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Design, implementation, and evaluation of a knowledge translation intervention to increase organ donation after
Janet E Squires1, Jeremy M Grimshaw, Monica Taljaard
1Ottawa Hospital Research Institute, Clinical Epidemiology Program, 501 Smyth Road, Room 1282, Box 711, Ottawa, ON K1H 8 L6, Canada. jasquires@ohri.ca.
Background:
A shortage of transplantable organs is a global problem. There are two types of organ donation: living and deceased. Deceased organ donation can occur following neurological determination of death (NDD) or cardiocirculatory death. Donation after cardiocirculatory death (DCD) accounts for the largest increments in deceased organ donation worldwide. Variations in the use of DCD exist, however, within Canada and worldwide. Reasons for these discrepancies are largely unknown. The purpose of this study is to develop, implement, and evaluate a theory-based knowledge translation intervention to provide practical guidance about how to increase the numbers of DCD organ donors without reducing the numbers of standard NDD donors.
Methods:
We will use a mixed method three-step approach. In step one, we will conduct semi-structured interviews, informed by the Theoretical Domains Framework, to identify and describe stakeholders' beliefs and attitudes about DCD and their perceptions of the multi-level factors that influence DCD. We will identify: determinants of the evidence-practice gap; specific behavioural changes and/or process changes needed to increase DCD; specific group(s) of clinicians or organizations (e.g., provincial donor organizations) in need of behaviour change; and specific targets for interventions. In step two, using the principles of intervention mapping, we will develop a theory-based knowledge translation intervention that encompasses behavior change techniques to overcome the identified barriers and enhance the enablers to DCD. In step three, we will roll out the intervention in hospitals across the 10 Canadian provinces and evaluate its effectiveness using a multiple interrupted time series design.
Discussion:
We will adopt a behavioural approach to define and test novel, theory-based, and ethically-acceptable knowledge translation strategies to increase the numbers of available DCD organ donors in Canada. If successful, this study will ultimately lead to more transplantations, reducing patient morbidity and mortality at a population-level.
Insights
This study aims to increase deceased organ donation (DCD) by developing and testing a knowledge translation intervention. The goal is to provide guidance for increasing DCD donors without impacting NDD donors, ultimately saving lives.
Area of Science:
- Transplantation research
- Public health interventions
- Behavioral science in medicine
Background:
- Organ transplantation faces a global shortage, with deceased organ donation (DCD) offering significant potential for increase.
- Current variations in DCD utilization worldwide, particularly in Canada, highlight a need to understand and address underlying discrepancies.
- Standard neurological determination of death (NDD) donation remains crucial, and strategies must ensure DCD increases do not compromise NDD rates.
Purpose of the Study:
- To develop, implement, and evaluate a theory-based knowledge translation intervention aimed at increasing deceased organ donation (DCD) rates.
- To provide practical guidance for healthcare professionals and organizations to enhance DCD without negatively impacting NDD donor numbers.
- To address the largely unknown reasons behind the discrepancies in DCD utilization across different regions.
Main Methods:
- A mixed-method, three-step approach will be employed, starting with semi-structured interviews guided by the Theoretical Domains Framework.
- Intervention mapping principles will be used to design a theory-based knowledge translation intervention incorporating behavior change techniques.
- The intervention's effectiveness will be evaluated across 10 Canadian provinces using a multiple interrupted time series design.
Main Results:
- Identification of key determinants influencing the evidence-practice gap in DCD.
- Pinpointing specific behavioral and process changes required to boost DCD rates.
- Defining target clinician groups and organizations for tailored intervention strategies.
Conclusions:
- A novel, theory-based, and ethically sound behavioral approach will be utilized to increase DCD organ availability in Canada.
- Successful implementation is expected to enhance organ transplantation rates, thereby reducing patient morbidity and mortality.
- This research offers a scalable model for improving organ donation strategies globally.
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