Increasing donor designation through black churches: Results of a randomized trial

Context: African Americans are disproportionately represented among those awaiting a transplant, but many are reluctant to donate their organs. Objective: To test the effectiveness of using lay health advisors to increase organ donation among church members. Design: Churches were pair-matched by average estimated income and size and then randomized to 1 of 2 interventions: one addressing organ donation and the other addressing increasing consumption of fruits and vegetables. Setting: Twenty-two African American churches in Southeast Michigan. Patients or Other Participants: Church members were trained to serve as lay health advisors (called peer leaders). Interventions: Peer leaders conducted organ donation discussions with church groups and showed a DVD created for this program that was tailored to African American churches. Main Outcome Measures: The primary outcome was verified registration in the state's donor registry. Participants also completed pre/post questionnaires regarding their attitudes about organ donation. Results: Once clustering, baseline value, and demographics were adjusted for, the intervention and comparison groups did not differ on any of the 3 attitude scales on the posttest. In logistic regression analysis, with baseline donation status, demographics, and church clustering controlled for, the odds of self-reported enrollment at 1-year posttest did not differ by condition (odds ratio, 1.23; 95% CI, 0.87-1.72). A total of 211 enrollments in the state registry from participating churches were verified. Of these, 163 were from intervention churches and 48 were from comparison churches. Conclusions: Use of lay health advisors through black churches can increase minority enrollment in a donor registry even absent change in attitudes.