Keys to Open the Door for Blood Donors to Return

How to increase first-time donors' returns? The postdonation letter's content can make a difference

Background

Retention of first‐time donors is pivotal for blood collection centers. The present study built on research showing the importance of donor identity among regular donors and sought to compare the effectiveness of various communication strategies on return rate.

Study Design and Methods

Postal letters were sent to a large sample of first‐time whole blood donors (N = 1219) a few weeks following their first donation. Four versions of this letter were differently constructed in a way to boost the acquisition of donor identity (i.e., by including information about their ABO and Rh(D) blood group, emphasizing the salience of donor identity, offering a keyring with personalized information, or specifying the percentage of those sharing the same ABO and Rh(D) blood group). One version with no identity‐related information served as a control condition. Participants' subsequent blood donations were tracked for 5–22 months after receiving the letter.

Results

Survival analysis showed that the return rate was significantly higher among those who had received information about the percentage of the country's population with the same ABO and Rh(D) blood group (in comparison with the four other versions). There was no significant effect on the blood type rarity.

Conclusion

Blood collection centers could orient the strategy employed to communicate with first‐time donors to improve donors' retention. Arousing a sense of social identification with others with the same blood type may reveal a promising avenue.

On consciousness of the decision to discontinue blood donation: Intention to return and effective recovery activities

OBJECTIVES

This study aims to (1) explore the consciousness of blood donors' decision to stop donating blood, (2) analyse the association with the donors' intention to return to blood donation and the various reasons for discontinuation, and (3) identify effective activities for the recovery of donors who are no longer donating blood.

MATERIALS/METHODS

Survey data of former German blood donors who did not donate blood for >36 months were collected (n = 1263). The data were analysed using multivariate linear regression and mediation analyses.

RESULTS

This study provides new insights into the consciousness of blood donors' decision to stop donating blood. Former blood donors may be located at distinct stages of consciousness about their decision of discontinuation. The results indicate that 44.9% of the former blood donors did not consciously decide to stop blood donation. Of the lapsed donors, 16.9% decided consciously and 18.2% were in between. Furthermore, 25.2% of the respondents who did not consciously decide to stop donating blood were willing to restart the same. The most effective activities for recovery are more flexible donation hours (29.1%), appointment-scheduling online (24.8%), and sending out reminders (18.1%).

CONCLUSION

Addressing unconsciously lapsed donors is promising. Blood donation service providers should implement measures that support busy people; such measures may include appointment scheduling or pause-options. The implementation of a systematic recovery management, entailing an analysis of the decision to discontinue blood donation with subsequent segmentation is advisable. This can help to foster individualised communication with blood donors.

Notifying donors when their deferral is ending: An effective donor retention strategy

BACKGROUND

The application of a temporary deferral often leads to donor lapse. Contributing factors may be donors not knowing when their deferral ends or not being contacted and asked to return. The aim of this study was to determine the effectiveness of a reminder message notifying donors that their deferral is coming to an end in increasing donors' postdeferral return rates. We evaluated the optimal time, content, and mode of delivery of the reminder message.

STUDY DESIGN AND METHODS

Two studies were conducted with deferred donors. Study 1: donors (n = 1676) were randomized to be sent a reminder message at one of three time points (4 weeks before, 1 week before, and 1 week after their deferral ended) or to a no contact control condition. Study 2: donors (n = 1973) were randomized to three message type conditions (emotive email, nonemotive email, nonemotive SMS). Attempted return behavior was extracted (appointments, attendances) at 1 month.

RESULTS

In Study 1, being sent the reminder message increased odds of donors attempting to return within 3 months compared with the control group (OR:2.01). Sending the reminder 1 week before the deferral ended was the most effective time point. In Study 2, the nonemotive message increased the odds of attempting to return compared with the emotive message (OR:1.38). No differences were found between email and SMS messages.

DISCUSSION

Sending a reminder message to donors when their deferral is coming to an end is a simple, effective, and cost-effective method to retain donors.

Exploring predictors of Australian community members' blood donation intentions and blood donation-related behavior during the COVID-19 pandemic

BACKGROUND

With the coronavirus disease 2019 (COVID-19) pandemic continuing to accelerate and blood collection agencies (BCAs) warning of shortages, it is critical to identify the current determinants of donor behavior for donors and nondonors.

STUDY DESIGN AND METHODS

In May and June 2020, Australian residents who believed themselves eligible to donate blood responded to measures assessing constructs from an integrated protection motivation theory, organizational trust, and theory of planned behavior framework, with donor status also assessed.

RESULTS

A total of 507 residents (47% male, mean age 28.69 years; 272 had donated/attempted to donate) participated. A revised structural equation model was a good fit to these data. In this model, perceived risk, severity, anxiety, and response cost associated with donating during the COVID-19 pandemic underpinned threat appraisals, while response efficacy, self-efficacy, and attitude toward donating during COVID-19 informed coping appraisals. Trust in the BCA predicted lower threat and higher coping appraisals, and higher coping appraisals predicted stronger subjective norms. Intention to donate during the COVID-19 pandemic was positively predicted by subjective norm and self-efficacy. Donation-related behavior was positively predicted by intention, with this relationship stronger for nondonors than donors.

CONCLUSION

Self-efficacy and approval from others, underpinned by coping appraisals and organizational trust, play a critical role in intentions to donate. BCAs that focus on maintaining trust with (potential) donors, providing clear messaging stating the minimal threat of contracting COVID-19 from donating and the protective measures in place, and showing how donating is achievable, may help to ensure a safe and secure blood supply throughout the COVID-19 pandemic.

Demographical Pattern of Blood Donors and Pre-Donation Deferral Causes in Dhahran, Saudi Arabia

Background

Understanding the demographic features of blood donors is important for identifying the donor structure and guiding the recruitment and retention strategies of donors. This study was aimed to determine the demographic characteristics of blood donors, the types of donation drives, and the frequency and reasons for pre-donation deferral in our population.

Methods

This cross-sectional study included data analysis of all prospective blood donors presenting themselves for donation at the Blood Bank of the King Fahad Military Medical Complex, Dhahran, Saudi Arabia between January 2010 and December 2018. Eligibility of blood donation was assessed using a standardized history questionnaire, physical examination, hemoglobin estimation, pulse rate, blood pressure, and temperature. The questionnaire included the demographic features of the donor such as age, gender, and the reason for donation and other specific risk factors that potentially affect the safety of the donor or the recipient. Data analyzed using the analysis of SPSS version 20 (SPSS Inc., Chicago, IL, USA) were used to calculate the unadjusted odds ratios (OR) and the respective 95% confidence interval for the association between the various demographic parameters.

Results

A total of 28,189 potential donations were recorded during the study period; of these, 77.4% were family replacements with females accounting for only 1.8% of all donations. Most of the donors were Saudi nationals (92.1%) of whom donors between 18 and 34 years old constituted 87.9%, while those over 40 years old represented only 7.9% of the donations. Pre-donation temporary deferral occurred in 3300 (11.7%) of all potential donation attempts. The most common causes being the recent intake of medication (24.4%) followed by low hemoglobin (14.8%), low or high blood pressure (14.6%), low or high pulse rate (13.6%), and low weight (11.6%).

Conclusion

A profile of blood donors consisting mainly of young male citizens who mostly donated for family replacement was detected. Deferral rate was found to be average when compared to other countries; the causes being similar to those detected in other developed countries. Simple descriptive statistics has shown no marked difference was noted over the 9 years of the study in neither the profile of blood donors nor the cause for temporary deferral of prospective blood donors.

Are different motivations and social capital score associated with return behaviour among Brazilian voluntary non-remunerated blood donors?

BACKGROUND

We examined the association between social capital score, motivator factors and demographic and donation characteristics and donor return at three Brazilian blood centres in Recife, São Paulo and Belo Horizonte.

MATERIAL AND METHODS

A total of 5974 donors were interviewed about motivation factors to donate and cognitive and structural social capital just before an effective donation in three Brazilians blood centres in 2009. We assessed the return to a new donation within 2 years for each of these donors. Demographic and donation characteristics, motivators and scores of social capital and their association with donors' return were assessed.

RESULTS

Overall, 3123 (52.3%) of the study subjects returned for a blood donation at least once. Predictors of donors' return were male gender (adjusted odds ratio [AOR] = 1.6, 1.3-1.9, for replacement and AOR = 1.3, 1.2-1.6, for community donors), previous donation (AOR = 2.7, 2.3-3.3, for replacement and AOR = 2.9, 2.5-3.5, for community donors) and high altruism (AOR = 1.3, 1.1-1.7, for replacement and AOR = 1.2, 1.0-1.5, for community donors). Altruism was the only motivator associated with return behaviour. Donors from Recife and São Paulo were more likely to return for replacement and/or for community donations than donors from Belo Horizonte. There was no association between social capital score and donor return behaviour.

CONCLUSION

The likelihood to return for a subsequent blood donation is dependent upon characteristics of individual donors and also varies in different regions of Brazil. However, social capital was not associated with the likelihood of return behaviour. A better understanding of altruistic categories and appeals may help to improve donor recruitment and retention.

Recruitment strategies: non-donor segmentation based on intrinsic and extrinsic stimuli

BACKGROUND AND OBJECTIVES

Non-donor behaviour can be influenced by many variables, both intrinsic and extrinsic, which differ among individuals. The aim of this study was therefore to segment Spanish non-donors based on criteria such as barriers and motivations, which influence the decision to donate for the first time, with the aim of improving the efficiency and effectiveness of recruitment actions.

MATERIALS AND METHODS

A total of 2383 non-donors residing in Spain evaluated 21 barriers and 25 motivations through an online self-administered survey distributed by blood transfusion centres, which are responsible for donations in Spain, and several Spanish universities. After validating these scales and determining the underlying categories in each of them, latent class/profile analysis was performed to segment non-donors.

RESULTS

Spanish non-donors were divided into six clusters. According to their barriers and motivations, the following labels were assigned: (1) 'Impure altruists', (2) 'I want to, but make it easy for me', (3) 'Free-riders', (4) 'Reciprocal altruists', (5) 'I can't because I'm scared' and (6) 'I want to, but I can't'. Specific marketing actions were proposed for each cluster based on their characteristics, prioritizing them depending on their attractiveness.

CONCLUSION

The scales which were designed to evaluate barriers and motivations make a solid contribution to the existing literature due to their holistic, integrative nature. The existence of differentiated clusters and the lack of resources of blood transfusion centres make it clear that there is a need to define and implement targeted marketing strategies.

Segmenting Active Blood Donors According to Their Barriers to Develop Retention Programs

Given the lack of a consensus on a catalogue of donation barriers, this study proposes a holistic scale of barriers which was used to segment Spanish active blood donors to define specific retention and loyalty strategies. A sample of 26 626 active donors from 14 of the 17 Spanish blood transfusion centers assessed a total of 25 barriers through an online survey. This scale was validated and 4 barrier categories were defined: Informative, Intrinsic, Time-space and Procedural. Segmentation was performed through k-means clustering. Four active donor clusters were created: (1) "Very Inhibited" (13.2%), who experienced a high number of barriers in all categories; (2) "Uninhibited" (46.9%), which was the largest cluster with fewer barriers; (3) "Apprehensive" (16.9%), whose most prevalent barriers were Informative and Intrinsic in nature; and (4) "Busy" (23.0%), who experienced mainly Time-space and Informative barriers. Afterward, depending on the size of the cluster, the presence of barriers, and the greater ease or difficulty to act on them, the attractiveness of each cluster was established to propose specific marketing actions.

Give blood today or save lives tomorrow: Matching decision and message construal level to maximize blood donation intentions

The research extends construal theory by testing if a match between the temporal construal framing of a blood donation decision and a blood donation request leads to higher donation intentions than a mismatch. Results show participants considering future donation who read an abstract donation request have significantly higher donation intentions than those who read a concrete request. Conversely, participants considering donating today who read a concrete donation request have significantly higher donation intentions than those who read an abstract request. This study confirms the importance of matching the construal framing of the communication to the temporal framing of the decision.

Effect of Repeated Whole Blood Donations on Aerobic Capacity and Hemoglobin Mass in Moderately Trained Male Subjects: A Randomized Controlled Trial

Background

The aims of the present study were to investigate the impact of three whole blood donations on endurance capacity and hematological parameters and to determine the duration to fully recover initial endurance capacity and hematological parameters after each donation.

Methods

Twenty-four moderately trained subjects were randomly divided in a donation (n = 16) and a placebo (n = 8) group. Each of the three donations was interspersed by 3 months, and the recovery of endurance capacity and hematological parameters was monitored up to 1 month after donation.

Results

Maximal power output, peak oxygen consumption, and hemoglobin mass decreased (p < 0.001) up to 4 weeks after a single blood donation with a maximal decrease of 4, 10, and 7%, respectively. Hematocrit, hemoglobin concentration, ferritin, and red blood cell count (RBC), all key hematological parameters for oxygen transport, were lowered by a single donation (p < 0.001) and cumulatively further affected by the repetition of the donations (p < 0.001). The maximal decrease after a blood donation was 11% for hematocrit, 10% for hemoglobin concentration, 50% for ferritin, and 12% for RBC (p < 0.001). Maximal power output cumulatively increased in the placebo group as the maximal exercise tests were repeated (p < 0.001), which indicates positive training adaptations. This increase in maximal power output over the whole duration of the study was not observed in the donation group.

Conclusions

Maximal, but not submaximal, endurance capacity was altered after blood donation in moderately trained people and the expected increase in capacity after multiple maximal exercise tests was not present when repeating whole blood donations.

Electronic supplementary material

The online version of this article (doi:10.1186/s40798-016-0067-7) contains supplementary material, which is available to authorized users.

Healthy donor effect and satisfaction with health: The role of selection effects related to blood donation behavior

The objective of this paper is to quantify selection effects related to blood donation behavior and their impact on donors' perceived health status. We rely on data from the 2009 and 2010 survey waves of the German socio-economic panel (N = 12,000), including information on health-related, demographic and psychographic factors as well as monetary donation behavior and volunteer work. We propose a propensity score matching approach to control for the healthy donor effect related to the health requirements for active blood donations. We estimate two separate models and quantify selection biases between (1) active and inactive blood donors and (2) active donors and non-donors. Our results reveal that active donors are more satisfied with their health status; after controlling for selection effects, however, the differences become non-significant, revealing selection biases of up to 82% compared with non-donors. These differences also exist between active and inactive donors, but the differences are less distinct. Our methodological approach reveals and quantifies selection biases attributable to the healthy donor effect. These biases are substantial enough to lead to erroneous statistical artifacts, implying that researchers should rigorously control for selection biases when comparing the health outcomes of different blood donor groups.

Translation into Portuguese and validation of the Blood Donation Reactions Inventory

Background

the Blood Donation Reactions Inventory (BDRI) scale was proposed as part of a study about the predictors of psychological reactions in volunteer blood donors, as uncomfortable reactions are associated with a lower probability to return for further donations.

Objective

to translate the Inventory into Brazilian Portuguese and evaluate its psychometric properties (validity and reliability). The inventory has 11 items, but the literature suggests that shorter inventories, of four or six items, should be used.

Methods

this study was carried out at the blood center of Franca, Brazil. Three people with knowledge of English and familiarity with medical terms translated the Blood. Donation Reactions Inventory into Brazilian Portuguese. Aiming to evaluate the objectivity and relevance of the items of the translated instrument, its content was independently evaluated by a panel of eight assessors. After this, data on 1,001 blood donors was collected. Internal consistency was assessed by Cronbach’s alpha coefficient. An exploratory factor analysis with varimax rotation was used to analyze the measure for construct validity.

Results

the sample consisted of 65.8% men, and 27.3% first time donors. Internal consistency determined by Cronbach’s alpha coefficient was satisfactory for the 11, 6 and 4-item scales. Considering the factor analysis, the 11-item scale seems to measure more than one construct as three factors were identified with eigenvalues greater than 1. These factors correspond to ‘vasovagal adverse reactions’, ‘fear’ ‘anxiety/excitation’.

Conclusion

the Portuguese version of the Blood Donation Reactions Inventory is a valid and reliable instrument for collecting information regarding systemic reactions experienced by blood donors. The 6-item scale seems to be useful when the objective is to measure only vasovagal adverse reactions.

© 2014 Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular. All rights reserved.

Intention of future donations: a study of donors versus non-donors

BACKGROUND

Recent years have seen the level of blood donation at a world level come to a standstill or even decline. This situation requires blood donation services to make efforts to increase donor recruitment and retention, as well as to increase the frequency of donations among current donors. In order to obtain good results, it is essential to understand the factors that affect intention to donate.

OBJECTIVES

To determine the explanatory power of a set of factors on intention to donate blood, as well as evaluating the ability of current donors to motivate others.

METHODS/MATERIALS

A questionnaire was administered to a sample of 1015 Spanish individuals.

RESULTS

Results indicate that (i) motivations and hindering factors have the greatest explanatory power on intention to donate, (ii) experience as a donor is the most explanatory factor on future intention and (iii) there are significant behavioural and sociodemographic differences between donors and non-donors.

CONCLUSION

These findings suggest that it is necessary (i) to enhance the donor retention for maintaining the donation system using a personal and frequent communication with donors not only to remind them to schedule their next donation, but also to attract more donors; (ii) to recapture temporarily deferred donors, as they are less reluctant towards donation; (iii) to describe in detail how donation affects donors and clarify the importance of donation for society and (iv) to develop member get member programs in which current donors act as motivators amongst friends, coworkers and family.

Evaluation of the return rate of volunteer blood donors

Background

To convert first-time blood donors into regular volunteer donors is a challenge to transfusion services.

Objectives

This study aims to estimate the return rate of first time donors of the Ribeirão Preto Blood Center and of other blood centers in its coverage region.

Methods

The histories of 115,553 volunteer donors between 1996 and 2005 were analyzed. Statistical analysis was based on a parametric long-term survival model that allows an estimation of the proportion of donors who never return for further donations.

Results

Only 40% of individuals return within one year after the first donation and 53% return within two years. It is estimated that 30% never return to donate. Higher return rates were observed among Black donors. No significant difference was found in non-return rates regarding gender, blood type, Rh blood group and blood collection unit.

Conclusions

The low percentage of first-time donors who return for further blood donation reinforces the need for marketing actions and strategies aimed at increasing the return rates.

Achieving donor repetition and motivation by block leaders among current blood donors

This paper presents an explicative model on the recommendation of donating blood made to relatives and friends by current donors. This model establishes satisfaction and intention to return as direct antecedents, and the quality perceived in the donation process and the existence of inhibitors as indirect antecedents. The results show that (1) the perceived quality has a positive influence on satisfaction and intention to return; (2) the intention to donate again depends positively on satisfaction, but negatively on the existence of internal and external inhibitors; and lastly (3) the recommendation to donate depends on donor satisfaction and their intention to return to donate, this being the most influential factor. At the same time, we contrasted how the model does not vary, whether it is a first-time donor or a repeat donor.

A comparison of self-reported and record-linked blood donation history in an Australian cohort

BACKGROUND

Questionnaire-based studies investigating blood donation history rely on the accurate recall of information from participants for results to be valid. This study aimed to retrieve electronic records from a national blood donation service and link them to self-reported history of donation to assess agreement between the two sources.

STUDY DESIGN AND METHODS

Between 2004 and 2006, a sample of participants of northern European descent was selected from the Melbourne Collaborative Cohort Study (n = 31,192) to participate in the "HealthIron" study (n = 1438). A total of 1052 participants completed questionnaires that included questions about blood donation history. In 2009, consenting participants' records were linked to the Australian Red Cross Blood Service (ARCBS) to provide information on blood donations made between 1980 and follow-up (2004-2006). Those who commenced blood donation before 1980 were excluded.

RESULTS

A total of 718 participants were available for analysis. Of these, 394 (55%) provided signed consent, including 182 (82%) of the 227 participants who self-reported ever donating blood. The two data sources were concordant for 331 (87%) of participants, with a κ statistic of 0.74 (SE, 0.05) indicating a high level of agreement. Participants tended to overstate by a factor of 2.0 (95% confidence interval, 1.7-2.2) the number of donations they had made when compared with ARCBS records.

CONCLUSION

Participants in studies assessing self-reported blood donation history are likely to correctly indicate whether or not they have ever donated blood. Quantitative estimates are potentially inaccurate and could benefit from validating a sample of records to quantify the bias.