Wilk Piotr, Richard Lucie, Ouédraogo Alexandra M, Garg Amit X, Maltby Alana, Shariff Salimah Z
Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON.
ICES Western, London, ON.
Transplant Direct. 2020 Nov 10;6(12):e631. doi: 10.1097/TXD.0000000000001087. eCollection 2020 Dec.
A community that promotes prosocial behaviors such as organ donor registration or charitable giving could reinforce those behaviors among its residents. Understanding the nature of the relationship between prosocial behaviors at the community level and an individual's decision to engage in prosocial behavior can help in the targeting of communities with lower rates of prosocial activities. The objective of this study was to assess if the likelihood that an individual is a registered deceased organ donor in Ontario, Canada, is associated with community-level charitable giving.
This cross-sectional population-based study involved individual- and community-level data from multiple administrative data sources from ICES and Statistics Canada. To assess the unadjusted and adjusted effects of community-level charitable giving on organ donor registration, we ran 4 sequential multilevel random intercept logistic regression models and used a number of individual- and community-level confounding factors.
Statistically significant between-community variance (0.322, SE = 0.020) and interclass correlation coefficient (0.089) suggest that substantial variation in organ donor registration can be attributed to the between-community differences. Community-level charitable giving was correlated with organ donor registration (odds ratios, 1.351; 95% confidence intervals, 1.245-1.466) in the model containing only individual-level confounding factors. However, this relationship became statistically nonsignificant (odds ratios, 0.982; 95% confidence intervals, 907-1.063) when a series of community-level confounding factors were added to the model. Among these confounding factors, individuals' immigration status and community-level ethnic/immigrant concentration had the most pronounced association with organ donor registration.
The identification of the characteristics of populations and communities with low organ donor registration rates may inform future initiatives in the area of organ donation awareness and promotion to make them more effective among those particular groups.
一个促进诸如器官捐赠登记或慈善捐赠等亲社会行为的社区，可以在其居民中强化这些行为。了解社区层面亲社会行为与个人参与亲社会行为决策之间关系的本质，有助于针对亲社会活动率较低的社区。本研究的目的是评估在加拿大安大略省，个人成为登记在册的已故器官捐赠者的可能性是否与社区层面的慈善捐赠有关。
这项基于人群的横断面研究涉及来自ICES和加拿大统计局多个行政数据源的个人和社区层面数据。为了评估社区层面慈善捐赠对器官捐赠登记的未调整和调整后的影响，我们运行了4个连续的多层次随机截距逻辑回归模型，并使用了一些个人和社区层面的混杂因素。
具有统计学意义的社区间方差（0.322，标准误 = 0.020）和组内相关系数（0.089）表明，器官捐赠登记的显著差异可归因于社区间的差异。在仅包含个人层面混杂因素的模型中，社区层面的慈善捐赠与器官捐赠登记相关（优势比，1.351；95%置信区间，1.245 - 1.466）。然而，当在模型中添加一系列社区层面的混杂因素后，这种关系在统计学上变得不显著（优势比，0.982；95%置信区间, 907 - 1.063）。在这些混杂因素中，个人的移民身份和社区层面的种族/移民集中度与器官捐赠登记的关联最为显著。
识别器官捐赠登记率低的人群和社区的特征，可能为未来器官捐赠意识和推广领域的举措提供信息，使其在这些特定群体中更有效。
