Online appeals generate attention but no increase in organ donor registrations
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After disseminating five types of appeals through online advertisements, researchers found that although “substantial attention” was generated based on click-rate, this did not lead to a significant increase in organ donor registrations.
“Behavioral economics offers a range of insights including the power of social norms that may nudge individuals to make decisions in the setting of uncertainty or ambivalence,” Peter P. Reese, MD, MSCE, of the Perelman School of Medicine at the University of Pennsylvania, and colleagues wrote as a rationale for their study design. “One important feature of the organ donor registration decision is that individuals may never or only occasionally be presented with an opportunity to register. We designed the interventions in this study to present an opportunity for organ donor registration that was convenient, efficient, and scalable. The messages could be ignored without any social cost or other threats to autonomy and anonymity.”
To determine if online advertisements could impact organ donation rates, Reese and colleagues developed four specific appeals, as well as a control message which encouraged viewers to register but did not contain additional information or persuasive content. All ads, including the control message, “deployed colorful images” to draw attention and were displayed as banners throughout the Google ad network. Researchers noted the ads did not target specific user searches.
The four type of appeals were categorized as the persuasive narrative, the social norm message, the knowledge-based message and the reciprocity message.
“We selected persuasive narrative as a promising tool for organ donor registration because it could shift the viewer’s attention toward the narrative of a recipient and away from thoughts of the viewer’s own future death,” Reese and colleagues elaborated, adding that the social norm message was designed to “provide the viewer with the sense that registering as a donor is a sensible decision that many or most of their peers would make.”
For the knowledge-based message, researchers provided information about the positive impact organ donation could have on transplant recipients, while the reciprocity message offered an organ donation wristband to the viewer despite whether they registered.
“The gift might alleviate the sense that registering as a donor does not benefit the registrant,” they wrote.
An analysis of data using Google Analytics showed 5,156,048 impressions and 25,001 total clicks, leading to a click-through rate of 0.49%. The control and reciprocity messages both had the highest click-through rates (0.51%), while the social norm messages had the lowest (0.43%).
In total, there were 52 organ donor registration events, with the reciprocity message being most effective (152 people requested wristbands; 18 people registered as organ donors).
According to Reese and colleagues, the “modest” number of registrants may be explained by the fact that the messages were not targeted to specific users based on search, causing the messages to compete with “other compelling sources of attention ... or other advertisements on the page.”
“Future efforts should try to take advantage of settings where there is less information competing for recipients’ attention, where registration is convenient and where an organ donation message can more easily focus an individual’s attention, such as an ATM transaction or online tax preparation or social media,” the researchers suggested. “Alternatively, the message content could be repurposed with face-to-face encounters, at higher cost but perhaps greater effectiveness.”
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