From the English disease to 'Asian Rickets' : Rickets and osteomalacia, patient experience and medical perception

EThOS - Electronic Theses Online ServiceGBUnited Kingdo

What are effective approaches to increasing rates of organ donor registration among ethnic minority populations:a systematic review

OBJECTIVES: To identify effective interventions to increase organ donor registration and improve knowledge about organ donation among ethnic minorities in North America and the UK. DESIGN: Systematic review. DATA SOURCES: MEDLINE, EMBASE, PsycINFO, CINAHL and Cochrane Central searched up to November 2012, together with four trials databases and the grey literature. REVIEW METHODS: A systematic search followed by assessment of eligibility and quality. An interpretive and thematic approach to synthesis was undertaken. This examined the nature and delivery of interventions in relation to a range of outcomes: verified registration, changing knowledge and a measured shift towards greater readiness. RESULTS: 18 studies were included in the review, comprising educational and mass media interventions. Mass media interventions alone reported no significant change in the intention or willingness to register. Educational interventions either alone or combined with mass media approaches were more effective in increasing registration rates, with a strong interpersonal component and an immediate opportunity to register identified as important characteristics in successful change. CONCLUSIONS: Effective interventions need to be matched to the populations’ stage of readiness to register. Measured outcomes should include registration and shifts along the pathway towards this behavioural outcome

'Nudging' registration as an organ donor: implications of socio-cultural variations in knowledge and attitudes

Thaler and Sunstein’s behavioural-economics theory of ‘Nudge’ aims to achieve beneficial outcomes for individuals and the society through designing the contexts in which choices are made rather than relying on traditional policy levers of restrictions, penalties and education. This article examines Nudge strategies to increase registration as a deceased organ donor among minority ethnic groups based on 22 focus groups that were held with Black and South Asian minority ethnic groups in London, UK. The article identifies ways in which minority ethnic groups’ habitus appears to limit awareness and knowledge of the system of organ donation and shapes attitudes to registration, with the varying influence of faith/culture and trust in the system reflecting differences in prior contexts and experience. This questions a key requirement of Nudge in terms of its libertarian dimension and suggests that focusing on the immediate choice context and neglecting individuals’ prior dispositions may not achieve desired outcomes for socially heterogeneous populations. </jats:p