disseminate a two-pronged message: preventing chronic diseases (particularly hypertension, renal failure, and diabetes) and increasing awareness of organ donation (with information provided on the options for registering as an organ donor).

Before the inception of the National MOTTEP, a community focus group identified five main points of reluctance to organ donation in the African-American community that affect donation rates: the lack of community awareness of the need for transplantation, religious myths and misconceptions, general distrust of the medical community, fear of premature death, and racism (Callender et al., 2002). The focus group determined that the most effective communicators of information to potential donors would be individuals who shared a similar ethnicity and a similar set of cultural values with potential donors; individuals who conducted face-to-face dialogues with community members; and transplant recipients, potential recipients, donors, and donor families, along with healthcare professionals. This methodology was later enhanced through the use of widespread media campaigns and college outreach activities targeted to minority communities to effectively improve awareness of organ donation (Callender et al., 1995).

In 1998 and 1999, an assessment of the effectiveness of the National MOTTEP model was conducted with 914 adults with diverse ethnicities in 13 cities (Callender et al., 2001). Surveys completed before and after a MOTTEP presentation found significant increases in the levels of awareness of perceived need, trust in doctors, future plans to donate, and shifts in religious and spiritual beliefs about donation. In a further evaluation, telephone interviews were conducted 2 to 3 months following participation in a MOTTEP presentation. The interview was designed to assess whether the alterations in behavior were sustained and explicitly assessed the number of people who had signed donor cards, determined whether family discussions about donation were conducted, and determined whether the participants were willing to be donors after the intervention. A total of 253 telephone interviews were conducted. Preliminary analysis showed improvements in all three of the behaviors being measured (Callender et al., 2002). Furthermore, an analysis comparing the number of deceased donors at MOTTEP and non-MOTTEP sites found higher rates of donation for Caucasians, African Americans, Latinos, and Asians (Callender et al., 2005) (Table 6-2).

The National MOTTEP plans to continue its grassroots campaigns to educate minority communities about organ donation and strategies that can be used to prevent diseases and behaviors that lead to organ donation. Its next phase will focus on reducing institutional racism by empowering minority communities to respond to ethnic disparities, correcting false assumptions made by the medical community about their patients, and encouraging overall behavioral and attitude changes in the medical com-



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