A positive deviance approach to improve familial authorization for organ donation.

The current study evaluates the Positive Deviance Donation Collaborative, a communication training program designed to identify and disseminate behaviors of requesters with above-average rates of familial authorization to organ donation. The program initiated with a cohort of 99 requesters from 11 OPOs. Requesters' quarterly authorization rates were monitored for 33 months, and their pre-/post-intervention skills in active-empathic listening and self-efficacy to request donation were assessed. Overall, requesters' mean quarterly authorization rate was 53.69% (SD = 4.54). Multilevel models were used to examine change in authorization rates and communication skills, as well as associations between skills and authorization. Low intraclass correlation coefficients for authorization rates established that most variance was due to within-requester variation, rather than OPOs (ρ = 0.0129) or requesters within OPOs (ρ = 0.0221). Models indicated that authorization rates and communication skills failed to improve following intervention and did not identify an association between post-intervention communication skills and authorization. Results provide a framework to discuss programmatic challenges including extensive requester turnover (ie, ~60%), management of data collection across multi-site interventions, and program content.

Patients' Perspectives of Oral Healthcare Providers' Communication: Considering the Impact of Message Source and Content.

This study explores patients' perceptions of positive and negative communication experiences with dentists and dental hygienists using a sample of 267 individuals who reported having a general dental provider. Patients' oral health literacy, dental mistrust, use of dental health services, anxiety, and provider satisfaction are examined on the basis of reported communication experiences in the dental context. When comparing participants who had or had not experienced positive communication with a dentist, individuals with positive experiences demonstrated significantly higher levels of oral health literacy and provider satisfaction, as well as lower levels of dental mistrust. Participants who had experienced negative communication with a dentist reported significantly higher levels of anxiety and dental mistrust, as well as greater likelihood of ever leaving a dental practice, as compared to those without negative communication experiences. By contrast, positive and negative communication experiences with hygienists had limited impact on patient outcomes. Information derived from this investigation can be used by dental providers to guide communicative actions with patients, as well as by scholars to enhance existing theoretical explanations of the function of communication in dentistry.

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.

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.

#MeToo: Associations of educational institution religious affiliation with sexual health services and rates of sexual assault.

Objective: To explore the association of educational institution religious affiliation with provision of sexual health services and rates of sexual violence. Participants: Analysis of 500 US college/university websites; secondary data obtained from National Center for Education Statistics (NCES). Methods: Content analysis documented institutional religious affiliation and availability of sexual health services. Chi-square tests examined association of services with religious affiliation, while negative binomial models compared rape/fondling rates obtained from NCES between Christian/non-Christian schools. Results: Results demonstrated an overall deficit in services, with Christian campuses significantly less likely to offer 13 service. Christian schools had increased reports of rape (years 2015/2016) and fondling (year 2015). Conclusions: Results highlight insufficiency of sexual health services and the need for future research on specific forms of services available and other factors impacting sexual violence. Findings illuminate the importance of a campus' social environment on sexual assault occurrences/reporting and structuring services to meet student needs.