"While 90% of Americans agree that organ donation is a positive medical advancement,
only 30% of these Americans have legally recorded their organ donation wishes. The
lack of organs is explained in general by the avoidance of end of life issues, common to
most Western cultures, and more specifically by the lack of knowledge about legal organ
donation, which is complicated by common misperceptions and misinformation."

This 23-page case study analyses a communication campaign launched in April 2005 to spur residents of the state of California, in the United States, to share their organ donation wishes online. The campaign focused on educating the public about the importance of organ donation, calling upon Californians to act and attempting to break through the apathy and discomfort that organisers say may be associated with becoming an organ donor. According to the authors of this report, "the online registry's success was driven by a well-crafted strategic communication campaign underpinned by two core strategies - media advocacy, and grassroots support within local communities. The comprehensive campaign supporting the registry's launch provides a useful model for public health practitioners."

Specifically, this initiative is an effort on the part of the California branch of Donate Life America, which aims to serve as a national voice to inspire people to save and enhance lives through organ, eye, and tissue donation. Affiliation with this national campaign provided Donate Life California with access to pre-branded materials, including a logo, marketing materials, updated transplant facts and statistics, and pre-taped radio and television public service announcements (PSAs). These items were meant to call the public's attention to the "Donate Life California Registry", a confidential and bi-lingual (English- and Spanish-language) database designed to:

1. redefine and reposition organ donation as a public health problem for Californians;
2. educate the public and the media about the lack of organ donors;
3. spread awareness using community collaboration and media advocacy strategies; and
4. adopt a single call to action compelling Californians to become organ donors by registering online. (Launched with the goal of registering 15,000 people in 12 months, the registry attracted more than 175,000 registrations in the first 6 months).

This document examines the rationale behind, and the strategies that have shaped, this campaign. As indicated here, before the creation of the online registry, no formal registry for organ donation existed in California; thus, even if willing donors placed a pink donor dot sticker on their driver's license, this action was not legally binding unless would-be organ donors had shared their intentions with family members. For this reason, in 2004 Donate Life's California team developed a database prototype that would enable online donor registration; subsequently, various in-person meetings to discuss goals, audiences, and messages were conducted, as were phone conference calls and pitches designed to engage hospital partners, media partners, and community partners. For instance, to gain support from the community, to build partnerships, and to generate campaign idea the team staged 2 large workshops - one in Northern California and the other in Southern California. Specific examples of topics addressed during these daylong brainstorming sessions/discussions included: hospital representatives needing to know how to access the registry if they have a potential donor; community leaders and politicians wanting to learn more about organ donation to help spread the messages; and clergy members needing information regarding religious beliefs to dispel common misconceptions. Findings from the community workshops were used to refine campaign messages, develop timelines, and devise action plans.

What emerged was a 3-tier plan. The first tier of the campaign focused on promotion of the online registry and organ donation issues through media advocacy. As detailed in the report, these efforts focused on re-framing and repositioning media coverage of the organ donation issue from that of a personal problem affecting individuals and their families, to that of a public health issue affecting all Californians. Traditional media relations strategies and tactics, such as building relationships with reporters, were combined with community advocacy approaches in order to meet this health communication challenge. A vital element of this portion of the campaign focused on targeting and educating key news media organisations, as well as individual reporters. This process involved the creation of a media kit (prior to the campaign launch) designed to assist reporters with news gathering. The kit included fact sheets, such as "Community Outreach," which focused on specific statistics and information about the African-American, Latino, Chinese, and Filipino communities, as well as a discussion of common misconceptions about organ donation. Other elements of this kit included statistics about the growing waiting list and pamphlets, such as one entitled "Faith Based Efforts", which focused on how clergy members can discuss organ donation with their congregations. These resources were made available online. Also, in advance of the launch, the team prepared media releases for print and broadcast media, as well as scripts for live radio public service announcements (PSAs). News conferences, op-eds, and briefings were also conducted.

The second tier focused on community outreach through registry drives and the creation of partnerships. For example, in Southern California, mayors sponsored a competition called "City Challenge" to see which city could register the most residents per capita. In a similar competition, medical students challenged students at other Californian universities to sign up on the registry. The team also reached out to the faith-based community with tools such as church bulletins, announcements, and sermon topics for religious leaders to use with their congregations. The goal was to dispel the misconception that organ donation clashes with religious beliefs, and to increase awareness about the need for organ donors. In addition, the team sought partnerships with key political figures that could help spread the word about the new registry.

The third tier focused on reaching people without online access. To address this need, the team partnered with public libraries in several cities throughout the state. For instance, at the libraries, Donate Life California posters, literature, and table-top signs were placed around the public computers to encourage people to sign up on the new registry. Librarians were trained to help library patrons use the computers to register online.

An excerpt from the report follows:
"Through the hosting Web sites, www.donateLIFEcalifornia.org and the Spanish version at www.doneVIDAcalifornia.org, the team tracked the success of the massive launch campaign counting every visit, registration, link, and more. The initial goal for the registry was 15,000 registrants in the first twelve months. Within the first six months, more than 175,000 people registered....In all, the launch received more than 200 media stories in the first few months. This media coverage contributed significantly to educating Californians about organ donation issues and spreading awareness about the new registry....[By] January 2007, one million Californians had registered. The campaign planners are now focusing efforts on corporations to develop employer-sponsored events and activities to raise awareness about organ donation and educate employees about the registry."

Cases in Public Health Communication & Marketing, The George Washington University School of Public Health and Health Services, Volume 1 - June 2007; and Donate Life America.