To date, the organ donation community has focused much of its efforts on activities designed to educate and increase public awareness of organ donation. While many organ donation activities focus on educating the public-at-large through public awareness campaigns, a number of organizations have narrowed the focus of their activities to targeting school-aged children and teens. Evaluations of the impact of these activities tend to target pre-event measures rather than organ donation itself. The challenge in this instance is, first, to establish that changes in pre-event measures are due to the education activity and, second, to establish a link between that pre-event measure and the outcome goal of organ donation. The three education activities presented demonstrate the challenges of evaluating this type of activity.
Gloria Bohrer, Director of Public Education/Information of the Southern California Organ Procurement Center, presented DiscoveriesÒ , a school education program designed to teach students in grades 6-12 about organ and tissue donation and transplantation and the life-saving importance of both. The program consists of a 22-minute instructional video, an instructional guide, and a training component. The goal of the program is for students to gain knowledge and understanding about organ donation that will lead to the decision or the process of deciding to become an organ donor. Further, the program encourages students to talk with their families about their decision. The program is currently in place in a single pilot site, and plans are underway to expand it to three areas. The program, a prospective, self-controlled study, was evaluated using pre- and post-assessment surveys. The pre-assessment survey determined baseline understanding and attitudes towards organ donation, existence of "misinformation," and any issues and concerns about organ donation in general. The post-assessment survey determined the extent to which students had gained knowledge about organ donation and measured the change in their willingness to donate. The results of these surveys indicate that students (1) had gained knowledge and understanding of organ donation, (2) had engaged in discussions with their families, and (3) had either made a personal decision about donation or were thinking about the decision.
Warren Riley, Executive Director of The James Redford Institute, presented "Teen Talk on Transplantation," an informational program consisting of a short, high-impact film with companion materials designed to increase awareness of organ donation among teens. Before creating the film, a survey of 50 organ procurement organizations (OPOs) was conducted to gauge interest in the film as a medium for conveying this information. As a result of the OPO survey, the film was modified to emphasize the need to share the decision with family members and to stress that organ donation is the "gift of life." When completed, the film will be disseminated nationally to teen-targeted television such as MTV, drivers’ education classes, high school health classes, and the like. The evaluation of this program will consist of written pre- and post-tests to assess how the respondents’ attitudes on organ donation changed, whether respondents expressed a willingness to be an organ donor, and whether they shared the decision with family members.
- Awareness is an intermediate outcome and does not necessarily correlate with eventual outcomes. Follow-up and correlation of increased awareness with actual donation is necessary to determine if the program has any direct impact on organ donation rates.
- Ruling out confounding factors in these activities is very difficult. Because individuals assimilate information from many sources, it is difficult to use a pre-test/post-test design to determine whether changes in attitudes towards organ donation are due to the education program or some other factor.
Audience members also showed support for these educational programs with comments that "it is good to instill information at an early age" and "the target audience of today are the students of 30 years ago." Concern was expressed about very young children being exposed to death-related issues. Audience members suggested that these programs could be improved by creating developmentally appropriate programs that build on each other as students progress through grades in school, and that the programs should be administered by experts from outside the school rather than by the teachers. One audience member stressed that reaching into the schools should begin with educating children about chronic disease prevention, not just focusing on the "rescue" of receiving a donated organ.