Attitude research in the context of organ and tissue donation has long noted an inconsistency in terms of individuals' attitudes toward donation and the number of registered or card-carrying donors. The present research contends that this inconsistency is due to the measurement procedures used in the existent OTD attitude literature. To test this supposition the most commonly used OTD attitude scale, which dated back to Goodmonson and Glaudin (1971) and utilized Likert-type scaling, was pitted against metric multidimensional scaling procedures. Specifically, four studies were carried out to identify the key concepts students used in their cognitions regarding OTD, to determine the relationships among those concepts (i.e., their structure), and to examine the effects of new information on students' concept structure. Qualitative analyses of survey and interview data identified eleven concepts commonly associated with students' thoughts regarding organ donation which were incorporated into a 55-tem pair-comparison measure. Multiple logistic and linear regression analyses were used to test the predictive abilities of students' Likert-scaled attitudes. Likert attitudes and age were found to predict students' signing behavior, but neither attitudes nor age, race, or sex successfully predicted students' intentions to become donors. Multidimensional analyses of pair-comparison data were performed to identify underlying dimensions in the data, to generate pictorial representations of students' OTD attitude structures, and to identify structural changes occurring as a result of the acquisition of new knowledge regarding the donation and transplantation processes. Results and implications of attitude measurement choices are discussed in the domain of organ donation. The role of uncertainty in the attitude-behavior link is also discussed.
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