The Cultural-Cognitive-Normative (CCN) Framework: Understanding Organ Donation Intentions in Vietnam

This study introduces the Cultural-Cognitive-Normative (CCN) framework, a novel theoretical integration that explains organ donation intentions within culturally sensitive contexts. We examine how cultural values moderate the attitude-intention relationship in organ donation decisions by drawing on the Theory of Planned Behavior, the Health Belief Model, and the Value-Belief-Norm Theory. Using structural equation modeling with data from 305 Vietnamese citizens, we found strong support for our proposed model (R²=0.588 for donation intention). Results reveal that the perceived severity of organ shortage (β=0.569) and perceived behavioral control (β=0.458) strongly affect attitudes toward donation. At the same time, religious and cultural values significantly moderate the attitude-intention relationship (β=-0.328). This study contributes to organ donation literature by demonstrating how traditional cultural beliefs can attenuate the translation of positive attitudes into behavioral intentions. Our findings offer implications for policymakers and healthcare practitioners seeking to enhance organ donation rates in collectivistic societies with strong ancestral traditions.