Motivation in Italian whole blood donors and the role of commitment

Impact of promoting blood donation in general practice: Prospective study among blood donors in France

Introduction

Waiting rooms in general practitioners' (GP) surgeries are a potentially useful site for spreading educational messages about health behaviors. We aimed to evaluate the impact of posters displayed in GPs' waiting rooms on the number of donors attending the blood donation drives in the Aube Department of France. The secondary objective was to identify self-reported factors that incited people to give blood among donors who did and donors who did not see the posters.

Methods

Observational, multicenter, prospective study, from 1 June to 31 December 2021. Six blood donation centers in the Aube Department were selected. All GPs located within a 15 km radius around each center were invited to participate by hanging posters advertising blood drives in their waiting rooms. The number of blood donations per hour was measured before and during the campaign. Factors prompting people to give blood were evaluated by questionnaires completed by persons attending the blood drives.

Results

33 GPs participated. The number of donations per hour was lower in the year in which the posters were displayed (2021) compared to the previous year (12 vs. 15). A total of 1,469 questionnaires were completed by blood donors: 729 reported having seen the posters, and 740 reported not having seen the posters. Those who claimed to have seen the posters were more likely than those who claimed not to have seen the posters to respond that in parallel, they had been prompted to give blood via online publicity (7.5 vs. 3.9%, adjusted Odds ratio [aOR] 1.75, 95% confidence interval [CI] 1.12-2.82, p = 0.02). They also more often reported that they had been prompted to donate by television advertisements (8.0 vs. 4.2%, aOR 1.74, 95%CI 1.10-2.76, p = 0.02). Overall, 68% of all respondents indicated that posters in the GP's waiting room would incite them to give blood more often.

Conclusion

The number of blood donations per hour was lower during the year in which posters were displayed. Questionnaire data from donors suggests that promoting blood donation via posters in GPs' waiting rooms could have a positive effect: 68% of donors claimed that posters would incite them to give blood.

Patients' Engagement in Early Detection of COVID-19 Symptoms: An Observational Study in the Very Early Peak of the Pandemic in Italy in 2020

COVID-19 exerted a strong impact on the Italian healthcare systems, which in turn resulted in a reduction in the citizens’ trust towards healthcare authorities. Moreover, the focused attention on the typical COVID-19 symptoms (fever, cough) has also impacted the social representation of health priorities, potentially reducing the perceived importance and severity of other symptoms. This study aimed to determine the association of general-practitioner (GP) contact with various symptoms during the COVID-19 pandemic in Cremona, an Italian city at the very epicentre of the pandemic. Between April and June 2020, an anonymous survey was completed by 2161 respondents. Logistic-regression analyses were used to examine the associations of GP contact with sociodemographic characteristics and the presence of symptoms. Of the 2161 respondents (43.5% female, 75.0% aged less than 55 years), 959 (44.4%) reported experiencing various symptoms and 33.3% contacted a GP. GP contact was significantly associated with poor appetite (OR, 2.42; 95% CI 1.63 to 3.62; p < 0.001), taste dysfunctions (OR 1.67; 95% CI 1.20 to 2.34; p < 0.001) and sleepiness during the day (OR 4.15; 95% CI 2.13 to 8.09; p = 0.002). None of the gastrointestinal symptoms resulted in significantly increasing the likelihood of contacting a GP. This study offers a unique observation of citizens’ attitudes and behaviours in early symptom communication/detection during the initial peak of the Italian COVID-19 pandemic.

Motivation to Donate, Job Crafting, and Organizational Citizenship Behavior in Blood Collection Volunteers in Non-Profit Organizations

This study assesses the levels of and relationships between the Motivation to donate, Job crafting propensity, and the Organizational citizenship behavior of blood collection volunteers in a non-profit association. An Italian sample of AVIS (the Italian Association of Voluntary Blood donors) blood donors (N = 1215) actively involved in organizing blood collection, were asked to complete the Italian version of the Volunteer Function Index, the Job crafting scale, and the Organizational citizenship behavior scale. The tools were verified by Confirmatory factor analysis and their relationships were explored using Structural equation modeling for hidden variables. The three constructs have overall high scores. Motivation to donate and Job crafting show a clear correlation, with the latter influencing volunteer Organizational citizenship behavior. The study highlights the need to take into consideration the Motivation to donate, Job crafting and Organizational citizenship behavior of volunteers, particularly in countries such as Italy, where blood collection is almost exclusively carried out thanks to spontaneous, altruistic, and disinterested commitment.

A descriptive phenomenological analysis of the experience of blood donation as a regular donor

Maintaining adequate blood supplies requires the recruitment of a significant number of regular donors. However, research examining the first-hand experience of blood donation from the perspective of regular donors is very limited. This study sought to describe the essential features of this experience from the accounts of 10 regular donors, analysed using Colaizzi's descriptive phenomenological method. Eight essential themes contributed to the fundamental structure of the experience, emphasising issues of blood donor identity, comfortable routine, feeling good helping others and human connectedness and interaction in the donation process. Implications for future research and practice are discussed.

Life events and donor lapse among blood donors in Denmark

BACKGROUND AND OBJECTIVES

The likelihood of donating blood changes over the life course, with life events shown to influence entry to and exit from the donor population. While these previous findings provide valuable insights for donor management, blood collection agencies need to be cautious about generalizing findings to other countries as blood donor behaviour is context-specific. To examine cross-country variations in donor behaviour, the repeatability of a previous Dutch study on life events and blood donor lapse is examined by using a sample of Danish donors.

MATERIALS AND METHODS

Register data from Statistics Denmark was linked to the Scandinavian Donations and Transfusions database (n = 152 887). Logistic regressions were conducted to examine the association between life events in 2009-2012 and blood donor lapse in 2013-2014.

RESULTS

Of the total sample, 69 079 (45·2%) donors lapsed. Childbirth and losing a job increased the lapsing risk by 11% and 16%, respectively, while health-related events in the family (i.e. blood transfusion, disease and death) decreased the lapsing risk by 5%, 7% and 9%, respectively.

CONCLUSION

Life events are associated with donor lapse of Danish donors. These results are comparable to previous findings from the Netherlands (i.e. childbirth and labour market transitions increased lapsing risk; health-related events decreased lapsing risk), with two thirds of the associations being in the same direction. Differences between study results were mainly related to effect sizes and demographic compositions of the donor pools. We argue contextual factors to be of importance in blood donor studies.

[Nursing interventions to promote blood donor commitment: A rapid realist literature review]

BACKGROUND

Blood transfusions save lives. Although giving blood is of key importance to health care systems, there is still a long-term shortage of blood. Health services need the help of voluntary donors to provide an adequate supply. Nurses who work in transfusion centers play a crucial role in encouraging blood donor commitment. There is a need to identify and analyze donor motivations and effective nursing interventions.

OBJECTIVE

To identify existing donor mechanisms in order to facilitate nursing interventions.

METHOD

A realist literature review was conducted in 2018 following the method outlined by Pawson. Articles were identified from two scientific databases, and nine scientific articles selected. They were then analyzed using the realist evaluation framework.

RESULTS

The analysis highlighted three areas of intervention: mechanisms stemming from donors’ individual experiences; existing interventions that enable donors to go from intending to give blood to actually giving blood; and finally interpersonal interventions in the reciprocal partnership between nurses and donors. This relationship should help make giving blood a pleasant experience and have a positive impact on commitment, especially in relation to new donors.

Blood Donation across the Life Course: The Influence of Life Events on Donor Lapse

This article examines how blood donation loyalty changes across the life course as a result of life events. Previous studies have shown that life events affect involvement in prosocial behavior, possibly as a result of loss of human and social capital. Using registry data from the blood collection agency in the Netherlands, linked to longitudinal survey data from the Donor InSight study (N = 20,560), we examined whether life events are related to blood donor lapse. Childbirth, losing a job, and starting a job increase the likelihood of donor lapse, while health-related events (i.e., blood transfusion in a family member, death of a family member) decrease the likelihood of donor lapse. Moreover, results showed how social and practical concerns explain donors' decisions to donate blood after the occurrence of life events. We discuss theoretical implications for further studies on prosocial and health-related behavior.

The health and social impact of Blood Donors Associations: A Social Return on Investment (SROI) analysis

Although research on blood donation abounds, no studies have yet attempted to estimate the socio-economic value generated from Blood Donors Associations (BDAs). To fill this gap, the authors ran a Social Return on Investment (SROI) analysis on four units of the largest BDA in Italy, the Association of Voluntary Italian Blood Donors ("Avis"). This study used multiple methods for data collection and analysis. A systematic literature review helped the identification of proper financial proxies to highlight the economic value of the social and health impacts experienced by Avis members. A focus group with key informants gathered their views on the areas of impact selected for the analysis: early detection of diseases, adoption of healthier lifestyles, social capital, human capital, personal satisfaction and reinforcement of a 'giving culture'. Primary data collection involved (a) an Activity Based Costing analysis (b) a self-reported questionnaire to 1.066 BDA members and unassociated donors enabling the comparison of the blood donation experience of these two groups. The SROI analysis resulted in four positive ratios, varying between €1.70 and €13.80. This study contributes to the knowledge on impact evaluations in TSOs. Policy implications refer to BDAs deserving financial and material support for their capacity to generate positive social impacts.

Who donates? Cross-country and periodical variation in blood donor demographics in Europe between 1994 and 2014

BACKGROUND

Ageing European populations put pressure on national blood supplies, increasing the need for blood and donor base rejuvenation. Therefore, we investigate how European countries' blood donor populations differ and how they have evolved over the last 2 decades. Previous comparative research, based on 1994 Eurobarometer data, indicate that the typical donor is an educated, middle-aged, white, married male. Other sociodemographic and socioeconomic correlates, such as employment status and type of community, are less clear.

STUDY DESIGN AND METHODS

Multilevel analyses are performed on repeated cross-level data from the Eurobarometer (waves 1994, 2002, 2009, and 2014) to compare information on "ever having donated" across sociodemographic categories, countries, and periods.

RESULTS

There are consistent but moderate country and period differences. The donor population rose to become largest in most countries by 2009, and stabilized thereafter. Over the studied period, donors were more likely to be higher educated, married men. Nevertheless, changes across time in donor profiles within countries did occur. Women were less likely to donate blood, especially in Southern and Eastern Europe, but this gender gap has declined. Furthermore, educational attainment seems more relevant for women, although, more recently, to a lesser extent.

CONCLUSION

Although there is a promising trend in which women, young people, and students are increasingly likely to donate, more attention is needed to reach the unemployed and the low to medium educated. Because the unemployed may lack structural opportunities to donate, and the low to medium educated may lack relevant knowledge on blood donation necessity, we recommend providing practical opportunities and information on the necessity of blood donation.

Individual, contextual and network characteristics of blood donors and non-donors: a systematic review of recent literature

BACKGROUND

The ageing population and recent migration flows may negatively affect the blood supply in the long term, increasing the importance of targeted recruitment and retention strategies to address donors. This review sought to identify individual, network and contextual characteristics related to blood donor status and behaviour, to systematically discuss differences between study results, and to identify possible factors to target in recruitment and retention efforts.

METHODS

The systematic review was conducted in accordance with a predefined PROSPERO protocol (CRD42016039591). After quality assessments by multiple independent raters, a final set of 66 peer-reviewed papers, published between October 2009 and January 2017, were included for review.

RESULTS

Individual and contextual characteristics of blood donor status and behaviour were categorised into five main lines of research: donor demographics, motivations and barriers, adverse reactions and deferral, contextual factors, and blood centre factors. Results on donor demographics, motivations and barriers, and contextual factors were inconclusive, differing between studies, countries, and sample characteristics. Adverse reactions and deferral were negatively related to blood donor behaviour. Blood centre factors play an important role in donor management, e.g., providing information, reminders, and (non-)monetary rewards. No studies were found on network characteristics of (non-)donors.

DISCUSSION

Although individual and contextual characteristics strongly relate to blood donor status and behaviour, mechanisms underlying these relations have not been studied sufficiently. We want to stress the importance of longitudinal studies in donor behaviour, exploring the role of life events and network characteristics within blood donor careers. Increased understanding of donor behaviour will assist policy makers of blood collection agencies, with the ultimate goal of safeguarding a sufficient and matching blood supply.

Family donors are critical and legitimate in developing countries

INTRODUCTION

For many years, family blood donors have been considered less safe than volunteer non-remunerated blood donors and actively discouraged by international organisations and affluent countries support agencies for developing countries. In addition to safety, pressure and coercion was considered unethical. However these assumptions were not supported by evidence.

AIMS OF THE STUDY

To assemble recently collected evidence to reopen the assessment whether or not the ban of family blood donors is justified.

METHODS

Review of old and recent literature through Pubmed and references from identified articles.

RESULTS AND DISCUSSION

Viral marker data comparing confirmed seroprevalence in 1(st) time volunteer non-remunerated donors (VNRD) and family/replacement donors (FRD) corrected for gender and age, show no significant difference between the two groups. Evidence has been provided that for both VNRD and FAD benevolence is more appropriate than altruism. The two groups merge for psychological attitude to donation for which knowing someone needing transfusion is a powerful incentive to give blood. Excluding a life or death situation found in areas where severe blood shortage justifies replacement donation, pressures are exerted on both VNRD and FRD. There is no evidence of coercion of FRD. FRDs therefore meet all criteria for VNRD and are willing to become VNRD and to repeat donation. Ostracising FRD is illegitimate and damaging to the blood supply in resource poor areas. In some countries no difference is made between the two groups of donors representing similar populations asked to give blood in different circumstances.

CONCLUSIONS

FRDs remain a critical source of volunteer, non-remunerated, blood meeting all classical criteria of VNRD that should be considered legitimate and indispensable at this point in time instead of discouraged.

Differences in social representation of blood donation between donors and non-donors: an empirical study

BACKGROUND

Both donors and non-donors have a positive image of blood donation, so donors and non-donors do not differ regarding their views on donation but do differ in converting their opinion into an active deed of donation. Several studies have identified altruism and empathy as the main factors underlying blood donation. However, a mixture of various motivational factors mould the complex behaviour of donation. This paper presents an exploratory study on differences of social representations of blood donation between blood donors and non-donors, in order to understand the reasons that bring someone to take the decision to become a blood donor.

MATERIALS AND METHODS

Participants filled in the Adapted Self-Report Altruism Scale, Toronto Empathy Questionnaire and answered a test of verbal association. Descriptive and correlation analyses were carried out on quantitative data, while a prototypic analysis was used for qualitative data.

RESULTS

The study was carried out on a convenience sample of 786 individuals, 583 donors (mean age: 35.40 years, SD: 13.01 years; 39.3% female) and 203 non-donors (mean age: 35.10 years, SD: 13.30 years; 67.5% female). Social representations of donors seem to be more complex and articulated than those of non-donors. The terms that appear to be central were more specific in donors (life, needle, blood, help, altruism were the words most associated by non-donors; life, aid, altruism, solidarity, health, love, gift, generosity, voluntary, control, needed, useful, needle were the words most associated by donors). Furthermore, non-donors associated a larger number of terms referring to negative aspects of blood donation.

DISCUSSION

Aspects related to training and the accuracy of any information on blood donation seem to be important in the decision to become a donor and stabilise the behaviour of donation over time, thus ensuring the highest levels of quality and safety in blood establishments.

Seroprevalency of transfusion-transmitted infections in first-time volunteer and replacement donors in Tunisia

BACKGROUND

Replacement donors are considered as having a major risk of transmission of infections to recipients mainly by the World Health Organisation.

STUDY DESIGN AND METHODS

Seroprevalency of HBV, HCV, HIV and syphilis were determined in 19,783 whole blood donations collected in the Tunisian National Blood Transfusion Centre during the year 2010 (12,968 [65.55%] replacement donations and 6815 [34.44%] voluntary blood donations). For HBV, HCV and syphilis, we performed a univariate analysis to determine whether age, sex and type of donation were risk factors, then multivariate logistic regression, to see if these factors were independent.

RESULTS

Mean age of donors was 30.1 years (replacement donors 34.5 years, first time non-remunerated donors 34.5 years, P<0.001). The predominant age group was 30-39 years (35.51%) in replacement donors and 20-29 years (54.15%) in first time non-remunerated donors. Male gender was significantly predominant (73.00% men vs 27.00% women, P<10(-6)). There were significantly more men among replacement donors (82.27% vs 55.38%, P<10(-3)). There were more women in the age groups 18-19 and 20-29 years. Only one HIV seropositive donation was noted in a male first time non-remunerated donor aged 18. Replacement type of donation, male sex and age were three independent risk factors for the HBs Ag carriage. For anti-HCV antibodies and TPHA, only replacement type of donation and age were found out to be risk factors and only age was independent.

CONCLUSION

In Tunisia, replacement blood donors were at higher risk of infection transmission, but only for hepatitis B.

Gender differences and frequency of whole blood donation in Italian donors: even though I want to, I cannot?

Women are under-represented among blood donors and this difference is particularly strong in Italy. This study explore the reasons for the gender gap using a sample of donors who had stopped donating at least two years previously and analyzing the role of frequency of donation. No significant gender differences emerged between the reasons provided by subjects but Italy was the country with the longest prescribed interval between whole blood donations for women. The gender gap is related to the lengthy interval between successive donations of whole blood and reducing this interval could help increase the proportion of women donors.

Motivation and social capital among prospective blood donors in three large blood centers in Brazil

BACKGROUND

Studies analyzing motivation factors that lead to blood donation have found altruism to be the primary motivation factor; however, social capital has not been analyzed in this context. Our study examines the association between motivation factors (altruism, self-interest, and response to direct appeal) and social capital (cognitive and structural) across three large blood centers in Brazil.

STUDY DESIGN AND METHODS

We conducted a cross-sectional survey of 7635 donor candidates from October 15 through November 20, 2009. Participants completed self-administered questionnaires on demographics, previous blood donation, human immunodeficiency virus testing and knowledge, social capital, and donor motivations. Enrollment was determined before the donor screening process.

RESULTS

Among participants, 43.5 and 41.7% expressed high levels of altruism and response to direct appeal, respectively, while only 26.9% expressed high levels of self-interest. More high self-interest was observed at Hemope-Recife (41.7%). Of participants, 37.4% expressed high levels of cognitive social capital while 19.2% expressed high levels of structural social capital. More high cognitive and structural social capital was observed at Hemope-Recife (47.3 and 21.3%, respectively). High cognitive social capital was associated with high levels of altruism, self-interest, and response to direct appeal. Philanthropic and high social altruism were associated with high levels of altruism and response to direct appeal.

CONCLUSION

Cognitive and structural social capital and social altruism are associated with altruism and response to direct appeal, while only cognitive social capital is associated with self-interest. Designing marketing campaigns with these aspects in mind may help blood banks attract potential blood donors more efficiently.