A Qualitative Study of Turning Points or Aha! Moments in Older Adults' Discussions About Organ Donation.

INTRODUCTION: Older adults (50-70 years old) have lower organ donor registration rates than younger adults. Older adults have different informational needs and donor registration behavior than younger age groups. OBJECTIVE: The objective of this qualitative study was to understand insights of older adults about organ donation to effectively address the barriers to becoming an organ donor. This study identified turning points as "Aha!" moments that occurred during a dialogue intervention where older adults discussed benefits, barriers, and process to organ donation. SETTING AND PARTICIPANTS: Dialogues were held with small groups of older adults in 11 communities in a Midwestern organ procurement organization service area. Participants were positive to organ donation, but not registered as an organ donor. Methods/Approach: Qualitative analysis of verbatim comments from the dialogue and a follow-up survey were used to examine turning points or "Aha!" moments of participants' decision-making about organ donation and organ donor registration. FINDINGS: Twenty-one separate in-depth dialogues were conducted with 198 participants, with mean age of 60.57 years. There were 2757 separate comments coded with 465 of the comments (17%) identified as providing Aha! moments during the dialogue. Three themes include benefits of organ donation (30%), barriers about organ donation (39%), and organ donation process (31%). DISCUSSION: The research identified moments in the dialogue where possible learning about organ donation may have occurred. After participation in the dialogue process, there was an increase in intent to register to be an organ donor, organ donation discussion with family and friends, and organ donor registration.

Designing an educational strategy for increasing organ donor registration among older adults.

CONTEXT: Older adults (50-70 years of age) have lower organ donor registration rates than younger adults. Despite recent increases in organ donation registration of adults 18 to 49 years of age, the increase in older adult registrations is less. OBJECTIVE: To use research results from surveys and focus groups to inform an educational strategy and design for the older adult population. DESIGN: Pooled survey data from 3 statewide random-digit dial telephone interview surveys of 6230 adults, including 2631 respondents age 50 or older, were used to identify barriers to organ donor registration and information needs of older adults compared with younger adults. Two focus groups with older adults were used to further identify barriers and to pilot test messages for an educational strategy for older adults. SETTING AND PARTICIPANTS: Surveys were conducted with adults in Ohio. Focus groups were conducted in 2 major cities in Ohio with older adults, 50 to 70 years of age. RESULTS: Survey results indicate that older adults and younger adults differ on several factors regarding their beliefs, attitudes, and behavior concerning organ donation. Although older adults express positive attitudes toward donation, they often "opt out" from registering to be organ donors for age and health reasons. Focus groups show similar barriers to organ donor registration and indicate that brochures are a preferred way to educate older adults about organ donation. CONCLUSION: Using research results to identify barriers and information needs of specific demographic groups is very important in designing a targeted educational strategy. An educational campaign addressing the concerns and information needs of this age group could increase organ donor registration.

Persistent organic pollutants and stable isotopes in biopsy samples (2004/2006) from Southern Resident killer whales.

"Southern Resident" killer whales include three "pods" (J, K and L) that reside primarily in Puget Sound/Georgia Basin during the spring, summer and fall. This population was listed as "endangered" in the US and Canada following a 20% decline between 1996 and 2001. The current study, using blubber/epidermis biopsy samples, contributes contemporary information about potential factors (i.e., levels of pollutants or changes in diet) that could adversely affect Southern Residents. Carbon and nitrogen stable isotopes indicated J- and L-pod consumed prey from similar trophic levels in 2004/2006 and also showed no evidence for a large shift in the trophic level of prey consumed by L-pod between 1996 and 2004/2006. Sigma PCBs decreased for Southern Residents biopsied in 2004/2006 compared to 1993-1995. Surprisingly, however, a three-year-old male whale (J39) had the highest concentrations of Sigma PBDEs, Sigma HCHs and HCB. POP ratio differences between J- and L-pod suggested that they occupy different ranges in winter.