Background: Prevalence of end-stage renal disease is 3.5 times greater among the >2.5 million Native Americans (NAs) in the US than in Caucasians, due to earlier age of diabetes onset. NAs wait twice as long for kidneys, but donate at lower rates. It has been reported that fewer than half of all people who are willing to be organ donors discuss their wishes with family members. Further, studies in other minority groups have shown that those with positive attitudes about organ donation were more likely to engage in family discussion about organ donation. Fewer than half of all people who are willing to be organ donors discuss their wishes with family members. Methods: To determine factors correlated with willingness to donate (WTD), especially interactions of family engagement with WTD, a cross-sectional study was conducted. We first designed a survey specifically for the NA community using cognitive interviewing and purposeful sampling. Cross-sectional data was gathered via our survey from NA adults ≥18 years old recruited at regional pow-wows. NA community was involved in each aspect of study planning based on community-based participatory research principles. We examined bivariate associations between donation intentions and demographics, and crude associations between WTD and family discussions using chi-squared analysis. Results: Among NA adults (N=183) who took survey (55 tribes; 43% men; mean age 43, range 18-78 years), 65% reported WTD, but < 50% were organ donors on their drivers' license. While 93% of respondents agreed/strongly agreed that it is “Important to discuss my wishes for after my death with my family,” only 65% reported having actually done so. Believing in importance of discussing wishes for after with one's family was positively associated with willingness to donate (OR 9.51, CI 2.49-36.27), although actually having had those conversations was not associated. Interestingly, both believing it important to discuss wishes for after death with one's family and having actually had those conversations were positively associated with being an organ donor on one's driver's license (OR 4.73, CI 1.03-21.84, OR 2.05, CI 1.07-3.91). Discussion: Helping increase family conversations within the Native community might be an effective area to target to increase WTD in the Native community.

CITATION INFORMATION: Bongiovanni T, Rawlings J, Trompeta J. The Effect of Families on Organ Donation Among Native Americans. Am J Transplant. 2016;16 (suppl 3).

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