The Power of Apple: DMV Uses iPod Video To Encourage Organ Donation

NEW YORK (Reuters Health) - An organ donation video people can watch on an iPod while they wait at the Department of Motor Vehicles may encourage more to become donors, a new study suggests.

Researchers found that for folks getting a driver's license in their county, the iPod video seemed to sway the decision on becoming an organ donor.

Of people who saw it, 84 percent consented to be a donor, versus 72 percent of those who didn't watch the video.

The effect was larger among African Americans: 76 percent of those who saw the video became organ donors, compared with just 54 percent of those who did not.

The findings, reported in the Annals of Internal Medicine, point to one potential fix for a well-known problem: the need for donor organs far exceeds the supply.

In the U.S., the gap between organ demand and supply is particularly large among minorities.

One reason is that the need for donor organs is so great, said Dr. J. Daryl Thornton of Case Western Reserve University School of Medicine in Cleveland, Ohio, the lead researcher on the new study.

Minorities, and African Americans in particular, have higher rates of health conditions that can necessitate a new organ -- to replace a kidney damaged by high blood pressure or diabetes, for example.

African Americans are three times more likely than whites to develop kidney disease, and they account for one-third of the waiting list for donor kidneys.

Add to that the fact that not enough people consent to be organ donors. Surveys have pointed to some reasons: many people are unaware of the acute need for donor organs; others mistrust the medical establishment and think they won't get life-saving measures if doctors know they are a donor. Some people think their religion disapproves of organ donation, though most have no rules against it.

There have been some efforts, such as billboards and radio spots, to educate people about organ donation. But they haven't met with much success, Thornton told Reuters Health.

He and his colleagues thought a timely video -- shown at the DMV, right before people are asked to become donors -- might work better.

Video has the ability to capture people on so many different levels, Thornton said.

The researchers' video featured an ethnically diverse group of real people -- organ donors and recipients, family members of recipients and family of people who died waiting for an organ.

They all talked about what organ donation meant to them, Thornton said. And the discussion hit on common obstacles to people's willingness to become donors -- like mistrust of doctors and religious views on organ donation.

Thornton's team tested the five-minute video at 12 Cleveland-area DMVs, with two days spent at each location. Half of each day was designated as the intervention period (license-seekers watched the video on an iPod), and the other half was the control period (no one saw the video).

Overall, 443 people saw the video and 84 percent of them agreed to become organ donors. That compared with 72 percent of the 509 people who did not see the video.

About 20 percent of all study participants were African American. And the video seemed especially influential for them. It raised their consent rate by 22 percentage points, versus 11 percentage points among white license-seekers.

CHANGING VIEWS

Thornton's team also found that people's attitudes shifted after seeing the video. They felt more knowledgeable about organ donation and had fewer conflicts about it than their counterparts who had not seen the video.

That runs counter to the conventional wisdom that it's hard to change people's views on organ donation, according to Thornton.

We just have to present the information in a way that's accessible to people, he said.

As for the practicality of the video, Thornton said, one of the great things is that it's inexpensive.

In theory, DMVs anywhere could run the video -- and not necessarily via iPod, according to Thornton.

He said it could be shown on existing DMV TV screens, though it's not clear if that would be as effective as the iPod viewing.

Even if iPods were needed, Thornton said, they are fairly inexpensive now, and DMVs should be able to buy a few. The models used in this study run between $200 and $300.

I don't think this would be hard for any state to implement, Thornton said. He added that his team is currently working with Ohio to get the video into the rest of the state's DMV locations.

The study was funded by the National Institutes of Health and the Robert Wood Johnson Foundation.

A big question is still whether any increase in organ-donor consent will ultimately mean a bigger donor-organ supply. A lot of things happen between consent and donation, Thornton said.

A common scenario, he noted, is that an organ donor dies of a cause that prevents any tissue from being harvested.

In the U.S., more than 100,000 people are on the active waiting list for an organ transplant. But fewer than 30,000 transplants are performed each year, Thornton's team notes in the report.

Minorities make up half of that waiting list, but only account for 30 percent of donors.

That 30 percent does match the proportion of minorities in the U.S. population as a whole. But ideally, experts would like to see more minority donors. Because transplants have a greater chance of success when the donor and recipient are as genetically similar as possible, it's preferable to match people of the same race and ethnicity.

SOURCE: Annals of Internal Medicine, online April 3, 2012.