How Can We Improve Retention of the First-Time Donor? A Systematic Review of the Current Evidence

A rapid review of motives and barriers for living substance of human origin donation and an extended typology

Our objective is to review motives and barriers for non-reproductive, living substance of human origin (SoHO) donation, and to extend existing typologies beyond blood. The expansion of SoHO collection is currently unmatched by increased living donors. Thus, there is a critical need to understand how to effectively recruit and retain donors to ensure a sustainable supply of SoHO. We undertook a rapid review and narrative synthesis of published, peer-reviewed literature reporting on motives and/or barriers for living SoHO donation (whole-blood, blood products [2009-2023], bone marrow/stem cells, cord blood, organ, human breast milk, intestinal microbiota [2000-2023]). Results were interpreted through directed qualitative content analysis using an extended typology of motives/barriers largely drawn from blood donation research, and subsequently refined based on results to be inclusive of other SoHO. 234 articles with 237 studies met review criteria. Most were quantitative (74.3%), conducted in Western countries (63.8%), focused on blood donation (64.2%), reported motives and barriers (51.9%) and did not examine differences by donor characteristics or history (74%). We present a revised typology inclusive of motives/barriers for donation of substances beyond blood. This shows while broader motives and barriers are shared across substances donated, there are critical differences at the subcategory level that may account for heterogeneity in results of prior interventions. The nuances in how broad categories of motives and barriers manifest across different SoHO are critical for blood collection agencies to consider as they attempt to expand collection of products beyond whole-blood, plasma, and platelets. WHAT IS KNOWN ABOUT THE TOPIC?: Blood collection agencies (BCAs) continue to expand SoHO product collection beyond whole-blood, plasma, and platelets. The demand for SoHO is currently unmatched by increased living donors. The need to understand how to recruit new and retain existing living donors to ensure a sustainable supply of SoHO remains critical. However, there is no available synthesis of the factors, such as motives/facilitators and barriers/deterrents, to inform our understanding. WHAT IS NEW?: Comprehensively reviewed evidence for motives and barriers of willing/actual donors and nondonors across all types of non-reproductive living SoHO donation. Explored variations in motives and barriers based on substance, donor history and demographic differences (gender, age, ethnicity or culture). Extended typology of motives and barriers inclusive of all non-reproductive living SoHO, beyond solely whole-blood and blood products. Identified that while there are commonalities in the overarching motive and barrier categories across substances (e.g., prosocial motivation, low self-efficacy), within these broader constructs there are differences at the subcategory level (e.g., low-self efficacy was about eligibility, lifestyle barriers, or lack/loss of financial or material resources depending on the substance donated) that are crucial for development of future interventions and for BCAs to consider as they expand SoHO product collection. Highlighted the continued focus on motives and barriers for whole-blood and blood product donation to the exclusion of other, particularly newer, SoHO; lack of qualitative work for newer SoHO; and lack of consideration of differences based on donor characteristics (especially ethnicity/culture) and donor history, which limits our understanding. WHAT ARE THE KEY QUESTIONS FOR FUTURE WORK ON THE TOPIC?: What are the motives and barriers (in both qualitative and quantitative studies) for donation of newer SoHO such as stem cells, cord blood, human milk, and intestinal microbiota? Are there differences in motives and barriers within and across SoHO that are informed by individual and contextual-level factors? How can we develop interventions that respond to the nuances of motives and barriers present across different forms of SoHO that are effective in encouraging new and maintaining continuing donors?

The effectiveness of telephone surveys on the return of first-time donors: A randomized controlled trial

BACKGROUND

The management of blood supply depends, among other factors, on the effective remobilization of first-time donors (FTDs). This study investigates the efficacy of telephone calls to increase second donation rates.

STUDY DESIGN AND METHODS

A randomized controlled trial was conducted on 418 first-time blood donors. In the telephone group (TG, n = 206), men were contacted 9-10 and women 13-14 weeks after their first donation. They were asked about satisfaction and intention to return, and offered an appointment. The primary outcome was the return rate within 6 months after the first donation.

RESULTS

The mean age was 28.8 ± 10.0 years and 59.9% of FTDs were female. In the TG, 89.3% were reached. Approximately 50% of each group had donated a second time by 24.2 weeks for the control group (CG) and 14.8 weeks for the TG. The six-month return rate was 65.0% in the TG and 54.3% in the CG (95%-CI [0.9%; 20.6%]; p = .033). The restricted mean time to return within 6 months was 19.4 weeks in the CG compared to 17.2 weeks in the TG (95%-CI [0.7; 3.7]; p = .004). The intervention effect tended to be larger in men than in women.

DISCUSSION

Contacting FTDs by phone after their first donation increases the six-month return rate and reduces the interval to a second donation. Male donors appear to be more receptive to this intervention. Whether the effect of the intervention helps to establish a donor identity in the long term should be the subject of further studies.

The efficacy and effectiveness of drinking interventions to reduce vasovagal reactions in blood donors: A systematic review and meta-analysis

BACKGROUND AND OBJECTIVES

Blood establishments strive to ensure the safety and comfort of blood donors while minimizing adverse events. This review aims to assess the efficacy and effectiveness of eating and/or drinking interventions before, during and/or after blood donation in reducing vasovagal reactions (VVRs).

MATERIALS AND METHODS

We analysed randomized and non-randomized controlled trials comparing eating and/or drinking interventions to no intervention, placebo or usual practice on (pre-)syncopal VVRs and related symptoms. The GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach was used to assess the risk of bias and overall certainty of the evidence.

RESULTS

Pre-donation water ingestion likely results in reduced on-site VVRs, compared to no water (2 fewer per 100 donors, moderate-certainty evidence). A pre-donation isotonic drink likely results in reduced VVRs, compared to usual practice (2 fewer per 100 donors, moderate-certainty evidence). Pre-donation salt-loaded sweetened lemon water may result in fewer off-site VVRs, compared to sweetened lemon water only (1 fewer per 100 donors, low-certainty evidence). Pre-donation water and a gel cap containing sucrose with 250 mg caffeine may result in fewer blood donor reaction ratings, compared to pre-donation water only (low-certainty evidence).

CONCLUSIONS

Pre-donation plain water ingestion or isotonic drink probably results in a large reduction in on-site and off-site VVRs. Pre-donation water ingestion with caffeine consumption or salt supplementation may result in a VVR reduction, compared to water ingestion only. Future large trials are required to increase the certainty of the effect of these and other interventions in the prevention of VVRs.

Gamification Approach to Provide Support About the Deferral Experience in Blood Donation: Design and Feasibility Study

BACKGROUND

Multiple studies have examined the impact of deferral on the motivation of prospective blood donors, proposing various policies and strategies to support individuals who undergo this experience. However, existing information and communications technology systems focused on blood donation have not yet integrated these ideas or provided options to assist with the deferral experience.

OBJECTIVE

This study aims to propose an initial gamified design aimed at mitigating the impact of the deferral experience by addressing the drivers of awareness and knowledge, interaction and validation, and motivation. Additionally, the study explores the feasibility of implementing such a system for potential users.

METHODS

We conducted a literature review focusing on the dynamics of motivation and intention related to blood donation, as well as the deferral situation and its impact on citizens. Through this review, we identified weak donor identity, lack of knowledge, and reduced motivation as key factors requiring support from appropriate interventions. These factors were then defined as our key drivers. Taking these into account, we proposed a gamification approach that incorporates concepts from the MDA framework. The aim is to stimulate the aforementioned drivers and expand the concept of contribution and identity in blood donation. For a preliminary evaluation, we designed a prototype to collect feedback on usability, usefulness, and interest regarding a potential implementation of our proposed gamification approach.

RESULTS

Among the participants, a total of 11 citizens interacted with the app and provided feedback through our survey. They indicated that interacting with the app was relatively easy, with an average score of 4.13 out of 5 when considering the 11 tasks of interaction. The SUS results yielded a final average score of 70.91 from the participants' answers. Positive responses were received when participants were asked about liking the concept of the app (3.82), being likely to download it (3.55), and being likely to recommend it to others (3.64). Participants expressed positivity about the implementation of the design but also highlighted current shortcomings and suggested possible improvements in both functionality and usability.

CONCLUSIONS

Although deferral is a common issue in blood donation, there is a missed opportunity in existing ICT services regarding how to effectively handle such experiences. Our proposed design and implementation seem to have captured the interest of prospective users due to its perceived positive usefulness and potential. However, further confirmation is needed. Improving the design of activities that currently rely heavily on extrinsic motivation elements and integrating more social components to create an enhanced activity loop for intrinsic motivation could further increase the value of the proposed project. Future research could involve conducting a more specialized and longitudinal design evaluation with a larger sample size.

A virtual reality paradigm simulating blood donation serves as a platform to test interventions to promote donation

Effective interventions that support blood donor retention are needed. Yet, integrating an intervention into the time-pressed and operationally sensitive context of a blood donation center requires justification for disruptions to an optimized process. This research provides evidence that virtual reality (VR) paradigms can serve as a research environment in which interventions can be tested prior to being delivered in blood donation centers. Study 1 (N = 48) demonstrated that 360°-video VR blood donation environments elicit a similar profile of emotional experience to a live donor center. Presence and immersion were high, and cybersickness symptoms low. Study 2 (N = 134) was an experiment deploying the 360°-video VR environments to test the impact of an intervention on emotional experience and intentions to donate. Participants in the intervention condition who engaged in a suite of tasks drawn from the process model of emotion regulation (including attentional deployment, positive reappraisal, and response modulation) reported more positive emotion than participants in a control condition, which in turn increased intentions to donate blood. By showing the promise for benefitting donor experience via a relatively low-cost and low-resource methodology, this research supports the use of VR paradigms to trial interventions prior to deployment in operationally-context field settings.

Sociodemographic Profile of Blood Donations and Ways to Encourage Them

INTRODUCTION

Maintaining blood stocks in Brazil faces challenges; hence, it is crucial to develop effective strategies to recruit and retain donors, such as campaigns and social marketing programs to raise awareness, but there is a lack of studies about the donators' profiles, as well as their barriers or incentives.

OBJECTIVE

The objective of this study was to analyze the characteristics of donors and the factors that influence their decisions.

METHODS

This was a cross-sectional study carried out between April and November 2022 using a structured questionnaire sent through a community created on Facebook, addressing common people over 18 years old, containing closed questions, supported by Google Forms. Statistical analyses were carried out using IBM SPSS Statistics for Windows, Version 17 (Released 2008; IBM Corp., Armonk, New York, United States) and the Chi-square and Fisher's exact tests, with p < 0.05.

RESULTS

The sample relied on 1019 participants, women (72.8%), age group > 30 years (81.1%), the most represented blood type was O positive (37.5%), and men donated more frequently than women (76.5% vs. 40.6%). The main reasons for not donating are medical conditions (39.7%) and lack of time (33.8%). The main reasons for donating are helping voluntarily (97.6%) and donating to family/friends (96.4%).

CONCLUSION

There was a significant difference between the genders of blood donors, with more men donating, especially those over 30 years old, and with income between 1-8 minimum wages. The main barriers to donating are lack of time and information. Based on this, it is possible to target campaigns at women, young people, and people with income above nine minimum wages. The main reasons for donating are altruism, obtaining test results, and financial benefits.

A novel multiplex real-time PCR assay for the detection of cytomegalovirus, Epstein-Barr virus, herpes simplex virus 1/2 and strategies for application to blood screening

A multiplex real-time PCR has been developed to simultaneously detect transfusion-transmissible pathogens cytomegalovirus, Epstein-Barr virus and herpes simplex virus, as well as to provide sample quality testing, for the conserved regions of the cytomegalovirus UL123 gene, the Epstein-Barr virus BKRF1 gene, and the herpes simplex virus 1/2 UL30 gene, tested on 500 blood donors and 320 transfusion recipients. The laboratory sensitivities for all 3 pathogens were 100 copies/μL. Compared to the commercial real-time PCR reference kit, the multiplex real-time PCR assay for the detection of CMV, EBV and HSV presented 100% consistency. In 820 whole blood samples, the multiplex real-time PCR assay identified 34 (4.15%) positive for CMV DNA, 15 (1.83%) positive for EBV DNA, and 6 (0.73%) positive for HSV DNA. For blood transfusions in high-risk groups, whole blood herpes virus test should be included in the spectrum of pathogen testing for blood donors and recipients.

The Polish adaptation of the blood donation fears inventory

BACKGROUND AND OBJECTIVES

Given the decline in the number of voluntary blood donors in Poland and the lack of psychological research on blood donors and the donation system in the country, there is a need to develop a tool to measure barriers to recruiting new donors and retaining active donors. One significant barrier is the presence of specific fears associated with the blood donation process. Therefore, the main objective of this study was to perform the Polish adaptation of the Blood Donation Fears Inventory (the BDFI).

MATERIALS AND METHODS

The Polish adaptation of the BDFI was developed and tested on a sample of 409 individuals, consisting of 194 (47.5%) voluntary blood donors and 214 (52.5%) non-donors. The original tool comprises an 18-item scale that measures four different types of fears related to the blood donation process: (1) Fear of Syncopal Symptoms, (2) Fear of Blood and Needles, (3) Fear of Social Evaluation, and (4) Fear of Health Screen Results.

RESULTS

To determine the psychometric properties of the scale, exploratory factor analysis, confirmatory factor analysis (RMSEA =.098; CFI =.958; TLI =.935; SRMR =.035), second-order factor analysis (RMSEA =.097; CFI =.958; TLI =.936; SRMR =.036; NNFI =.936; NFI =.938), and bifactor analysis (RMSEA =.093; CFI =.969; TLI =.942; SRMR =.036; NNFI =.942; NFI =.952) were conducted. The reliability of the tool was assessed using Cronbach's Alpha and McDonald's Omega, resulting in high coefficients (ranging from.92 to.97) for each scale. Internal consistency was examined using the State-Trait Anxiety Inventory (STAI), while external consistency was examined using the Scale of Positive and Negative Experience (SPANE) and the Self-esteem Scale (SES).

CONCLUSION

Satisfactory results were obtained, establishing the Polish adaptation of the BDFI. This tool represents a novel contribution to the research on the blood donation system in Poland.

Factors Influencing Blood Donation Practice Among Health Care Providers of Public Hospitals in Bahir Dar City, North West Ethiopia: A Case Control Study

Background

Blood donation is a technique in which blood is collected from a healthy individual for transfusion to someone else. WHO estimates that it is necessary to donate blood to 2% to 3% of the country's population to meet blood needs. However, blood donation remains challenging in developing countries.

Objective

This study aimed to identify factors influencing blood donation practices among healthcare providers in public hospitals in Bahir Dar City.

Methods

This institution-based unmatched case-control study was conducted in Bahir Dar City Public Hospitals from May 01 to May 25, 2022. Total sample size was 491 (123 cases and 368 controls) and then the study subject was selected by using simple random sampling technic and collect data through self-administered questionnaire. Bi-variable and multi-variable binary logistic regression analyses were used to determine the association between dependent and independent variables. Finally, the results are presented in charts and tables, and the AOR and CI are reported. Statistical significance was set at P < 0.05.

Results

Fear of anemia (adjusted odds ratio (AOR): 0.02; 95% CI 0.007-0.078), lack of opportunity (AOR: 0.42; 95% CI 0.22-0.83), lack of time (AOR: 0.03; 95% CI, 0.005-0.199), profession (AOR: 0.15; 95% CI, 0.05-0.42), aware of free medical checkup (AOR: 31.79; 95% CI 13.13-76.94), willingness to donate blood (AOR: 5.09; 95% CI 2.25-11.50), blood group type (AOR: 5.67; 95% CI 1.42-22.68), and higher work experience (AOR: 7.99; 95% CI 2.59-24.67) were found to be significantly associated with blood donation practice.

Conclusion

This study revealed that multiple factors influenced the practice of blood donation among healthcare providers. Therefore, access to blood donation areas and emphasizing the importance of donor blood donation are important for facilitating blood donation.

Demographics of first-time donors returning for donation during the pandemic: COVID-19 convalescent plasma versus standard blood product donors

BACKGROUND

Previous studies have demonstrated low first-time donor return rates (DRR) following catastrophic events. Little is known, however, about the influence of demographic factors on the DRR of first-time donors during the COVID-19 pandemic, including the unique motivation of COVID-19 convalescent plasma (CCP) donors as compared to non-CCP donors.

STUDY DESIGN AND METHODS

Thirteen blood collection organizations submitted deidentified data from first-time CCP and non-CCP donors returning for regular (non-CCP) donations during the pandemic. DRR was calculated as frequencies. Demographic factors associated with returning donors: race/ethnicity, gender, and generation (Gen Z: 19-24, Millennial: 25-40, Gen X: 41-56, and Boomer: ≥57 years old), within the CCP and non-CCP first-time cohorts were compared using chi-square test at p < .05 statistical significance.

RESULTS

From March 2020 through December 2021, there were a total of 44,274 first-time CCP and 980,201 first-time non-CCP donors. DRR were 14.6% (range 11.9%-43.3%) and 46.6% (range 10.0%-76.9%) for CCP and non-CCP cohorts, respectively. Age over 40 years (Gen X and Boomers), female gender, and White race were each associated with higher return in both donor cohorts (p < .001). For the non-CCP return donor cohort, the Millennial and Boomers were comparable.

CONCLUSION

The findings demonstrate differences in returning donor trends between the two donor cohorts. The motivation of a first-time CCP donor may be different than that of a non-CCP donor. Further study to improve first-time donor engagement would be worthwhile to expand the donor base with a focus on blood donor diversity emphasizing engagement of underrepresented minorities and younger donors.

Prosocial behavior in emergencies: Evidence from blood donors recruitment and retention during the COVID-19 pandemic

The impact of COVID-19 represents a specific challenge for voluntary transfusional systems sustained by the intrinsic motivations of blood donors. In general, health emergencies can stimulate altruistic behaviors. However, in this context, the same prosocial motivations, besides the personal health risks, could foster the adherence to social distancing rules to preserve collective health and, therefore, discourage blood donation activities. In this work, we investigate the consequences of the pandemic shock on the dynamics of new donors exploiting the individual-level longitudinal information contained in administrative data on the Italian region of Tuscany. We compare the change in new donors' recruitment and retention during 2020 with respect to the 2017-2019 period (we observe 9511 individuals), considering donors' and their municipalities of residence characteristics. Our results show an increment of new donors, with higher proportional growth for older donors. Moreover, we demonstrate that the quality of new donors, as proxied by the frequency of subsequent donations, increased with respect to previous years. Finally, we show that changes in extrinsic motivations, such as the possibility of obtaining a free antibody test or overcoming movement restrictions, cannot explain the documented increase in the number of new donors and in their performance. Therefore, our analyses indicate that the Tuscan voluntary blood donation system was effective in dealing with the challenges posed by the COVID-19 pandemic.

Promoting blood donation through social media: Evidence from Brazil, India and the USA

Social media has the potential to encourage prosocial behaviors at scale, yet very little causal evidence exists on the impact of related efforts. Blood donation is a particularly difficult, but essential prosocial behavior that is often critically undersupplied. We examine the effect of Facebook's blood donation tool on voluntary blood donation. We partnered with four major blood banks in the United States covering 363 collection facilities in 46 states and Washington, D.C. We tracked the tool's impact on blood donations during its staggered rollout on a sample of more than 47,000 facility-date observations from March 2019 to September 2019. The tool caused an increase of 0.55 total donations per facility per day (+4.0% [95% CI: 0.04%-8.0%]), and an increase of 0.15 donations from first-time donors per facility per day (+18.9% [95% CI: 4.7%-33.1%]). Longitudinal evidence from Brazil and India suggests the share of donors who both received a message from the tool and stated they were influenced by Facebook to donate increased from 0% to 14.1% [95% CI: 12.1%-16.2%] in the first year of the tool's deployment (i.e., September 2018 to August 2019). These meaningful increases, especially from first-time donors, demonstrate that social media platforms can play an important role in fostering offline prosocial behaviors that benefit the health and well-being of societies around the world.

A typology of strategies that recognize, reward, and incentivize blood donation

BACKGROUND

Blood collection agencies (BCAs) worldwide are continuously looking to improve recognition, reward, and incentive (RRI) policies to optimize the recruitment and retention of blood donors. However, given the inconsistent categorization and variety of strategies available, there is a need for a theoretically informed and empirically supported framework to guide RRI research and policy development.

STUDY DESIGN AND METHODS

Survey data from 1028 voluntary nonremunerated whole blood and plasma donors in Australia was used to validate a theorized RRI typology based on distinctions between the level of congruency with the act of donating blood (congruent vs. incongruent), visibility of acknowledgment (public vs. private), benefits provided (self vs. other), and likely reinforcement schedule (fixed vs. variable).

RESULTS

A six-factor solution met all statistical criteria and was most consistent with a priori theoretical underpinnings. The factors were labeled (i) deal promotion, (ii) loyalty program, (iii) BCA token, (iv) health check, (v) charity donation, and (vi) travel compensation.

DISCUSSION

This typology provides researchers with a standardized theoretical and conceptual framework to organize and synthesize findings from the existing literature and help BCAs develop RRI policies that are likely to be successful. We present a future research agenda across and within the RRI strategies.

The effect of temporary deferrals on donor return: A 26-year assessment in a setting without retention activities

BACKGROUND

Previous studies that describe the negative association between temporary deferrals and donor return rates commonly come from settings where mechanisms are in place to win back lapsing donors. There is little evidence on the size and prevalence of this negative association in settings with no such retention activities.

STUDY DESIGN AND METHODS

We use data from more than 2 million donation attempts made at a blood collection agency in Brazil over a 26-year period. We describe the distribution of deferrals across donor demographic and behavioral characteristics, and estimate multivariate survival analysis models with matched samples to measure the impact of deferrals on return rates. We control for sex, race, age, education, donation type, number of previous attempts, previous donations, and previous deferrals. We test for heterogeneous effects in interaction models with selected donor demographic and behavioral characteristics.

RESULTS

Temporary deferrals were associated with a 50% decrease in the likelihood of return. Although the effect was observed for all population subgroups and across the full length of the dataset, it varied in magnitude. The influence of deferrals was more negative among older donors and those reporting replacement motives, and less negative among more educated donors and those with a previous donation.

DISCUSSION

We found that temporary deferrals meaningfully harm donor careers in a setting where specific retention activities are absent. Although the effects are widespread across the population and persistent in time, there are also heterogeneities, which must be considered when designing interventions targeted at wining-back specific groups of deferred donors.

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.

Nucleic acid testing identifies high prevalence of blood borne viruses among approved blood donors in Mozambique

Background

Although blood transfusion is an intervention that saves lives, it poses significant risks to the blood receivers, including the transmission of bloodborne pathogens. We aimed at determining the prevalence of Human Immunodeficiency Virus (HIV), Hepatitis B virus (HBV), and Hepatitis C virus (HCV) in candidates approved for blood donation, and in samples considered to be negative in reference blood banks in Mozambique.

Methods

A cross-sectional study was performed between November 2014 and October 2015 in Maputo and Beira cities. Demographic information was obtained from all consenting blood donors using a structured questionnaire. Plasma samples were screened for HIVAb/Ag combinations, HBsAg and Anti-HCV. Blood donors considered to be negative by serological testing were re-tested in pools of six plasma samples using nucleic acid testing (NAT).

Results

Most blood donors were male 2,320 (83.4%) with an age range of 18 to 34 years. The overall seroprevalence of HIV, HBV and HCV infections among blood donors approved for donation was 4.6% (127; 95% CI 3.8–5.4), 4.5% (124; 95% CI 3.7–5.3) and 0.4% (11; 95% CI 0.2–0.7), respectively. The overall frequency by NAT of HIV RNA, HBV DNA, and HCV RNA in serologically negative blood donor samples was 2.6 per 1000 blood donors (7; 95% CI 1.1–5.4); 12.5 per 1000 blood donors (33; 95% CI 8.6–17.5) and 2.6 per 1000 blood donors (6; 95% CI 1.0–5.7), respectively.

Conclusion

Our results show high seroprevalence of HIV and HBV infections in blood donors approved for donation, and high frequency of molecular biomarkers of HIV, HBV, and HCV in blood considered to be safe. These results suggest the need for a new blood screening policy in Mozambique, including the use of NAT to detect infectious blood donations during the immunologically negative window.

Blood Donation Fear, Perceived Rewards, Self-Efficacy, and Intention to Return Among Whole Blood Donors in China: A Social Cognitive Perspective

With the increasing demand from aging population and seasonal blood shortage, recruiting and retaining blood donors has become an urgent issue for the blood collection centers in China. This study aims to understand intention to donate again from a social cognitive perspective among whole blood donors in China through investigating the association between the blood donation fear, perceived rewards, self-efficacy, and intention to return. A cross-sectional survey was conducted in six cities, which are geographically and socioeconomically distinct areas in Jiangsu, China. Respondents completed a self-administrated questionnaire interviewed by two well-trained medical students. A total of 191 blood donors were included in the current study. Descriptive analysis, correlation analysis, and a generalized linear regression model were used to explore the association between demographic characteristics, psychological factors, and intention to donate again. After controlling other covariates, donors with higher fear scores reported lower intention to return (p = 0.008). Association between self-efficacy and intention to return was statistically significant (p < 0.001), whereas the association between intrinsic rewards (p = 0.387), extrinsic rewards (p = 0.939), and intention to return were statistically insignificant. This study found that either intrinsic rewards or extrinsic rewards are not significantly associated with intention to donate again among whole blood donors in China, and fear is negatively associated with intention to donate again. Therefore, purposive strategies could be enacted beyond appeals to rewards and focus on the management of donors’ fear.

Motivation, blood donor satisfaction and intention to return during the COVID-19 pandemic

Background and Objectives

This study aimed to describe motives as well as donation experiences and the intention to return for further donations of German whole blood donors who donated at the beginning of the COVID‐19 pandemic.

Materials and Methods

To describe motives and donor experiences, a retrospective survey was conducted among whole blood donors that had a donation appointment at the German Red Cross Blood Donation Service in the first 4 weeks of the pandemic. A donor questionnaire including 17 retrospective questions was sent to 7500 donors. Donor motivation and donor experiences were compared for different donor groups using chi‐square statistics. Finally, in an ordinal logistic regression model predictors for the intention to return were identified.

Results

More than half of the participating donors (56.9%) wanted to contribute to the fight against the pandemic by donating blood. Most of the donors were satisfied with their last donation experience and felt safe during the blood donor appointment. However, some donors would have liked more information on how to deal with the pandemic (20.3%). Intention to return for further donations was strongly associated with overall satisfaction (OR: 1.67, CI: 1.47–1.90) and the feeling of being safe during blood donation (OR: 1.33, CI: 1.05–1.68).

Conclusion

Donor satisfaction with the last donation was high and the vast majority of donors felt very safe. However, those donors who felt unsafe expressed a low intention to return and blood donation services should therefore carefully monitor donor satisfaction.

Autonomic, endocrine, and psychological stress responses to different forms of blood draw

Background

Although fingerstick is often favorably compared to venipuncture as a less invasive method of drawing blood for clinical labs, there is little empirical research that compares physical and psychological stress responses to fingerstick vs. venipuncture (blood draw using a needle in the arm) within the same person.

Methods and findings

We assessed changes in cortisol (a stress hormone), heart rate variability (a marker of autonomic stress), and psychological stress in 40 healthy women who completed both venipuncture and fingerstick. Contrary to our predictions, there was a significant decline in cortisol across conditions, with greater decline from pre- to post-draw in response to venipuncture than fingerstick. There were similar patterns of rise and fall in heart rate variability in both types of blood draw, suggestive of mild vasovagal responses. Psychological measures of stress (such as negative emotion and perceived stress) were generally stronger predictors of participant’s reported pain and blood draw preferences than physical stress measures.

Conclusions

These findings challenge the characterization of fingerstick as necessarily “less invasive” than venipuncture, as participant’s stress responses to fingerstick were equivalent to (and for some measures greater than) their response to venipuncture. Heart rate variability response to fingerstick significantly predicted that individual’s vasovagal-like responses to venipuncture, suggesting that measuring heart rate variability during pre-donation hemoglobin testing may identify donors at risk for adverse events during venipuncture.

An intervention study for the prevention of vasovagal reactions and evaluating donors' experience: Analysis of donors' return for subsequent donation

BACKGROUND AND OBJECTIVES

The EPISoDe (Experience Success in Donation) study investigated the effect of interventions on self-reported vasovagal reactions (VVRs) in first-time and novice (second to fourth donation) whole blood donors aged ≤30 years, demonstrating a 23% reduction of VVR from water drinking shortly before donation in the novice donors. Because donation experience and complications affect donor retention, we analysed intervention group donors' return for subsequent donation, a predefined secondary outcome.

MATERIALS AND METHODS

The interventions were as follows: 330 ml water, 500 ml water, ball squeezing before phlebotomy (placebo) and a control group. All donors received an online questionnaire about their experience within a week after donation. In the Netherlands, eligible donors are invited at least yearly depending on hospitals' needs. We analysed attendances within 421 days through return percentages and binomial logistic regression.

RESULTS

Of the 8300 EPISoDe participants, 6538 (78.8%) returned within 421 days. Return did not differ between the two water groups, whereas odds for return were significantly higher in both water and placebo intervention donors compared to the control group (odds ratio [OR] 1.14, 95% confidence interval [CI] 1.00-1.29 and 1.22, 1.05-1.43, respectively) after adjustment for occurrence of VVR, unsuccessful collection, gender and donation history. Staff-recorded or self-reported VVR at index donation was associated with reduced odds for return (OR 0.47, 95% CI 0.37-0.60 and OR 0.53, 95% CI 0.46-0.61, respectively).

CONCLUSION

In this cohort of younger inexperienced blood donors, 78.8% returned for subsequent donation. Donors who received an active study intervention, either water or placebo, were more likely to return than control group donors.

Knowledge Level, Motivators and Barriers of Blood Donation among Students at Qatar University

In Qatar, one out of every ten patients admitted to the hospitals is in urgent need of a blood transfusion or blood products. The aims of this study are as follows: (1) to assess the level of awareness and knowledge about blood donation and (2) to identify the factors that contribute to the willingness to donate blood among young adults. A cross-sectional survey using a constructed questionnaire was conducted among students at Qatar University. A total of 590 responses were collected, out of which 423 were suitable for analysis. Only 72 out of 472 (15%) participants were blood donors. The chi-square test and t-test were then used to study the association of blood donation status with different factors. Significant values were considered to be p ≤ 0.5. Gender and age were found to be significantly associated with blood donation status, with a higher frequency of donation among males and adults above the age of 24 years old. On the other hand, the total knowledge score was found to not be significantly associated with blood donation status with a mean score of 60.5% for both groups (blood donors, non-blood donors). The most common motivators that encouraged blood donors were donating to help people, followed by having a blood mobile unit come to your place, whereas the most common barriers reported by non-blood donors were failing to meet the requirements, followed by "never having been asked to give blood". This is the first study in Qatar to assess blood donation status. It provides insights that would help in developing effective strategies for the recruitment and retention of young adult blood donors in Qatar and countries with similar cultures. Raising awareness about blood donation, along with providing more mobile blood donation units at public places, will aid in increasing the frequency of blood donation among young adults.

Analysis of Influencing Factors of College Students’ Intention to Repeated Blood Donation Based on Structural Equation Modeling

To research the influencing factors of college students' blood donation behavior intention and propose intervention strategies to improve the repeated blood donation rate of college students. Questionnaire survey was used to research and analyze the influencing factors of behavior intention. Amos 21.0 software was used to establish structural equation modeling and perform confirmatory factor analysis. SPSS 20.0 was used for statistic. The model was proved with highly adaptability, with χ2/df = 2.956 < 3. Factors influencing college students' intention of repeat blood donation behavior can be summarized into four: attitude, external motivation, advice-taking, and perceived behavioral control. Among them, attitude and perceived behavioral control have a great direct impact on behavioral intention, while the external motivation and recommendation acceptance have an indirect impact by influencing the other two factors. In view of those evaluation items with high path coefficient in each factor, we can develop recruitment strategies to influence college students’ repeated blood donation behavior and provide scientific suggestions for improving their repeated blood donation rate.

The vasovagal reaction experience among blood donors: A qualitative study of factors that affect donor return

RATIONALE

Blood collection agencies face ongoing challenges in retaining voluntary donors to meet the demand for blood and blood-related products by healthcare services. A known deterrent to continued blood donation is the experience of a vasovagal reaction (VVR). However, there has been little research into donors' experiences of these reactions and the factors that influence their decision to return, which is essential information to inform strategies to improve donor return.

OBJECTIVE

The aim of this paper was to explore blood donor views and experiences of a VVR, with a particular interest in how the reaction influenced their return behaviour, using the Transactional Model of Stress and Coping.

METHODS

We conducted 34 semi-structured in-depth interviews between February and April 2018 with a sample of Australian donors who had experienced a VVR in the last seven days. Transcripts were analysed using the Framework Method.

RESULTS

The VVR elicited various emotional responses, which appeared to be influenced by social support, being aware of the possibility of experiencing a VVR, or the donation outcome. In turn, the VVR experience affected intentions to return, with those who reported more positive experiences expressing stronger intentions. Further, donors felt more likely to return if they perceived their risk of a recurrent event as low and if they were able to identify appropriate problem and emotion-focused coping strategies.

CONCLUSION

This article provides novel insights into possible ways to encourage blood donor return following a VVR.

A prospective study on COVID-19 convalescent plasma donor (CCP) recruitment strategies in a resource constrained blood centre

Background and Objectives

The COVID-19 pandemic has spread across 87 million people with more than 1·8 million deaths in the world. As there is no definite treatment modality, the use of convalescent plasma has become increasingly popular worldwide. This study aimed to identify an appropriate strategy of donor recruitment and to evaluate the appropriateness of pre-set plasma donation guidelines.

Material and Methods

In this prospective study conducted from May to September 2020, the donors were recruited under the following two circumstances: Group I, patients in the post-COVID-19 follow-up in the clinic, and Group II, patients recovered from COVID-19 recruited through mass and electronic media. A pre-set donor selection criteria and laboratory investigation was designed according to national and international guidelines. Approximately 500 ml of COVID-19 convalescent plasma (CCP) was collected from recovered individuals in each group by two different cell separators. The overall donor's attendance rate, deferral rate, adverse events and donor compliance was analysed and compared between the two groups.

Results

There was a significant difference in attendance in relation to registration between the groups (P < 0·0001). Donor deferral was significantly higher in group II compared with group I. The single most frequent cause of donor deferral was low antibody index (P = 0·0001). The total donor adverse event rate in CCP donation was significantly lower compared with routine plateletpheresis procedures. The donor's compliance to blood centre's protocol was satisfactory in both the groups.

Conclusion

Recruitment of patients in the post-COVID-19 follow-up in the clinic was more effective than the general recruitment through mass and electronic media for convalescence plasma donation in a resource-constrained blood centre.

Improving the donation experience and reducing venipuncture pain by addressing fears among whole-blood and plasma donors

BACKGROUND

Fear of blood donation is implicated in vasovagal reactions, donor recruitment, and retention. This study examined the extent to which fear among donors is associated with various donor outcomes in an Australian sample, and whether fear can be addressed on-site to reduce adverse reactions and improve the donation experience.

STUDY DESIGN AND METHODS

Six hundred and sixty-four donors (age M = 33.4, SD = 12.7; 55% female) participated in a two-center, pragmatic, parallel group, individually randomized controlled trial. Following donor registration and consent, whole-blood (n = 539) and plasma (n = 125) donors were assigned to one of four Conditions: control; fear assessment; fear assessment + brochure; fear assessment + brochure + tailored conversation focused on any self-reported fear and coping strategies. Post-donation questionnaires assessed the donors' experience including positive support, donor self-efficacy, anxiety, fear, venipuncture pain, and vasovagal reactions.

RESULTS

Fear among donors predicted higher venipuncture pain, post-donation anxiety, and vasovagal reactions and remained significant after controlling for other established predictors (i.e., total estimated blood volume, age, sex, and donation experience). Mediational analyses showed that exposure to brochures (with or without the tailored conversation) was associated with less pain, with this effect mediated by donor perceptions of more positive support. Venipuncture pain was also associated with vasovagal reactions, reduced likelihood of return within 6 months, and less satisfaction with the donation experience.

CONCLUSION

The current results underline the importance of interventions to address fear among both whole-blood and plasma donors to secure the safety and well-being of donors and the blood supply.

"Blood for Blood"? Personal Motives and Deterrents for Blood Donation in the German Population

It is crucial to provide updated knowledge about blood (non-)donors, as it is necessary to design targeted interventions with the aim of retaining blood donors and thus contributing to a functioning health system. This study investigates the prevalence and socio-demographic patterning of lifetime blood donation, assessing blood donation intention within the next 12 months and exploring personal motives and deterrents of blood donation qualitatively in the German population. A face-to-face cross-sectional survey with 2531 respondents was conducted, representative of the German population in terms of age, gender, and residency. Closed as well as open questions were asked. Qualitative content analysis was used for coding the qualitative material. Basic descriptive statistics were conducted to address our research questions. More than one-third of the participants reported that they have donated blood at least once in their lifetime. Motives and deterrents were assigned to 10 domains with 50 main categories and 65 sub-categories. The most frequently stated motives for blood donation were "altruism", "social responsibility", and "charity", whereas the most frequently stated deterrents were "health status", "age", and "lack of time". This study provides information to tailor recruitment and reactivation strategies to address donors at different career steps-from non-donor to loyal donor.

Blood Donor Deferral Analysis in Relation to the Screening Process: A Single-Center Study from Southern India with Emphasis on High Hemoglobin Prevalence

Purpose

Donor deferral results in loss of potential, motivated blood donors, and thereby, availability of blood for needy patients. This study analyses the frequency and reasons for donor deferral, including high hemoglobin deferral, which is underreported in India.

Methods

Retrospective analysis of the deferral record of whole blood donors from January 2014 to December 2018 was performed with respect to the pre-donation screening process at our center. Accordingly, the deferrals are categorized as stage1 – evaluation of Donor History Questionnaire (DHQ), stage 2 – medical examination, stage 3 – hemoglobin (Hb) check using copper sulfate method or a gradually implemented quantitative hemoglobin analyzer, and stage 4 – before phlebotomy. Donor demographic details, donation frequency, and deferral reasons were noted. Descriptive statistical analysis was performed using SPSS version 20 (IBM, USA).

Results

Of 99,680 pre-donation screenings, 10.6% was deferred. The highest deferral (56.02%) was at stage 3 (based on hemoglobin level) contributed by low (52.45%) and high (3.75%) hemoglobin deferrals against cut-off of 12.5 to 18 g/dl. High Hb was noted only in male donors when screened by hemoglobin analyzer. Further, a steady fall in low hemoglobin but a rise in high hemoglobin deferral rate owing to the gradual implementation of hemoglobin analyzer over the study period was noted. The deferrals in stage 1, 2, and 4 were 29.64%, 13.97%, and 0.36%, respectively. Overall, the deferral rate was higher in females (49.88%), and in first-time (13.63%), and 18 to 25 yrs age-group (4.25%) donors for low Hb, underweight, and tattooing/ear piercing.

Conclusion

Insights on donor deferral reasons promote proactive measures towards donor recruitment and retention. Further, donor hemoglobin screening by quantitative method, if followed uniformly by all blood centers across the country, will help identify the true prevalence of high hemoglobin in Indian blood donors and ensures donor safety.

The effects of text messaging for promoting the retention of the first-time blood donors, a randomized controlled study (TEXT study)

BACKGROUND

Donor recruiting remains a challenging process to obtain sufficient blood product supply worldwide. This was a randomized controlled trial aimed to evaluate the efficacy of text messaging for promoting the retention of first-time blood donors.

STUDY DESIGN AND METHODS

Participants enrolled were 18 years of age or older who were first-time blood donors and able to understand text messages. Participants were randomized in a 1:1 ratio (text group vs control group). Only participants who were allocated in the "text group" received a text message once their blood product was dispatched from the transfusion service. The content of the text message was "We would like to inform you that your blood has been used for patients on the date (DD/MM/YY)." The primary outcome of the study was the rate of returning at 9 months after the first donation.

RESULTS

In an intention-to-treat analysis, 1270 participants were allocated to the text group and 1270 participants to the control group. The primary outcome occurred in 199 in the text group (22.4 per 100 donor-years) and 152 in the control group (16.9 per 100 donor-years). The incidence rate ratio was 1.31 (95% confidence interval, 1.06-1.63; P = .005). The number needed to treat was 22. The median time to return for blood donation was 112 days (interquartile range [IQR], 98-146) in the text group and 113 days (IQR, 97-144) in the control group.

CONCLUSION

Among first-time blood donors, text messaging after blood product being dispatched is an effective and simple intervention to increase the retention rate for subsequent donations.

Measuring public awareness about blood donation in Assir, South-Western Saudi Arabia

OBJECTIVES

Blood transfusion is a life-saving measure in many acute and chronic conditions. Voluntary blood donation by healthy donors has been promoted by the World Health Organization (WHO) to ensure the availability of safe blood. Difficulty in the recruitment of donors and their retention is a problem faced in most populations. A paucity of research to identify barriers to blood donation in the Southwestern region of Saudi Arabia prompted us to explore this important public health issue.

MATERIALS AND METHODS

A cross-sectional survey was performed using a pre-tested, structured, self-administered questionnaire comprising of questions on demographical details, awareness regarding blood donations, perceived barriers to blood donations, attitude towards blood donation, etc. was distributed to the general population in Assir region through one to one contact in big malls, hospital area as well as electronically through social media. The data thus collected was statistically analysed using appropriate tests.

RESULTS

A total of 844 subjects were surveyed. Most of the respondents (65.0%) reported not having donated blood in the past. The blood donation was found to have a significant relationship (≤0.05) with age, gender, occupation, and education status. Roughly, 40.0% of the respondents suggested that blood donation could be promoted by raising public awareness.

CONCLUSION

Gaps were identified in the awareness of the studied population regarding blood donation. Specific awareness drives may help overcome these barriers to voluntary blood donation.

Effective methods for reactivating inactive blood donors: a stratified randomised controlled study

BACKGROUND

Recruiting of sufficient numbers of donors of blood products is vital worldwide. In this study we assessed the efficacy and cost-effectiveness of telephone calls and SMS reminders for re-recruitment of inactive blood donors.

METHODS

This single-centre, non-blinded, parallel randomised controlled trial in Guangzhou, China included 11,880 inactive blood donors whose last donation was between January 1 and June 30, 2014. The donors were randomly assigned to one of two intervention groups (telephone call or short message service [SMS] communications) or to a control group without intervention. SMS messages with altruistic appeal were adopted in the SMS group; in addition to altruistic appeal, reasons for deferral of blood donation were also asked in the telephone group. All participants were followed up for 1 year. The primary outcome was re-donation rate, and rates in different groups were compared by intention-to-treat (ITT) analysis and estimation of the average treatment effect on the treated (ATT). Secondary outcomes were the self-reported deterrents. Other outcomes included the re-donation interval, and the incremental cost-effectiveness ratio (ICER) of telephone calls and SMS reminders on re-recruitment.

RESULTS

ITT analysis revealed no significant differences in the re-donation rate among the three groups. ATT estimations indicated that among compliers, telephone calls significantly increased re-donation compared to both SMS reminders and no intervention. Donor return behaviour was positively associated with receiving reminders successfully, being male, older age, and previous donation history. The SMS reminder prompted donors to return sooner than no reminder within 6 months, and according to ICER calculations, SMS reminders were more cost-effective than telephone calls. Donors reported time constraints as the most main causes of self-deferral in the telephone group, and altruistic appeal had a positive effect on these donors.

CONCLUSIONS

Interventions to reactivate inactive blood donors can be effective, with telephone calls prompting more donors to return but at a greater cost than SMS messages. SMS reminder with altruistic appeal can urge donors to re-donate sooner within 6 months than no reminder.

TRIAL REGISTRATION

NCT03366441 (Reactivation of Inactive Blood Donors). Retrospectively registered 4 December 2017.

Motivation structures of blood donation: a means-end chain approach

Understanding blood donation behaviours is pivotal to recruiting and retaining blood donors. Despite rich literature, this is the first study investigating the content and structure of motivations that underlie blood donation using a means-end chain approach. Based on soft laddering interviews with 227 respondents (31 first-time blood donors and 196 repeat blood donors) in the Klang Valley of Malaysia, we identified that their blood donation was primarily driven by the attribute 'help people', the consequences 'increase blood supply' (as perceived by first-time blood donors) and 'indirect downstream reciprocity' (as perceived by repeat blood donors) associated with the attribute and the belief that the consequences can lead to the fulfilment of the value 'humanitarianism'. Understanding of such hierarchical links between motivators is crucial in developing self-relevant communications. The resultant outcomes are likely to be more effective than the traditional approaches in behavioural change.

A systematic review and network meta-analysis of incentive- and non-incentive-based interventions for increasing blood donations

BACKGROUND AND OBJECTIVES

Blood services are tasked with efficiently maintaining a reliable blood supply, and there has been much debate over the use of incentives to motivate prosocial activities. Thus, it is important to understand the relative effectiveness of interventions for increasing donations.

MATERIALS AND METHODS

This systematic review used a broad search strategy to identify randomized controlled trials comparing interventions for increasing blood donations. After full-text review, 28 trials from 25 published articles were included. Sufficient data for meta-analysis were available from 27 trials. Monetary incentives were assumed to be equivalent regardless of value, and non-monetary incentives were assumed to be equivalent regardless of type. Non-incentive-based interventions identified included existing practice, letters, telephone calls, questionnaires, and the combination of a letter & telephone call. A network meta-analysis was used to pool the results from identified trials. A subgroup analysis was performed in populations of donors and non-donors as sensitivity analyses.

RESULTS

The best performing interventions were letter & telephone call and telephone call-only with odds ratios of 3·08 (95% CI: 1·99, 4·75) and 1·99 (95% CI: 1·47, 2·69) compared to existing practice, respectively. With considerable uncertainty around the pooled effect, we found no evidence that monetary incentives were effective at increasing donations compared to existing practice. Non-monetary incentives were only effective in the donor subgroup.

CONCLUSION

When pooling across modes of interventions, letter & telephone call and telephone call-only are effective at increasing blood donations. The effectiveness of incentives remains unclear with limited, disparate evidence identified.

The Impact of an Undergraduate Biology Class on Donor Recruitment at a Hospital-Based Blood Donor Center

OBJECTIVES

A biology class, BIOL 294H, taught undergraduates about platelet donation while partnering with the University of North Carolina's (UNC's) hospital-based Blood Donation Center to recruit apheresis platelet donors. We identified our platelet donors' demographics and learned how BIOL 294H affected recruitment.

METHODS

Every platelet donor presenting to the UNC Blood Donation Center from February 7, 2017, to March 10, 2017, was asked to complete an electronic 10-question survey.

RESULTS

A total of 159 unique donors completed the survey; 64% were female and 75% were between ages 18 and 25 years. Overall, 70% were UNC undergraduate students. Over half (56%) reported first learning about platelet donation through word of mouth, and 22% cited specific efforts associated with BIOL 294H.

CONCLUSIONS

Recruitment of undergraduate platelet donors primarily included BIOL 294H peer interactions and deliverables from the class, such as social media updates and events on campus. The sustained recruiting efforts of our students over many years contributed to recruitment of a majority of our platelet donors.

Knowing the Blood Nondonor to Activate Behaviour

This work is aimed at further developing the study of blood nondonor behaviour through a joint analysis of sociodemographic characteristics, psychological and physical barriers, impure altruism and anticipated emotions, as predictors of intention to donate. To that end, a step-by-step hierarchical regression analysis was applied on a sample of 2383 Spanish nondonors. The study’s results confirm the influence of traditional variables (sociodemographic characteristics, psychological and physical barriers and impure altruism), as well as the power of anticipated emotions, both positive and negative, of donation action and inaction as variables explaining the intention to donate. Another important contribution has been to develop the moderating role of psychological and physical barriers, in addition to impure altruism, on cause–effect relationships between anticipated emotions and intention to donate. A number of practical implications can be derived from this study for transfusion centres responsible for donation promotion.

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.

Do deferred donors continue their donations? A large-scale register study on whole blood donor return in the Netherlands

BACKGROUND

Temporary deferral of whole blood donors is essential for a safe blood supply, yet deferral may impact donor return. Different deferral reasons may differently affect return, and donor experience may interfere with this. Therefore, we studied the joint effect of deferral reason and donor experience on return.

STUDY DESIGN AND METHODS

We used a large‐scale retrospective cohort design including all Dutch donors with a whole blood donation attempt in 2013 to 2015 (n = 343,825). We established details of the target donation (including deferral reason if applicable), details of attendances in the 2 years after the target donation, donor characteristics (blood type, sex, age), and donor experience (first‐time, novice, experienced, reactivated). Descriptive statistics as well as time‐to‐events methods were used.

RESULTS

Experienced donors were most likely to return, even after deferral (nondeferred 96% vs. deferred 92%). First‐time and reactivated donors were less likely to return after deferral (69 and 61%, respectively) compared to their nondeferred counterparts (82 and 76%, respectively). First‐time hemoglobin (Hb)‐deferred donors were less likely to return and slower to return than other donors. Similar results were found for reactivated donors deferred for short‐term medical reasons.

CONCLUSION

Deferral reason and donor experience individually as well as jointly impacted donor return. Particularly first‐time and reactivated donors were at risk of nonreturn, especially when deferred for Hb or short‐term medical reasons, respectively. Blood banks designing and implementing donor retention strategies should thus not only take successful but also unsuccessful donation experiences and different experience levels into account.

Beyond Description: The Predictive Role of Affect, Memory, and Context in the Decision to Donate or Not Donate Blood

Background

Research on the recruitment and retention of blood donors has typically drawn on a homogeneous set of descriptive theories, viewing the decision to become and remain a donor as the outcome of affectively cold, planned, and rational decision-making by the individual. While this approach provides insight into how our donors think about blood donation, it is limited and has not translated into a suite of effective interventions. In this review, we set out to explore how a broader consideration of the influences on donor decision-making, in terms of affect, memory, and the context in which donation takes place, may yield benefit in the way we approach donor recruitment and retention.

Summary

Drawing on emerging research, we argue for the importance of considering the implications of both the positive and the negative emotions that donors experience and we argue for the importance of directly targeting affect in interventions to recruit nondonors. Next, we focus on the reconstructed nature of memory and the factors that influence what we remember about an event. We discuss how these processes may impact the retention of donors and the potential to intervene to enhance donors' recollections of their experiences. Finally, we discuss how our focus on the individual has led us to neglect the influence of the context in which donation takes place on donor behavior. We argue that the amassing of comprehensive large data sets detailing both the characteristics of the individuals and the context of their giving will ultimately allow for the more effective deployment of resources to improve recruitment and retention.

Key Messages

In suggesting these directions for future research, our want is to move beyond the ways in which we have traditionally described blood donation behavior with the aim of improving our theorizing about donors while improving the translational value of our research.

In search of stool donors: a multicenter study of prior knowledge, perceptions, motivators, and deterrents among potential donors for fecal microbiota transplantation

Fecal microbiota transplantation (FMT) is a highly effective therapy for recurrent Clostridioides difficile infection. Stool donors are essential, but difficult to recruit and retain. We aimed to identify factors influencing willingness to donate stool. This multi-center study with a 32-item questionnaire targeted young adults and health care workers via social media and university email lists in Edmonton and Kingston, Canada; London and Nottingham, England; and Indianapolis and Boston, USA. Items included baseline demographics and FMT knowledge and perception. Investigated motivators and deterrents included economic compensation, screening process, time commitment, and stool donation logistics. Logistic regression and linear regression models estimated associations of study variables with self-assessed willingness to donate stool. 802 respondents completed our questionnaire: 387 (48.3%) age 21-30 years, 573 (71.4%) female, 323 (40%) health care workers. Country of residence, age and occupation were not associated with willingness to donate stool. Factors increasing willingness to donate were: already a blood donor (OR 1.64), male, altruism, economic benefit, knowledge of how FMT can help patients (OR 1.32), and positive attitudes towards FMT (OR 1.39). Factors decreasing willingness to donate were: stool collection unpleasant (OR 0.92), screening process invasive (OR 0.92), higher stool donation frequency, negative social perception of stool, and logistics of collection/transporting feces. We conclude that 1) blood donors and males are more willing to consider stool donation; 2) altruism, economic compensation, and positive feedback are motivators; and 3) screening process, high donation frequency, logistics of collection/transporting feces, lack of public awareness, and negative social perception are deterrents. Considering these variables could maximize donor recruitment and retention.

Blood donation from 2006 to 2015 in Zhejiang Province, China: annual consecutive cross-sectional studies

OBJECTIVES

To describe the basic demographical characteristics of whole blood donors in Zhejiang Province, China, from 2006 to 2015 and to examine the trends in individual characteristics associated with blood donation and the relationship between weight and donation.

DESIGN

Cross-sectional study comparing characteristics of blood donors and annual donations for the period 2006 to 2015.

SETTING

Urban and rural communities in Zhejiang, China (11 cities, 89 districts or counties and 1379 townships).

PARTICIPANTS

3 226 571 volunteer blood donors.

OUTCOME MEASURES

Volume of each whole blood donation and donation frequency. All data were collected by trained staff and entered into a standardised electronic information system.

RESULTS

The number of blood donations generally trended up in Zhejiang Province from 2006 to 2015. Donors were predominately males aged 18 to 25 years, but this major donor age group shifted to the 26 to 45 year range by 2015. The rate of repeated blood donation was 30.8 per cent. The blood volume per donation concentrated in 200 mL and 400 mL categories has been gradually shifted to 300 mL and 400 mL. Approximately one-third of donors had a college education. The average weight of donors increased over time for both men and women. Both the blood volume of each donation and donation frequency were proportional to weight.

CONCLUSIONS

The trend of voluntary non-remunerated blood donation in Zhejiang province is positive. However, given the expected growth in demand for whole blood, more research is needed to increase both the donor pool and the rate of repeated donation. The relationship between body weight and blood donation warrants further study because while improving nutritional status is associated with higher average donation volume and more frequent donations, overnutrition may lead to poorer quality of donated blood. Blood donation may present a unique opportunity for health education and body weight management to monitor and improve population health.

2018 European Conference on Donor Health and Management

The third European Conference on Donor Health and Management (ECDHM) was held in Copenhagen from 5th to 7th September 2018 and was co-organised by the ECDHM committees and European Blood Alliance. This is an international conference with a focus on 'donor health', including donors of blood, organs and other substances of human origin, and remains the only conference focusing exclusively on donor medicine. This overview presents a selection of research topics in relation to iron, the keynote speeches and plenary talks. The keynote speeches cover the epidemiology of donors and recipients, whole-blood donor recruitment and retention and the safety of donors and recipients of plasma and plasma products. Talks from the plenary speakers reviewed modern multi-omic approaches to study red cell quality and the central, perennial question of what motivates a donor to give blood and how can this be encouraged.

Determinants of blood donation willingness in the European Union: a cross-country perspective on perceived transfusion safety, concerns, and incentives

BACKGROUND

Willingness to donate blood depends on personal characteristics, beliefs, and motivations, but also on the cultural context. The aim of this study was to examine whether willingness to donate blood is associated with attitudes toward blood transfusion, personal motivators, and incentives and whether these factors vary across countries in the European Union (EU).

STUDY DESIGN AND METHODS

The sample consisted of 27,868 participants, from 28 EU member states, who were interviewed about blood donation and transfusion-related issues for the 2014 round of the Eurobarometer, a country-comparative survey, collected on behalf of the European Commission. Participants were asked whether they would be willing to donate blood and for which reasons (motivators) and which incentives are appropriate to receive in return for a blood donation.

RESULTS

Willingness to donate varied significantly across countries and was positively associated with perceived blood transfusion safety. Furthermore, helping family or people in need were the most powerful motivators for blood donation willingness in almost all countries. In contrast, the number of participants who were willing to donate to alleviate shortages or to contribute to research varied widely across countries. The wish to receive certain incentives, however, did not seem to be related to willingness to donate.

CONCLUSION

Perceived blood transfusion safety and personal motivations may be stronger determinants of willingness to donate than receiving certain incentives. EU-wide strategies and guidelines for donor recruitment and retention should take both overall and country-specific patterns into account. For example, education on the importance of donation could be considered.

Well-being and return rate of first-time whole blood donors

BACKGROUND AND OBJECTIVES

Previous studies observed a transient increase in well-being in about one-third of regular donors after blood donation. In addition, personal contact with donors after donation seems to increase return rates. We were interested whether changes in well-being and/or personal contact after the first donation impact return rates of first-time donors (FTDs).

MATERIALS AND METHODS

First-time donors were randomized to a questionnaire group (QG), in which questionnaires assessing the well-being had to be filled in, or a control group (CG), which was not contacted with a questionnaire. The QG had to complete the same questionnaire three times at the day of the first donation and then four times over an 8-week period with reminding calls by the study coordinator. Return rates of participants were followed for 12 months.

RESULTS

A total of 102 FTDs participated in the QG and 115 in the CG. Changes in well-being after the first donation had minimal impact on the return rates. In contrast, contacting FTDs after their first donation had a significant impact on the return rate of male donors (89·2% in the QG vs. 58·3% in the CG; P = 0·001). Females showed no significant difference in return rates between both groups (P = 0·32).

CONCLUSION

The well-being of FTDs had no influence on their return rate. The intervention of regular contacts during a research project follow-up resulted in an increased return rate of male but not of female FTDs. The pronounced difference of the impact of this intervention between male and female donors requires further studies.