The California Transplant Donor Network
Consumer Behavior MKT338; Fall 2009
By: Elizabeth Kulin, Brian Louie, Jeong Ju Kim, Duangjai Teeranutranont
We would like to thank the numerous individuals who helped us conduct interviews and
surveys. Especially our community members, friends, members of the Hope Lutheran
Church & School in Daly City, the San Francisco Atheist Group, physicians Dr. Carl
Spitzer and Dr. Matt Lewin, and staff members at The California Transplant Donor
Table of Contents
Research Method Summary ……………………………………………………… p. 4
1. Primary research details ……………………………………………………. p.4
2. Secondary research details …………………………………………………. p.5
Main Problems…………………………………………………………………….. p. 6
1. Fear of Participation………………………………………………………… p.6
2. Opt-in Confusion……………………………………………………………. p.7
3. Lack of motivation………………………………………………………….. p.8
Target Market……………………………………………………………………… p.8
Target Market Rational…………………………………………………………… p.9
Marketing Strategy and Plan…………………………………………………….. p.11
1. Cause marketing…………………………………………………………… p.11
2. Outdoor advertising………………………………………………………... p.13
3. Spokesperson………………………………………………………………. p.16
4. Grassroots………………………………………………………………….. p.17
Donor Card Example…………………………………………………………….. p.19
Research Method Summary
We conducted both primary and secondary research to get more committed donors to
understand donor’s thoughts and behaviors, and to understand the current situation of
donating and recognizing existing problems.
1. Primary research method
We interviewed a total of 19 people (13 of which were committed organ donors) in
various ways. Here are some details:
We interviewed two ER physicians, Dr. Carl Spitzer and Dr. Matt Lewin via
email to inquire about their experiences. From the interview, we learned that
physicians do not usually speak with the family about organ donation but organ
donation network counselors do. According to Dr. Carl Spitzer, this is because
families want to doctor to be trying to save their family member’s life and not
already be thinking about harvesting organs.
We conducted face-to-face interviews with five people at the 2009 Harvest
Carnival Health Day event at Hope Lutheran Church & School in Daly City on
October 17, 2009 after contacting one of the outreach coordinators for California
Transplant Donor Network. We asked these five individuals reasons why they
were and were not donors (4 out of 5 were donors). From these interviews, we
concluded that they become donors to help people within their abilities and there
were no scary factors to the donors.
We interviewed three African Americans at Berkeley to see their thoughts about
organ donations. According to the interview, they are not committed organ
donors because they hold misconceptions related to organ donation such as too
old to donate, not healthy enough.
Out of the six non-organ donors we interviewed, three individuals claimed that
they do believe organ donation is an important cause because it can save lives.
However, they are not currently organ donors because opting-in is not viewed as
a high priority in their everyday lives. When asked if they ever plan to become
committed organ donors, they replied that it is something they have always
considered but have not been, and continue to not be, motivated to take action.
We designed 17 questions about organ donation statuses, demographics, and
lifestyles, and sent them to the San Francisco Atheist Group, one of the most
active Atheist-related organizations in the Bay Area, to know why or why not
individuals decide to become organ donors. From these questionnaires, we
concluded that lack of information was the biggest reasons to not become an
2. Secondary research method
We performed secondary research from multiple articles, government websites, journals,
and news publications. Here are some of our findings:
We used reports from the U.S. Department of Health & Human Services based on
donors’ age groups in California to see the average age of the demographic of
organ donors, and those willing to be organ donors. Based on the report, we
recognized that there is only one black donor for every 15 blacks in need,
compared to 1:5 ratio for the white population, and 1:9 ratio for the Hispanic
We researched Pubmed.com (U.S. National Institutes of Health) to see awareness
of donation by ethnicity groups.
From the article “The Secret to Winning Big in the African American Market,”
we found that African-Americans are more inclined to be involved in something
that they know will directly benefit the African American community. 87% of
African-Americans agree that they would be more likely to buy products from a
company that they felt gave back to the African-American community.
We also researched Mayoclinic.com and donatelifeny.org to know how people
can be an organ donor and what the process of organ donation is.
From the research, the most valuable insights that we found are:
a) The main reasons why people are hesitating to be donors are inaccurate
information or lack of information.
b) African Americans are also one of the lowest organ donor groups in the U.S, but
are in high demand.
1. Fear of Participation:
From our insight research, our team realized some factors that hold people back
from being organ donors. One of the fundamental yet major factors is that people lack the
correct understanding of what it means to be an organ donor. A large number of people
we interviewed were misguided by inaccurate concepts that we believe they may have
gathered from pop media television shows, such as “ER” and “Grey’s Anatomy”, which
portray topic of organ donating as a one associated with death, fear and pain.
A recent survey attempted to uncover the reasons why only 38% of drivers in the
United States are registered as organ donors, when the registration process is very simple
to complete when receiving a drivers license from the DMV. An online survey of 5,100
people, conducted by the advocacy group Donate Life America, found that the primary
fears associated with organ donation were; a fear that they were too old, or not healthy
enough, to donate (23%), concerned that doctors will not try as hard to save their life if
the doctors were to be aware they are donors (50%), and the fear of their organs would be
subject to sale on a black market (44%)(Parker, 2009).
The largest misunderstanding is related to the most common fear (that doctors
will not try to save a patient’s life if they are an organ donor). We believe that this
misconception stems from the media, which portrays doctors in TV shows handling
organ donation procedures. In reality this is not true, and doctors do not even have direct
contact with patients regarding this topic. Two physicians whom we interviewed
supported this reality. One doctor, Matt Lewin stated that, “Having the doctor
responsible for the patient's life and also talking about donation can cause a lot of
discomfort and, potentially, suspicion about other motives.” We learned that the topic of
organ donation is handed by organ donation organizations such as our client; The
California Transplant Donor Network, who manages all organ donors ‘ & recipients’,
profiles, and liaise with donors (or their families) for permission to perform organ
2. Opt-in Confusion:
During our secondary research, we learned that are three methods that individuals
can take to become committed organ donors: 1. Register with a state donor registry. 2.
Opt-in at the DMV. 3. Sign a donor card and send to the government (OrganDonor.gov).
However, during out primary research, we realized that most individuals (12 out of the 13
committed organ donors we interviewed) are aware of only the second sign up method. It
is important for our client to know that their target audience is unaware that they are also
able to register quickly and easily by also signing up via the web at www.ctdn.org or by
calling our clients hotline phone number at 888-570-9400.
3. Lack of motivation:
From our primary research and responses from non-organ donors we learned that
there is a lack of motivation among some people to actually take action and become
committed organ donors. Although they have positive associations to organ donating, it is
not a cause of high priority to them. It is interesting to note that these individuals also did
not have a personal connection with someone in need of an organ transplant (directly or
indirectly). Research shows that such individuals are more apt to not consider becoming
an organ donor until they are about to die (Sperling, 2009). Studies show that these
people lack motivation because they do not see what they can tangibly or intangibly
benefit from by being an organ donor (Sperling, 2009). Since this group does have
positive associations to the cause of organ donating, they might be a potential target
market for our client and motivated to opt-in if they believe they could be rewarded for
taking action. Therefore, our marketing plan should include tactics that can reach such an
audience and messaging that can motivate them to take action.
Based on primary and secondary research, it is apparent that there is a need to
increase the number of African American committed organ donors. This group is ideal
because the number of potential acquisitions is extremely high (making it a large target
market), and they are also a group that is able to be converted (unlike other groups that
may be unconvertible due to religious complications).
Target Market Rational
African Americans are at a higher risk for hypertension, diabetes and renal
diseases, in comparison to than other ethnicities (Carolyn, 2000). This increases their
potential need for organ transplants as a demographic group. However, as mentioned
earlier in this report, they remain one of the lowest committed organ donor groups in the
U.S. According to U.S. Department of Health & Human Services, 30,222 African
Americans (~.078% of the total U.S. black population) were on the U.S. need transplant
waiting list, compared to 47,436 whites (~.020% of the total U.S. white population) in
2008. However, during that same year, only 2,006 African Americans (~.005% of the
total U.S. black population) were committed organ donors, in contrast with 9,669 whites
(~.004% of the total U.S. white population) (OPTN data, U.S. Census Bureau, 2009).
This means that there is only 1 black donor for 15 blacks in need, compared to 1 -5 for
the white population, and 1-9 for the Hispanic population (OPTN data, 2009). This large
disparity, between needed organs and committed organ donors among the African
American population, stems from our clients three major problems (fear, confusion and
lack of motivation.
One study on African American families revealed that only 32.8% knew about the
need for more black donors (Siminoff & Lawrence & Arnold, 2003). Another study
showed that African Americans are more likely to associate fears of death and lack of
trust in physicians, than white individuals. Actually, the study showed that 37.9% of
African Americans held this fear, compared to only 21.2% of whites in the study
(Siminoff, 1999). During our primary, 3 out of the 5 African Americans who were
interviewed were not organ donors. These individuals claimed that they are not
committed organ donors because they hold misconceptions about organ donating. We
believe that a strong marketing campaign could change the misconceptions about organ
donating among this group, from associations of fear to associations of hope.
According to the article “The Secret to Winning Big in the African American
Market,” 87% of African-Americans agree, “I would be more likely to buy products from
a company that I felt gave back to the African-American community.” (Muley, 2007).
Therefore African Americans are more inclined to be involved in something that they
know will directly benefit the African American community. Our client, CTDN could
leverage this information and, through education to the African American population
about the high volume of need for organ donations among their community members,
encourage them to support and help. However, the opportunities to educate this
population about this situation must be increased, as many public opinion studies have
shown that knowledge about this particular situation has been slow to permeate the black
community (Siminoff & Arnold, 1999).
Furthermore, this group is not limited by their religion to become organ donors, as
some individuals and groups are. Although 87% of African Americans claim to be
religious, and 59% of this group identifies as Protestant, but unlike other religions that
prohibit organ donation, Protestant churches tend to support organ donation (Michelle,
2009)(Moore W, 2008). Protestants are typically heavily involved in their churches, and
85% of black Protestants report that faith is a key component of their lives, and attend
worship services once a week or more (Wyler G, 2008).
Our goal is to develop a marketing plan that can reduce the fears associated with
organ donating, clarify opt-in confusion, and motivate African Americans to become
committed organ donors.
Marketing Strategy and Plan
As our research shows, our client has three specific problems and our marketing
strategy/plan must address these issues. We must choose marketing tactics that can most
effectively reach the target market and create messages that can changes peoples
perception of organ donation, reduce confusion about how to become an organ donor,
and motivate the target market to take action and opt-in. The marketing tactics, the
messaging within, will support the goal of increasing the number of African-American
organ donors, is as follows:
1. Cause Marketing:
Companies join with social causes to increase their brand equity by associating
their brand name with a cause that their consumers care about (US Fed News Service,
2009). The beneficiary should be a company with large reach among our target market,
and also with an interest in participating in cause marketing. The cell phone industry,
and specifically the cell phone service provider T-mobile, could supply both to CTDN.
Cell phone subscription penetration rose from roughly 35% of the total U.S.
population in 2000 to an expected 90% or higher by the end of 2009. Competition in the
market has pressured carriers to offer unlimited texting and Internet access. With the vast
majority of Americans utilizing cell phone service, carriers must retain current customers
and win new ones from competitors. 4 lead competitors have 80% of subscriber
consumers and 85% of the industry revenue (Mintel, Mobile Communication Services,
2009). 69.7% (~27m people) of African Americans own a cell phone (Alleven, 2008). In
2009, Mintel research database performed a study on a sample of African American cell
phone subscribers and learned that their cell phone brand preference is 3 out of the top 4
leading service providers. Additionally, preference differences among the top 3 service
providers, AT&T (23%), the Verizon Wireless (20%), and T-Mobile (18%), is not
drastically large. Since AT&T and Verizon Wireless together account for almost 60% of
the industry’s revenue and subscribers, T-Mobile might be the most responsive to
participating in a cause-marketing campaign that could help increase their revenue and
competitive advantage (Mintel, Mobile Communication Services, 2009).
This program will include marketing communication messaging to consumers,
and also a partnership pitch to the beneficiary. The pitch to T-Mobile will have to
convince them that promoting our cause will strengthen their brand equity among a
shared target market and help them monetarily (either through acquisitions, activation,
and/or retention). This is an example of a pitch letter to T-Mobile from CTND:
“Joining with our social cause, The California Transplant and Organ Network,
can help you strengthen your brand image and bottom line. Research shows that cause
marketing can increase a company’s sales volume, and make consumers feel good about
buying products (US Feed News Service, 2009). Additionally, this partnership will be
low cost to you. Typically, in cause marketing partnerships, the beneficiary donates part
of their proceeds made from sales to the specific cause. However, we simply ask that you
use these proceeds to promote the benefits of becoming an organ donor to your
consumers, place an organ donation sign up button on your website, and a sign up option
on consumer invoices (a check box). We also ask that all of the smartphones that you sell
(blackberry, Sidekick, Android, and the Shadow) be installed with free organ donation
app that allows consumers to learn more about our cause, read and share personal stories
of how organ donation changed their lives, and convenient opt-in (and opt-out) access.
We believe that these measures will show consumers your dedicated support of our
cause. Additionally, as we carry out our African American targeted campaign, to help a
community that is desperate needs more committed organ donors, your brand equity
could benefit. Since research shows that a majority of African-Americans choose to buy
products from companies that they believe support the African-American community, our
partnership will enable you to build your brand equity among this demographic group.”
This cause marketing partnership also helps CTDN overcome its main problems
and reach its goal. By partnering with T-Mobile, CTDN could leverage T-Mobiles reach
of the African American community, and their large promotional and advertising
capabilities. The support of a large brand name (T-Mobile) could translate to the target
market that this cause is of great importance. In turn, this could cause the target market
to recognize the immense need for organ donors among their community, and encourage
them to take action. Additionally, partnering with T-Mobile will enable there to be
multiple clear to understand contact methods, such as online, by phone and text, by which
the target market individuals can respond by to become committed organ donors.
2. Outdoor Advertising:
The online publisher, Entrepreneur.com, defines outdoor advertisement as “Any
advertising done outdoors that publicizes your business's products and services.”
It is our recommendation that our client participate in this tactic by placing print
advertisements in public transportation vehicles and locations (bus stops and terminals).
As Americans drive less due to the economic recession, they are using public
transportation more than they have in the past (Mintel, American Lifestyles, 2009). In
effort to grow brand awareness among our target market of African Americans, public
transportation outdoor advertisement could potentially reach the 37% of African
American households that do not own automobiles (Mintel, Auto Market, 2002). It is
important to note that these advertisements should be placed specifically on public
transportation vehicles in metropolitan areas for two reasons: 1. Public transportation is
more prevent in metropolitan areas (Mintel, Auto Market, 2002) and 2. According to the
US Census, 72% of African Americans live in central cities of metropolitan areas (US
Census Bureau, African American History Month, 2005).
In the metropolitan neighborhoods that are highly populated by African American
people, research shows that the outdoor advertisements are disproportionate to that of
more affluent areas, and that advertisements of specifically alcohol and tobacco brands
are pervasive (Kwate & Lee, 2006). Therefore, we believe that the CTDN outdoor
advertisements, which are attempting to help strengthen the African American
community, will be positively accepted and supported by the neighborhood members.
From a branding perspective, this could help strengthen the organization’s brand image
among African Americans. Additionally, by placing print advertisements on vehicles and
in locations for a significant amount of time (perhaps for the entire month of February for
Black History month), they will be regularily seen by the daily public transportation
users. Therefore, this tactic would increase the chances of visibly, impressions, and also
be remembered by the audience. Therefore, this tactic could strategically build brand
awareness among the desired target market.
The advertisements should include messaging that strongly encourages and
motivate the target market to become committed to donating. During primary research, 7
out of 13 (54%) committed donors claimed that they are donors because they want to
help save a life. The act of helping those in need was studied by James Andreoni in
1990, which claimed that people provide aid to others in need because doing so awards
them with a good emotional feeling. Since his studies, marketers have been using this
theory, called “Warm Glow Giving” to attempt to persuade audiences to respond to their
call to actions. Warm glow giving This would be an appropriate campaign to use.
Additionally, as mentioned earlier in this report, African Americans are extremely
community oriented, and are interested in helping other African Americans. Therefore, a
warm glow messaging strategy should be incorporated with messages that relate to this
desire of wanting to help strengthen the African American community. For example,
taglines such as: “Your community needs your help,” “Be hero for your community,” “In
a short moment, you could help change your community,” and “Take action for your
community.” These messages educate the audience that their help is needed, tell them
that they have the ability to do so (triggering the desire to help others), and that doing so
will help their community (triggering the desire to help strengthen their community).
These messages will encourage the target market to take action and become committed
Furthermore, by associating these messages with images that show individuals of
the African American community, and specifically of individuals seemingly in need of
help, the visual component of the ads could ignite a desire to help them, and a sense of
urgency to take action, among the audience. We recommend that images of average
African American people be used in the outdoor advertisements, to enable the audience to
personally relate to them. This could increase the chances for the images to spark an
emotional response in the audience, and strengthen the ads attempt to ignite a sense of
urgency to take action. Furthermore, by including a strong call to action and clear
response method instructions, such as, “Become an organ donor now. Go to
www.ctdn.org OR call 888-570-9400 OR text HELP to 11222 ” constituents will be
encouraged, and understand how to become organ donors.
Secondary brand associations such as spokespersons can enable brand equity to
be transferred to a brand and increase its popularity and image. We recommend that
CTDN partner with NBA Basketball stars, Sean Elliott or Alonzo Mourning as a way to
reach the African American community and achieve its goal.
Approximately 52% of all African Americans are sports fans (Mintel, Sports
Event Marketing, 2008). Additionally, both Elliott and Mourning have survived organ
donations (as recipients of organs). They are living success stories that can represent the
benefits and necessity of African Americans becoming committed organ donors.
Furthermore, their association with popular events and sports among the African
American population can be leverage to change the perceptions about organ donation,
and motivate individuals to opt-in.
This spokesperson could be featured in our client’s promotional video addressing
African Americans, and help educate the audience about the disparity between needed
organs and availability of organs among their community, and how to become a
committed participant. Additionally, this video could trigger emotional responses from
audience viewers by adding visuals of the spokesperson organ donation experience. For
example the video could start in color, and change to black and white as images of the
basketball player being rushed to the hospital emergency room is shown. Then, as soon
as the audience believes that the player is in desperate need of help, the spokesperson will
explain how greatly affected the African American community is by the need for organ
transplants, and how ethic matches are often critical for survival. The video will then
show the spokesperson survival, and explain that an organ donor saved their life. We
believe that such a message within a video would spark emotion within African
American viewers and encourage them to become committed organ donors.
This video could be played during a live game at a sporting arena where an
audience would be present (since both athletes are retired, it would have to be during a
charity game or guest appearance). To increase motivation, and enable an easy way for
individuals to sign up to become donors, the spokesperson could led a mobile marketing
campaign for CTDN and encourage the audience to text in their opt-in to CDTN. As an
additional incentive, individuals who do opt-in could receive a limited edition item (such
as a T-shirt) signed by the spokesperson.
Participating in grassroots events is a great way for a brand to grow awareness
among a target market on a local level. Typically it involves a brand creating presence at
a specific time and place in which their target audience is congregating. For example, as
mentioned earlier in this report, many African Americans congregate weekly at the
Protestant church, and it is very much a community event. Therefore, our client could
participate in these services. Doing so would associate the CTDN brand name with the
target markets church, allow for donor registry cards to be passed out among attendees,
and offer an opportunity for relationships with potential new committed donors t be build.
Additionally, the reverends (Minister) of specific churches could support our mission and
promote the benefits of becoming an organ donor to the audience who respect and trust
him or her.
Another way that CTDN could participate in grassroots events that target the
African American community is to participate in, and even potentially create, community
fairs during the Black History Month in February. The fair could include booths of other
health-related agencies, and be located in neighborhoods that are highly African
American populated. The face-to-face interaction with the target market could enable
CTDN to directly educate individuals about the need for organ donors among their
community, and motivate them to taking action by filling out a donor card.
Donor Card Example
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Following is the ways that people can be an organ donor.
1) Donor registry. Most states have registries. So people can register with their state’s donor registry at
2) Driver’s license: when people obtain or renew your license, they can designate their choice on their
driver's license. If you register, your license will indicate that you are a donor. This way, doctors will
know right away that you wish to donate your organs in the event of your death.
3) Donor Card: people can sign and carry a donor card from organdonor.gov.
Following is the process of organ donation.
1) Donor Referral:
At or near the time of a patient's death, a physician, nurse, or other designated representative from the
hospital contacts the Organ Donor Network. They provide confidential information to determine if the
patient is a potential donor.
2) Medical Evaluation:
The transplant coordinator obtains detailed medical information about the patient's current medical
condition as well as any past medical history.
3) Declaration of Death
4) Consent for Organ Donation is obtained
5) Medical Examiner/Coroner:
Prior to the recovery of any organs or tissues, the transplant coordinator must also contact the
appropriate county Medical Examiner or coroner if the death is under their jurisdiction.
6) Organ Allocation and Recipient Identification:
Specific information about each donor, including his or her blood type and body size, are entered into
the national computer system. An individualized list is generated for each donor that identifies patients
who match for those particular organs. The transplant surgeon always makes the final decision about
whether or not the donor and intended recipient is a good match.
7) Organ Recovery Procedure
The recovery of the organs is performed in the Operating Room where the donor is being cared for. The
transplant coordinator oversees the arrival and departure of the surgical recovery teams. The recovery
team consists of surgeons, nurses, the transplant coordinator and an organ preservation technician.
8) Organ Preservation
Just prior to being removed from the donor, each organ is flushed free of blood with a specially
prepared ice-cold preservation solution that contains electrolytes and nutrients. The organs are then
placed in sterile containers, packaged in wet ice, and transported to the recipient's transplant center.
9) Donor Family Follow-up
After the organ transplants have been completed, a letter is sent to the donor's family that includes
information about the outcome of the donations. Some people say that they are too old to donate but the
decision to use their organs is based on strict medical criteria, not age. So, let the doctors decide
whether your organs and tissues are suitable for transplantation.