Article

Bone Marrow Donation: Factors Influencing Intentions in African Americans

Mary Ellen Smith Glasgow

Gerald Bello

African American, bone marrow transplant
ONF 2007, 34(2), 369-377. DOI: 10.1188/07.ONF.369-377

Purpose/Objectives: To identify factors influencing the intentions of African Americans to donate or not to donate bone marrow.

Design: Exploratory, descriptive.

Setting: Participants were recruited from three churches, four public housing developments, and a university teaching hospital—all in the Philadelphia, PA, area.

Sample: African American adults aged 18-60 years and able to read, write, and speak English.

Methods: Focus groups were conducted for the purpose of instrument development. A factor analysis was conducted on questionnaire data. A multiple regression was conducted of the demographic variables and the factors that contributed to behavioral intention to donate or not to donate bone marrow.

Main Research Variables: Attitudes, subjective norms, perceived behavioral control, and behavioral intentions regarding bone marrow donation.

Findings: "Fear or not trusting," "external influences," and "concerned about resources" correlated significantly with the intention not to donate bone marrow. Helping others, approval of people, and value of knowledge correlated significantly with the intention to donate bone marrow.

Conclusions: Greater attention must be paid to increasing donations and improving the critical need for bone marrow donors. Patient education programs should be expanded to improve African Americans' knowledge of the importance of bone marrow donation, including the process, associated costs, and resources available to donors.

Implications for Nursing: Nurses—irrespective of practice areas—are key contributors to increase the rate of bone marrow donation, particularly among African Americans.

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    References

    Ahijevych, K., & Bernhard, L. (1994). Health-promoting behaviors of African American women. Nursing Research, 43, 86-89.
    Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50, 179-211.
    Ajzen, I., & Fishbein, M. (1980). Understanding attitudes and predicting social behavior. Englewood Cliffs, NJ: Prentice-Hall.
    Ballen, K.K., Hicks, J., Dharan, B., Ambruso, D., Anderson, K., Bianco, C., et al. (2002). Racial and ethnic composition of volunteer cord blood donors: Comparison with volunteer unrelated marrow donors. Transfusion, 42, 1279-1284.
    Beatty, P.G., & Anasetti, C. (1990). Marrow transplantation from donors other than HLA identical siblings. Hematology/Oncology Clinics of North America, 4, 677-686.
    Beatty, P.G., Atcher, C., Hess, E., Meyer, D.M., & Slichter, S.J. (1989). Recruiting blood donors into a local bone marrow donor registry. Transfusion, 29, 778-782.
    Bloom, J.R., Hayes, W.A., Sanders, F., & Flatt, S. (1987). Cancer awareness and secondary prevention practices in Black Americans: Implications for interventions. Family and Community Health, 10(3), 19-30.
    Confer, D.L. (2001). The National Marrow Donor Program: Meeting the needs of the medically underserved. Cancer, 91(1, Suppl.), 274-278.
    Daniels, D.E., Rene, A.A., & Daniels, V.R. (1994). Race: An explanation of patient compliance—Fact or fiction. Journal of the National Medical Association, 86, 20-25.
    Dedier, J., Penson, R., Williams, W., & Lynch, T., Jr. (2002). Race, ethnicity, and the patient-caregiver relationship. Oncologist, 7(Suppl. 2), 43-49.
    Fernandez, C.V., Gordon, K., Van den Hof, M., Taweel, S., & Baylis, F. (2003). Knowledge and attitudes of pregnant women with regard to collection, testing and banking of cord blood stem cells. Canadian Medical Association Journal, 168, 695-698.
    Gluckman, E. (2000). Current status of umbilical cord blood hematopoietic stem cell transplantation. Experimental Hematology, 28, 1197-1205.
    Gutoski, M. (1995). Study verifies lack of ethnic diversity in bone marrow donors. Oncology Nursing Forum, 22, 717.
    Hair, J.F., Anderson, R.E., Tatham, R.L., & Black, W.C. (1995). Multivariate data analysis (4th ed.). Englewood Cliffs, NJ: Prentice-Hall.
    Harris, D.R., Andrews, R., & Elixhauser, A. (1997). Racial and gender differences in use of procedures for black and white hospitalized adults. Ethnicity and Disease, 7, 91-105.
    Institute of Medicine. (2002). Unequal treatment: Confronting racial and ethnic disparities in healthcare. Washington, DC: National Academies Press.
    Laver, J.H., Hulsey, T.C., Jones, J.P., Gautreaux, M., Barredo, J.C., & Abboud, M.R. (2001). Assessment of barriers to bone marrow donation by unrelated African-American potential donors. Biology of Blood and Marrow Transplantation, 7, 45-48.
    Locke, D. (1992). Increasing multicultural understanding. Newbury Park, CA: Sage.
    Loue, S. (1999). Gender, ethnicity, and health research. New York: Kluwer Academic/Plenum Publishers.
    Manninen, D.L., & Evans, R.W. (1985). Public attitudes and behavior regarding organ donation. JAMA.253, 3111-3115.
    McLaughlin, G.H. (1969). SMOG grading: A new readability formula. Journal of Reading, 12, 639 - 646.
    McNamara, P., Guadagnoli, E., Evanisko, M.J., Beasley, C., Santiago-Delpin, E.A., Callender, C.O., et al. (1999). Correlates of support for organ donation among three ethnic groups. Clinical Transplantation, 13(1, Pt. 1), 45-50.
    Mitchell, J.M., Meehan, K.R., Kong, J., & Schulman, K.A. (1997). Access to bone marrow transplantation for leukemia and lymphoma: The role of sociodemographic factors. Journal of Clinical Oncology, 15, 2644-2651.
    Mori, M., Graves, M., Milford, E.L., & Beatty, P.G. (1996). Computer program to predict likelihood of finding an HLA-matched donor: Methodology, validation, and application. Biology of Blood and Marrow Transplantation, 2, 134-144.
    National Marrow Donor Program. (1999). About the National Marrow Donor Program [Brochure]. Minneapolis, MN: Author.
    Ontilio, A.A., Lin, Y.H., Okonofua, E.C., Afrin, L.B., Ariail, J., & Tilley, B.C. (2004). Race, education, and knowledge of bone marrow registry: Indicators of willingness to donate bone marrow among African Americans and Caucasians. Transplantation Proceedings, 36, 3212-3219.
    Perez, L.M., Schulman, B., Davis, F., Olson, L. Tellis, V.A., & Matas, A.J. (1988). Organ donation in three major American cities with large Latino and black populations. Transplantation, 46, 553-557.
    Prottas, J.M., & Batten, H.L. (1991). The willingness to give: The public and the supply of transplantable organs. Journal of Health Politics, Policy and Law, 16(1), 121-134.
    Sekeres, M.A., Peterson, B., Dodge, R.K., Mayer, R.J., Moore, J.O., Lee, E.J., et al. (2004). Differences in prognostic factors and outcomes in African Americans and whites with acute myeloid leukemia. Blood, 103, 4036-4042.
    Siminoff, L.A., & Arnold, R. (1999). Increasing organ donation in the African-American community: Altruism in the face of an untrustworthy system. Annals of Internal Medicine, 130, 607-609.
    Simmons, R.G., Schimmel, M., & Butterworth, V.A. (1993). The self-image of unrelated bone marrow donors. Journal of Health and Social Behavior, 34, 285-301.
    Switzer, G.E., Dew, M.A., Butterworth, V.A., Simmons, R.G., & Schimmel, M. (1997). Understanding donors' motivations: A study of unrelated bone marrow donors. Social Science and Medicine, 45(1), 137-147.
    Switzer, G.E., Myaskovsky, L., Goycoolea, J.M., Dew, M.A., Confer, D.L., & King, R. (2003). Factors associated with ambivalence about bone marrow donation among newly recruited unrelated potential donors. Transplantation, 75, 1517-1523.
    Villarruel, A.M. (1995). Culturally competent nursing research: Are we there yet? Capsules and Comments in Pediatric Nursing, 1(4), 18-26.
    Yancey, A.K., Coppo, P., & Kawanishi, Y. (1997). Progress in availability of donors of color: The National Marrow Donor Program. Transplantation Proceedings, 29, 3760-3765.
    Young, H.M., Lierman, L., Powell-Cope, G., Kasprzyk, D., & Benoliel, J.Q. (1991). Operationalizing the theory of planned behavior. Research in Nursing and Health, 14, 137-144.
    Zachariah, R. (1995). Re: Replication research in nursing [Letter to the editor]. Research in Nursing and Health, 18, 575-576.