Willingness of Veterans to Consider Organ and VCA Donation: Effects of a Randomized Educational Trial

There are 18 million living military veterans in the United States, yet this population has not been the focus of educational campaigns to increase donation awareness and willingness to donate organs. This study examined whether willingness to donate organs varies by veteran-inclusive and vascularized composite allograft (VCA)-inclusive messaging. A total of 549 US veterans nondonors were randomized to four education groups: (1) general donation messaging, no veterans or VCA, (2) veteran-inclusive donation messaging, no VCA, (3) veteran- and VCA-inclusive donation messaging, or (4) no donation messaging (Control). Willingness to donate traditional and VCA organs was assessed pre-intervention, post-intervention, and at 3-weeks. Generalized Estimating Equations (GEE) models showed significant group X time interaction effects for traditional (Wald χ² = 91.3, p < 0.001) and VCA (Wald χ² = 36.3, p < 0.001) donation willingness. For traditional donation willingness, improvements were higher in veteran-inclusive messaging groups than the Control group (p < 0.01). There was no difference between veteran-inclusive and non-veteran groups, nor between VCA-inclusive and non-VCA video groups. For VCA donation willingness, significant increases were observed in the veteran-inclusive plus VCA messaging group compared to messaging without veterans or VCA and Control groups (p < 0.03). At follow-up, the education groups had more veterans who registered as donors, compared to the Control group (p = 0.02). Veteran-inclusive donation messaging may not be necessary to increase willingness to donate traditional organs, although it offers some advantages for increasing VCA donation willingness.