A psycho-cognitive segmentation of organ donors in Egypt using Kohonen’s self-organizing maps

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Abstract

This study uses self-organizing maps (SOM) to examine the effect of various psychographic and cognitive factors on organ donation in Egypt. SOM is a machine learning method that can be used to explore patterns in large and complex datasets for linear and nonlinear patterns. The results show that major variables affecting organ donation are related to perceived benefits/risks of organ donation, organ donation knowledge, attitudes toward organ donation, and intention to donate organs. The study also shows that SOM models are capable of improving clustering quality while extracting valuable information from multidimensional data.

Research highlights

► This is, to the best of our knowledge, the first study to investigate the market segmentation of organ donors’ market in Egypt. ► Organ donation intentions are affected by several psycho-cognitive factors. ► SOM models can be used to improve the clustering quality of organ donors.

Introduction

Since the first kidney transplant operation was performed in 1954 (Cantwell & Clifford, 2000), advances in medical technology have transformed organ transplantation from an experimental treatment to the therapy of choice for patients with organ failure. Today the transplantation of many organs has become a reality, these include kidneys, hearts, lungs, livers, eyes and even brain tissues (Gibson, 1996). Such therapy leads to a substantial increase in the quality of life of recipients in terms of physical and emotional activity, social relationships and professional development (Martinez et al., 2001). Organ transplantation results also in a considerable savings in health expenditure, since it is cost-effective compared to alternative techniques (Evans & Kitzmann, 1998).

Although there are growing numbers of people on waiting lists for organ transplantation, there remains a critical shortage of available organs. For example, During 2005 approximately 91,000 patients with end-stage failure were on the US Organ Procurement and Transplantation Network waiting list for organ transplantation (O’Connor, Wood, & Lord, 2006). The US is not the only nation facing this problem, nor is it alone in attempts to market the idea of organ donation to its residents. In Kuwait, for example, it is estimated that about 250 people have renal failure each year. Yet the country deals with an average of 40 suitable donors each year (Kandela, 1997).

As Islamic religion plays an important role in the daily life and government legislation in the Arab world, organ transplantation had to wait for religious edicts or fatwas. In 1982 a fatwa in Saudi Arabia regarding the permissibility of cadaveric donor transplantation paved the way for organ donation in the country. All Arab countries that have cadaveric organ programs follow the required consent opt-in system. Only Tunisia applies the presumed consent opt-out system (Al-Sayyari, 2008). However, some Muslim scholars and muftis (religious jurists) still oppose organ donation as the human body is God’s creation and must not be desecrated following death, but they encourage xenotransplantation research (Bruzzone, 2008).

Although public perception of organ donation critically affects the availability of organ transplantation, systematic research into the attributions that respondents in Egypt make about their organ donation behavior and into the relationships between these attributions is virtually nonexistent. This is surprising because “understanding consumers’ perceptions of cause-and-effect relationships would seem to be central to consumer behavior” (Folkes, 1988, p. 548). As it has been recognized that there is a pressing need to understand motivations behind organ donation as well as provide a greater cross-cultural perspective on issues related to organ donation (Lwin, Williams, & Lan, 2002), the timing is therefore right for marketing research that examines factors that motivate organ donation behaviors in a non-Western context. Gaining a detailed understanding of why individuals undertake pro-organ donation behavior is important for policy makers and researchers seeking solutions to social marketing problems that require behavioral change. Social marketing, a form of marketing which is rapidly growing, is based on the traditional marketing exchange theory, which states that consumers will adopt behavior change when barriers are reduced and benefits highlighted, according to their specific needs (Quinn, Bell-Ellison, Loomis, & Tucci, 2007). Successful strategies dealing with obesity, tobacco consumption, family planning, safe sex, recycling and sustainability are the more common applications of social marketing initiatives. However, very few studies applied the concepts of social marketing to organ donation (e.g. Weber, Martin, & Corrigan, 2006)

This paper will first present the research objective followed by relevant literature review and hypotheses development. Next, methodology and results will be discussed. Implications section follows. Finally, research limitations and directions for future research will be explored.

Section snippets

Research objective

Segmenting organ donors is very important because the first step in planning the target marketing strategy is to segment the market and develop profiles of the resulting market segments. In fact, the usefulness of market segmentation hinges upon accurate profiling. Relatively low accuracy in forecasting segment membership will result in ineffective marketing programs and potential negative impact due to targeting unintended segment members. Despite the importance of profiling organ donors,

Literature review and hypotheses development

Drawing on research from North America and Europe, there is a wealth of evidence that suggest that a wide variety of factors influence organ donation behavior. These can be characterized as altruistic values, perceived benefits and risks, knowledge, and attitudes.

Sample

Collecting data by mail surveys in the Arab world has been very difficult (Nasif, Al-Daeaj, Ebrahimi, & Thibodeau, 1991). In order to ensure an acceptable number of responses data were collected by local collaborators using the mall-intercept survey technique (Bush & Hair, 1985). Graduate marketing students handled the fieldwork. Some were responsible for recruiting participants as they completed their shopping trip and were leaving the mall. Participants were then accompanied to a more quiet

Product moment correlations

Though it does not prove causation, correlation can serve as predictor of causation (Sekaran, 2000). The product moment correlations between the variables are shown in Table 1. This table was constructed to get a feel for the associations among the six constructs constituting the model. Most of the correlation coefficients were significant and had the expected sign. Thus the constructs, in general, are highly related. However this result should be interpreted with some caution due to the large

Discussion and implications

The marketing of organ donation is least common in Egypt where transplantation is either unavailable or organs are extremely scarce. There have been many proposals to address the desperate need for organs by expanding the donor pool, such as adopting necessary legislations and revision of organ transplantation laws in Egypt based on current socio-cultural change, providing compensation for organ donors, and establishing a self-governing market in organs. This study indicates that organ

Limitations and future research

The study suffers from a number of limitations. First, this study has used a cross-sectional rather than a longitudinal approach. This implies that much more emphasis has been placed on observing respondents’ behaviors than in observing changes in behavior. There would seems to be hence a need for much more longitudinal research to focus on observing changes in respondents behavior over time. Second, the measures used in the study are based on self-reports of past behaviors or predictions about

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