Abstract: FR-PO0962
Assessing Potential Donors' Readiness, Decisional Balance, and Self-Efficacy: Development and Validation of Measures Associated with Donation
Session Information
- Transplantation: Clinical - Pretransplantation, Living Donation, and Policies
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Potter, Thomas B, Houston Methodist, Houston, Texas, United States
- Al Awadhi, Solaf, Houston Methodist, Houston, Texas, United States
- Peipert, John D., University of Birmingham, Birmingham, England, United Kingdom
- Waterman, Amy D., Houston Methodist, Houston, Texas, United States
Background
Assessing potential donors’ readiness to donate, views regarding living kidney donation (LKD), and how problematic donation challenges are helps to understand their decision-making. Using the Transtheoretical Model of Behavioral Change (TTM), we developed and validated new measures of donor readiness, self-efficacy (believed ability to overcome LKD-related challenges), and decisional balance (the pros and cons of LKD; DB)
Methods
After completing evaluation at a transplant center, 339 potential donors answered questions about readiness to take donation-supportive action, 13 possible pros and cons to donation (from “Not important” to “Extremely Important”), and self-efficacy in facing 12 potential challenges (“Not at all Confident” to “Completely Confident”). Readiness was grouped into 2 categories (Precontemplation/Contemplation/Preparation (Pre-Action) and Action/Maintenance (Action)). We conducted exploratory bifactor analysis to assess dimensionality and reliability of the three scales. Univariable logistic regression was used to determine scale associations with 12-month donation.
Results
Potential donors were 67.0% female and had a median age of 46 years (55.2% White, 13.9% Black, 17.4% Hispanic). Donors were in pre-Action (16.4%) or Action (83.6%), 246 (72.6%) completed donation within 12 months and those in Action had higher odds of 12-month donation (Odds ratio: 2.00 [1.08-3.72]; p=0.028). Each scale was unidimensional and internally consistent (Total McDonald’s ωs of 0.96, 0.89, and 0.83). The final Pros and Cons scales were positively associated with actual donation, respectively (1.13 [1.02-1.27]; p=0.025; 0.84 [0.74-0.94]; p=0.003) as was the final self-efficacy measure (per-point odds ratio: 1.04 [1.01-1.06]; p=0.005).
Conclusion
Applying the tenets of TTM, these newly validated measures can identify individuals likely to complete donation and better overcome fears and challenges identified during evaluation, increasing donation rates.
Funding
- NIDDK Support