information orientation, but not with health consciousness. Mass media use and contact with a health care professional for health information were not related to health consciousness or health information orientation. However, mothers' education level moderated the relationship between interpersonal communication and health consciousness, and between print media use and health information orientation. Results are discussed with an emphasis on the theoretical and practical implications of our findings.

Examining the Principles of Influence on Safer Sex Communication During Casual and Committed Sexual Encounters.

Teens and young people are at risk for contracting sexually transmitted infections. Understanding how relationship context may moderate the effectiveness of safer sex communication strategies among this demographic is important information for practitioners striving to promote safer sex behaviors. In this study, focus groups (N = 9) with college students were conducted and analyzed to examine the relation between 6 principles of influence (authority, consistency, liking, reciprocity, scarcity, and social proof) and safer sex communication during committed and casual sexual encounters. Results revealed that with the exceptions of social proof and consistency, the principles of influence were endorsed more frequently for casual than committed sexual encounters. For casual sexual encounters, the principles of authority, reciprocity, and scarcity arose as influential principles. For committed sexual encounters, the principles of consistency, liking, and reciprocity arose as influential principles. These results are discussed with an emphasis on the theoretical and practical implications.