EXPLORING Donation-RELATED KNOWLEDGE, Attitudes, and Beliefs IN Relation to Distrust AMONG African American Adults

PURPOSE: African Americans (AAs) are overrepresented on the organ transplant waiting list because they are disproportionately impacted by certain health conditions that potentially warrant a life-saving transplant. While the AA need for transplantation is considerably high, organ and tissue donation rates are comparatively low, resulting in AAs spending more than twice the amount of time on the national transplant waiting list as compared to people of other racial/ethnic backgrounds. Low donation rates are likely due to negative attitudes and concerns about inequalities in the donation and transplantation system. Historical and current injustices in the health care system are thought to contribute to distrust; which in turn is thought to impede interest in donation. However, there has been little empirical investigation of the relationship between distrust of the health care system and donation-related knowledge, attitudes, and beliefs among AAs. The aim of this study is to examine this relationship.

METHODS: Data were collected from the baseline assessment of a randomized effectiveness study that is evaluating the effectiveness of a self-administered intervention (Project ACTS: About Choices in Transplantation and Sharing). Self- administered questionnaires were completed by 585 AA adults residing in the metropolitan Atlanta area. Measures assess donation/transplantation-related knowledge, attitudes and beliefs and trust in the healthcare system.

RESULTS: Bivariate analyses indicate that general knowledge of the donation/transplantation system (inverse relationship), knowledge of AA donation related statistics (inverse relationship), and beliefs about donation (positive relationship) are significantly correlated with distrust in the healthcare system (all ps<.01). However, while insignificant, knowledge of what signing a donor card means, personal knowledge of a donor/donor family or recipient and knowledge of a person on the waiting list, were negatively correlated with distrust in the healthcare system.

CONCLUSIONS: AAs distrust in the healthcare system is deeply rooted in current and historical social realities. Additional research is needed to explore how to develop interventions that address this distrust in a meaningful way in order to improve engagement in donation and transplantation among AAs.