A multi-method approach to the study of “attitude” in organ donation research
Date of Issue2017-05-11
Wee Kim Wee School of Communication and Information
The practice of organ transplantation in China has been under-regulated for many years. Reports of organ trafficking, transplant tourism, and transplant commercialism have been common in this country (Huang et al., 2008). In recent years, the Chinese government has changed the country’s organ transplantation policy and launched a nationwide organ donation system in 2013 (Huang et al., 2013). This new organ donation program, however, has met with little success. By the third year of the program’s implementation, only 70,217 Chinese have registered as organ donors (China Organ Donation Administrative Center, 2016). The huge shortage of organ donors in China underscores the need for social and behavioral interventions. This doctoral thesis consists of five studies designed to understand the attitudes regarding organ donation in the context of Chinese culture. This research project begins by examining and refining the notion of attitude as conceptualized and operationalized in studies of organ donation informed by the theory of planned behavior (TPB). Study 1 categorizes the refined notion of attitude into four theoretical aspects. It then creates a reliable, valid attitude measure which contains two statistically independent dimensions: positive and negative attitudes, and establishes the measurement invariance across two distinctive Chinese samples. Study 2 employs the refined attitude measure to predict organ donation intentions and organ-donor registration behavior based on the TPB. Results show that negative attitudes, positive attitudes, subjective norms, and the distrust of organ allocation system significantly impact the behavioral intention, which in turn predicts the registration behavior. Furthermore, the attitudinal factor is the strongest predictor of the behavior among all the TPB components. Study 3 involves an experiment that investigates the persuasiveness of evidence type in organ donation messages on attitudes. It finds that including narratives in persuasive message results in a significantly lower level of negative cognitive beliefs than does using statistics alone. Yet a boomerang effect exists that, when narrative messages are presented, individuals with high motivation to approach emotion is more likely to report a higher level of negative cognitive beliefs, compared with individual low in such a motivation. Study 4 employs a qualitative approach to extent the inventories of attitudes regarding organ donation. Through qualitatively analyzing all messages about organ donation posted during 2015 on Weibo, the most popular social networking site in China, it provides supporting evidence for the refined notion of attitudes created in Study 1, and also documenting several aspects of attitudes regarding organ donation that have rarely reported in previous literature. Study 5 retains a focus on the attitude but breaks a new ground by exploring the opinion leaders for organ donation, who are able to affect others’ attitudes on organ donation. It maps the sharing network of the popular organ donation messages on Weibo and explores the opinion leadership within this network. It reveals that personal attributes, professional knowledge, and social positions predict individual’s local opinion leadership. Alternatively, only personal attributes and social positions are significantly associated with one’s global opinion leadership. This research effort contributes to an understanding of organ donation in the Chinese context. The findings from this doctoral thesis will be instrumental in the design of educational interventions to expand the pool of available organs in China.
Nanyang Technological University