A Confirmatory Analysis of the Organ Donation Readiness Index: Measuring the Potential for Organ Donations Among African Americans

Abstract

The need for transplant exceeds the number of available organs. Antigen compatible organs are particularly scarce for African Americans because of their proportionately lower rate of donations. This study presents a measure of organ donation readiness. Examination of the factor structure and a test of weak invariance were conducted on cross-sectional (n = 2,662) and longitudinal data (n = 1,316) in a community-based sample of African Americans. A second-order structural equation was used to model the relationship between three latent factors. The results corroborate earlier research and confirm a second-order model structure consisting of 3 factors (Fear, Knowledge, and Action) in a set of 9 self-report items. The second-order model specification provided a good fit to the data. Social workers involved in organ procurement efforts and counseling of family members may find the instrument a useful tool for identifying readiness for organ donation among African Americans.

Keywords

health minorities structural equation model

Get full access to this article

View all access options for this article.

References

Alexander, G. C. , & Sehgal, A. R. (1998). Barriers to cadeveric renal transplantation among Blacks, women, and the poor . Journal of the American Medical Association, 280, 1148-1152 .

Bock, R. D. , & Lieberman, M. (1970). Fitting a response model for n dichotomously scored items . Psychometrica, 35, 179-197 .

Callender, C. O. (1987). Organ donation in the Black population: Where do we go from here? Transportation Proceedings, 19(Suppl 2), S36-S40 .

Callender, C. O. (1992). Organ/tissue donation in African Americans: A national stratagem . In The surgeon general’s workshop on increasing organ donation (pp. 145-162 ). Rockville, MD: Health Resources and Services Administration, Division of Organ Transplantation.

Caplan, A. L. (1988). Professional arrogance and public misunderstanding . Hastings Center Report, 18, 34-37 .

Christoffersson, A. (1975). Factor analysis with dichotomized variables . Psychometrica, 40, 5-32 .

Creecy, R. F. , Wright, R. , & Berg, W. E. (1992). Discriminators of willingness to consider cadaveric kidney donation among Black Americans . Social Work in Health Care, 18, 93-105 .

Davidson, M. N. , & Devney, P. (1991). Attitudinal barriers to organ donation among Black Americans . Transplantation Proceedings, 23, 2531-2532 .

Dennis, G. C. (1999). Organ and tissue donation and transplantation . Journal of the National Medical Association, 91, 193-194 .

10.

Devore, W. , & Schlesinger, E. G. (1991). Ethnic sensitive social work (3rd ed.). New York: Macmillan .

11.

Dhooper, S. S. (1990). Organ transplantation: Who decides . Social Work, 35, 322-327 .

12.

Eggers, P. W. (1995). Racial differences in access to kidney transplantation . Health Care Financing Review, 17, 89-103 .

13.

Geva, J. , & Welnman, M. L. (1995). Social work perspectives in organ procurement . Health and Social Work, 20, 287-293 .

14.

Griffin, L. W. , & Bratton, L. B. (1995). Fewer Black kidney donors: What’s the problem . Social Work in Health Care, 22, 19-42 .

15.

Hoyle, R. , & Panter, A. (1995). Writing about structural equation models. In R. Hoyle (Ed.), Structural equation modeling: Concepts, issues, and applications (pp. 158-176). Thousand Oaks, CA: Sage .

16.

Hu, L. , & Bentler, P. (1995). Evaluating model fit. In R. Hoyle (Ed.), Structural equation modeling: Concepts, issues, and applications (pp. 76-99). Thousand Oaks, CA: Sage .

17.

Jöreskog, K. (1993). Testing structural equation models. In K. Bollen & J. Long (Eds.), Testing structural equation models (pp. 294-316). Newbury Park, CA: Sage .

18.

Jöreskog, K. , & Sörbom, D. (1996). LISREL 8: User’s reference guide. Chicago: Scientific Software International .

19.

Kasiske, B. L. , London, W. , & Ellison, M. D. (1998). Race and socio-economic factors influencing early placement on the kidney transplant waiting list . Journal of the American Society of Nephrology, 9, 2142-2147 .

20.

Kasiske, B. L. , Neylan, J. F. , Riggio, R. R. , Danovitch, G. M. , Kahanna, L. , Alexander, S. R. , et al. (1991). The effect of race on access and outcome in transplantation . New England Journal of Medicine, 324, 302-307 .

21.

Kline, P. (1994). An easy guide to factor analysis. London: Routledge .

22.

Muthén, B. (1982). Some categorical response models with continuous latent variables. In K. Jöreskog & H. Wold (Eds.), Systems under indirect observation (Vol. Part I, pp. 65-79). New York: North-Holland .

23.

Muthen, B. (1983). Latent variable structural equation modeling with categorical data . Journal of Econometrics, 22, 43-65 .

24.

Muthen, B. (1989). Dichotomous factor analysis of symptom data . Sociological Methods and Research, 18, 19-65 .

25.

Muthen, B. (1993). Goodness of fit with categorical and other non-normal variables. In K. A. Bollen & J. S. Long (Eds.), Testing structural equation models (pp. 205-234). Newbury Park, CA: Sage .

26.

Park, M. H. , Tolman, D. E. , & Kimball, P. M. (1996). Disproportionate HLA matching may contribute to racial disparity in patient survival following cardiac transplantation . Clinical Transplantation, 10, 625-628 .

27.

Plawecki, K. A. , Frieberg, G. , & Plawecki, J. A. (1989). Increasing organ donations in the Black community . American Nephrology Nurses Association Journal, 16, 321-324 .

28.

Radecki, C. , & Jaccard, J. (1997). Psychological aspects of organ donation: A critical review . Health Psychology, 16, 183-195 .

29.

Radecki, C. , & Jaccard, J. (1999). Signing an organ donation letter: The prediction of behavior from behavioral intentions . Journal of Applied Social Psychology, 29, 1833-1853 .

30.

Reitz, N. N. , & Callender, C. O. (1993). Organ donation in the African American population: A fresh perspective with a simple solution . Journal of the National Medical Association, 85, 353-358 .

31.

Rozon-Solomon, M. , & Burrows, L. (1999). ’Tis better to receive than to give: The relative failure of the African American community to provide organs for transplantation . Mount Sinai Journal of Medicine, 66, 273-276 .

32.

Schweitzer, E. J. , Yoon, S. , Hart, J. , Anderson, L. , Barnes, R. , Evans, D. , et al. (1997). Increased living donor volunteer rates with a formal recipient family education program . American Journal of Kidney Diseases, 29, 739-745 .

33.

Tamburlin, J. , & Rice, C. (2002). Stages of change in organ donations among minorities . Human Behavior in the Social Environment, 5, 45-59 .

34.

United Network for Organ Sharing. (2004). Available at www.unos.org/latestData/step2.asp.

35.

U.S. Department of Health and Human Services . (1985). Report of the secretary’s task force on Black and minority health (Vol. 1). Washington, DC: U.S. Government Printing Office .

36.

Widaman, K. F. & Reise, S. P. (1997). Exploring the measurement invariance of psychological instruments: Applications in the substance use domain. In K. J. Bryant , M. Windle , & S. G. West (Eds.), The science of prevention (pp. 405-429). Washington, DC: American Psychological Association .

37.

Yuen, C. C. , Burton, W. , Chiraseveenuprapund, P. , Elmore, E. , Wong, S. , Ozuah, P. , et al. (1998). Attitudes and beliefs about organ donation among different racial groups . Journal of the National Medical Association, 90, 13-18 .