How Priority Incentives Impact Organ Donation Registration Intention and Related Behavior in China

The scarcity of human transplant organs in China underscores the need for improved public engagement in organ donation. In this study, we examined a cognitive-noncognitive dual pathway model of organ donation registration (ODR). Based on this model, we explored the efficacy and underlying mechanism of priority incentives, a strategy that gives priority to receive an organ to those who register to donate, in promoting ODR. Two online studies involving 1,632 non-donor Chinese adults were conducted. Study 1 used the dual pathway model to measure the effect of cognitive factors (CF) (i.e., attitude and subjective norm) and noncognitive affective factors (NF) (i.e., ick and jink) on ODR intention and related behavior. Study 2 manipulated priority incentives to examine its effect on ODR intention and related behavior and the cognitive-noncognitive pathways underpinning how it works. Both studies provided support for the structural validity of the dual pathway model. Study 1 found that ODR intention can be predicted by both CF and NF, while ODR-related behavior was solely predicted by NF. Study 2 showed that offering priority incentives can enhance ODR intention. Its indirect effect on ODR-related behavior was mediated through the path from CF to ODR intention. These results bridge a gap in understanding mechanisms of incentives toward ODR and have practical implications for improving ODR rates.