Culturally focused education about deceased donation is needed for American Indians (AIs). This study tested a program designed to impact intention to serve as a deceased donor for reservation dwelling AIs. A pre/posttest design and a community-based participatory research approach were used. The study was based upon the Transtheoretical Model. Adult participants (N = 1580, 58% women) were from four Northern Plains reservations. An outreach coordinator delivered the program using print and video materials. The outcome was stage of motivational readiness (SMR) to serve as a deceased donor. McNemar's test was used to compare pre- to postintervention changes in SMR. At baseline, 55% of participants were not thinking about being a donor (precontemplation stage) and 45% were thinking about it (contemplation stage). Postintervention, 43.1% of participants were unchanged in SMR and 56.9% progressed in SMR. Of those who progressed, 26.5% (n = 418) changed to the contemplation stage, 19.4% (n= 306) changed to the preparation stage (signed a donor card or joined a registry), and 11.1% (n = 175) confirmed a discussion of the decision with family (action stage). Progression in SMR from pre/post was significant, chi(2)(1) = 18.32, p < 0.05. The intervention resulted in important changes in deceased donor intentions for reservation dwelling AIs.