Micro-cultural customization of organ donation propagation messages.

OBJECTIVE: Organ transplantation is plagued by limited availability of organs. This study investigated the effect of messages promoting organ donation which were customized according to the language-defined micro-cultures in Switzerland. METHODS: Community-, informative-, and emotional-oriented messages were carried by conventional flyers. A 3 × 3 between-subjects experiment was conducted with short- and long-term willingness to donate, long-term signing of organ donation card and long-term interpersonal communication on organ donation as outcome variables. RESULTS: The culturally customized interventions appeared to have no immediate effect and consequently no differential effect on willingness to donate organs and on signing a donor card. Among the Swiss Germans, of the three messages, the community-oriented one instigated less interpersonal communication. CONCLUSION: Findings are consistent with a mechanism in which the message does not have an immediate effect on willingness to donate organs but motivates further thought and related behaviors that lead to higher commitment and later increased willingness to donate. PRACTICE IMPLICATIONS: Targeting not only the message but also the objective that drives the messages must be considered. Campaigns should include elements that build on the unfolding commitment process to promote the follow-up actions that lead to greater willingness.

Prior family communication and consent to organ donation: using intensive care physicians' perception to model decision processes.

ABSTRACT: Generally, the Swiss hold favourable attitudes to organ donation, but only few carry a donor card. If no card is found on a potential donor, families have to be approached about donation. The aim of this paper is to model the role that some family communication factors play in the family decision to consent or not to organ donation by a brain dead relative. Information was gathered in face-to-face interviews, using a questionnaire and recording open answers and comments. Eight heads of intensive care units (ICU) of Swiss hospitals and one representative from Swisstransplant were interviewed. Questions asked respondents to estimate the prevalence and effect of communication factors in families facing a decision to consent to donation. Answers were averaged for modelling purposes. Modelling also relies on a previous representative population survey for cross-validation. The family of the deceased person is almost always approached about donation. Physicians perceive that prior thinking and favourable predisposition to donation are correlated and that the relatives' predisposition is the most important factor for the consent to donation, up to the point that a negative predisposition may override an acknowledged wish of the deceased to donate. Donor cards may trigger family communication and ease the physicians' approach to family about donation. Campaigns should encourage donate-willing people to talk to their families about it, make people think about organ donation and try to change unfavourable predispositions. ACKNOWLEDGEMENT: the authors wish to thank the interviewees whose collaboration has provided them an overview of today's situation in Switzerland.