Development of a culturally sensitive, locality-based program to increase kidney donation

Diabetic kidney disease has become an epidemic in American Indian communities. In Central Arizona, the Salt River Pima-Maricopa, Gila River, and Ak-Chin Indian communities have the highest incidence rate of diabetes in the world. Over 200 diabetic people in these communities receive dialysis because of kidney disease, a frequency that is 10 to 15 times the national average. Very few of these patients ever receive a kidney transplant. The communities formed the Organ Donation and Kidney Transplant Education Committee, which designed culturally sensitive educational materials and trained tribal members to disseminate the information. The goals were to educate tribal members about the choices they have when faced with kidney failure and to increase organ donation within the communities. The committee also produced a 10- to 15-minute educational video presentation for use at community district meetings, health fairs, and local health clinics in the communities. One unexpected early outcome has been the opportunity to reflect on some assumptions and stereotypes about American Indians and organ donation commonly held by health care providers. The local organ procurement organization plans to use the video in training hospital donor requestors. What difference would it make to educate the communities and not change the assumptions of those in the hospitals requesting donation?