*Purpose: Asian Americans have the lowest organ donation registration rates in the United States (U.S.). We attempted to identify organ donation barriers among Chinese and Korean Americans by assessing their knowledge and attitudes toward organ donation.

*Methods: A questionnaire assessing organ donation knowledge and awareness, religious, cultural, and social attitudes toward organ donation was distributed to Chinese and Korean American college students and the general public (18+ years) in Queens, New York between March and November 2019.

*Results: Among the 514 participants, 371 (72%) were of Chinese descent and 132 (26%) were of Korean descent and 11 (2.1%) were mixed. The majority of participants were female (n=290, 56%) and born outside of the U.S. (n=321, 62%) living in the U.S. for an average of 13.8 years. Organ donation was recognized as a noble act by the majority (n=482, 94%) of the respondents, but only a minority (n=97, 19%) of the respondents were registered donors. Notably, most (n=266, 64%) of the non-registered respondents expressed willingness to register as an organ donor. Expressed willingness to donate coupled with a low median knowledge score (41%), indicated an opportunity to improve knowledge and awareness about organ donation in this population. The registered respondents had a significantly higher knowledge score (p<0.0001), more positive attitudes (p=0.0008) towards organ donation, and higher altruistic measures (p=0.032) than non-registered respondents. Factors including English language proficiency and greater level of U.S. acculturation (p=0.0038), prior familial discussions about donation (p<0.0001) and blood donation (p=0.002), and personal experience such as knowing other organ donor registrants (p<0.0001) were also associated with donor registration status. Combined measures of religious/spiritual beliefs (p=0.445) were not associated with registration status.

*Conclusions: The survey identified a knowledge deficit regarding organ donation among Asian Americans and the need to adopt culturally sensitive strategies such as stimulating family discussions about organ donation and providing educational material that is preferably in their native language.

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