Abstract

Approximately 70% of individuals needing a stem cell transplant do not have a genetically matched family member who can donate. These individuals must rely on unrelated donors registered with the National Marrow Donor Program (NMDP). Effective measures to solicit NMDP volunteers are needed. This study tested the hypothesis that an emotional appeal would be more likely to motivate NMDP registration than a rational appeal.

Participants were randomly assigned to a rational or emotional appeal and then asked to report if they would: (1) register with the NMDP; and (2) talk with family members about NMDP registration. Of the 47 participants receiving the emotional appeal, 40 (85%) agreed to register for the NMDP, while only 21 of 43 (49%) of the participants receiving the rational appeal agreed to register, a significant difference, 2 (1, N =90) = 13.53, p < .001, = .39. However, the emotional appeal (72%) and rational appeal (54%) groups did not differ in reported willingness to talk with their family about NMDP registration, 2 (1, N =90) = 3.44, p = .064, = .20.

Results suggest that an emotional appeal was more effective in motivating participants to consider registering for the NMDP. Other factors precluded participants from discussing NMDP registration with family members. Including personal stories in promotional material soliciting registration with the NMDP may motivate individuals to register. These results might also have implications for solid organ and umbilical cord blood donation.

Introduction

• Why the need for increased NMDP registration?

• Only about 30% of individuals needing bone marrow or blood/stem cell transplants find matching donors within their biological family.
• Of the remaining 70%, only about 85% find matching donors using preliminary searches of large international registries such as the NMDP.
  
• The NMDP has reported that approximately 30% of registered donors who are identified as matches are not available for further evaluation at the time of the request.
  
• Indications for bone marrow and blood/stem cell transplants:
  
• 75% of all NMDP facilitated transplants treat some form of Leukemia
  
• Other malignant conditions can be treated, such as neuroblastoma or non-Hodgkins lymphoma
  
• Other non-malignant conditions can also be treated, such as anemias, inherited immune system disorders or inherited metabolic disorders
  
• The purpose of the study is to examine the influence of two methods of communicating information about registering for the NMDP using
  
• A rationally-based vignette
  
• An emotionally-based vignette

Method

Procedure

• Participants (N=90) were either first (N=28) or second (N=62) year medical students.
• Following consent, participants were randomly assigned to read either an emotionally-based or a rationally-based vignette about the need to register with the NMDP.
• After reading the vignette, participants were asked (1) if they would be willing to register for the NMDP and (2) if they would be willing to speak with a family member about NMDP registration.

Vignettes

• Both vignettes included five sections, three of which were identical:
• The Need for Bone Marrow Donors
• Frequently Asked Questions
• What Can You Do?
• The emotionally-based vignette also included two narrative sections:
• A Survivor’s Story
• A Donor’s Story
• The rationally-based vignette also included two sections with statistical information:
• Who does it help?
• Who is on the registry?

Results

Willingness to Register Personally for the NMDP

Emotional Appeal:
Yes - 85%
No - 15%

Rational Appeal:
Yes - 49%
No - 51%

(χ2 (N = 90, df = 1) = 13.53, p < .001)
 
Willingness to Talk with Family about NMDP

Emotional Appeal
Yes - 72%
No - 28%

Rational Appeal
Yes - 54%
No - 46%

(χ2 (N = 90, df = 1) = 3.44, p = .064 )

Decision Outcomes

• Individuals presented with the emotional appeal were significantly more likely to agree to register for the NMDP than those given the rational appeal.
• No significant difference was found between the appeal groups on the talk to family outcome.
  

Correlates with Decision Outcomes

Agree to Register Condition

• Married participants were more likely to agree to register (χ2 (N = 90, df = 1) = 4.397, p = .036).
• Participants with a family history of cancer were more likely to agree to register (χ2 (N = 90, df = 1) = 11.05, p < .001).

Agree to Speak to Family Condition

• Only gender was significantly related to a participant’s decision to speak with a family member about registration (χ2 (N = 90, df = 1) = 7.773, p = .005). Women were more likely to be willing to talk with their family about NMDP registration.
  

Conclusions

• Overall, an emotional appeal was more effective for eliciting agreement to register for the NMDP.
• The two appeals were not significantly different in their ability to influence a participants’ decision to speak with a family member about NMDP registration.
• Several variables were correlated with dichotomous decisions, including marital status, family history of cancer, and gender.
  

Limitations

• Because participants were drawn from a medical student population, the sample may not be representative of the general population. The sample was more highly educated and younger than a population sample would have been.
• Participants were only asked if they would agree to donate and speak to a family member about donation. No behavioral report of registration or communication with families was collected. Future studies would be wise to include this component.