Reasons for (not) signing the state registry: Surveying Department of Motor Vehicles customers in New York state

Context - Prior research examining rationales for enrolling as an organ donor is biased because of its reliance on college student samples and retrospective recall.Objective - To characterize New York state residents' registry enrollment decisions in close proximity to a registration opportunity.Design - Surveys were conducted with customers exiting Department of Motor Vehicle offices.Participants - A total of 1325 customers were surveyed upon exiting 1 of 18 Department of Motor Vehicle offices spanning 9 counties.Main Outcome Measure - Customers making donation-relevant transactions (ie, license renewal/registration) reported whether they had registered as a donor that day, and all other customers reported whether they had registered as a donor in the past. Customers reported reasons to justify their enrollment decision through short interview questions.Results - Among current donation-relevant transactions (n = 299), 27% reported enrolling in the registry. Of remaining customers, 39% reported enrolling in the state registry in the past. For those who elected not to enroll, many failed to communicate a reason for their decision, or reported a lack of opportunity to sign or decisional uncertainty. Among enrollees, reasons for registration included the altruistic benefits of donation, prior registration, personal experience with donation, and rational arguments for donation.Conclusion - The value of point-of-decision survey data are discussed in relation to strategic efforts to promote organ donor registration.