Rationale: Compared to Caucasians, African Americans are less likely to become registered organ donors. In addition, although first-person consent laws have been passed in 48 states, hospitals remain reluctant to harvest organs without the consent of the registered donor's family. Epidemiologic studies on African Americans have focused on the willingness to donate organs. Little research has been done on the positive decision-making process of becoming a registered organ donor. Objectives: The goal of this project is to identify facilitators associated with becoming a registered organ donor and providing familial notification. We hypothesize that positive outcome expectations (physical, social, and self-evaluative) will be associated with increased African American organ donor registration. We also hypothesize that increased perceived self-efficacy (PSE) will be associated with increased familial notification. Design and Methods: Using the Social Cognitive Theory as a guiding framework, a qualitative study involving focus groups will be performed and then validated by large-scale quantitative telephone surveys. African Americans, age 19 and older, who made a decision regarding organ donation at the Alabama Department of Motorized Vehicles within the past 3 months will be stratified into those who chose to become a registered organ donor and those who declined. The dependent variables for analysis will be 1) becoming a registered organ donor and 2) family notification of the decision to become a registered organ donor. Significance: The study will identify the key factors that drive African Americans to become registered organ donors and the determinants of familial notification. This data will inform future interventions to increase African American donor registration and develop mechanisms to ensure family consent, thereby reducing disparities in organ donation and improving the health outcomes of African Americans. PUBLIC HEALTH RELEVANCE: African Americans who registered at the Alabama Department of Motorized Vehicles within the past three months will be stratified into those who chose to be an organ donor and those who declined. A qualitative study involving focus groups and validated by quantitative surveys will be performed to determine the factors associated with the decision of African Americans to become registered organ donors and to inform their families of their donation wishes.