Eliciting repeat blood donations: tell early career donors why their blood type is special and more will give again

How to convert whole‐blood donors to plasma donors: An investigation of the mechanisms of awareness of need for plasma and donors' perception of response efficacy

BACKGROUND

Blood donation services need to increase plasma donations to match the rising demand. However, evidence on how to best recruit donors among whole-blood donors is limited. Therefore, this study evaluated the effectiveness of a conversion strategy based on two different mechanisms that drive donor behavior: (a) awareness of the need for plasma donation and (b) perception of response efficacy regarding plasma donation.

STUDY DESIGN AND METHODS

An online experiment with 246 German Red Cross whole-blood donors (possibility of plasma donation, blood group AB) was conducted using a 2 × 2 factorial, between-subject setup, and a pre-post treatment measurement. The mechanisms varied and were addressed with experimental treatments and measured. Analyses of variance and hierarchical regression models were used to analyze the effects on intention and behavior.

RESULTS

The intention to donate plasma was low, but increased with treatment (mean value_overall of intention_{beforeTreatment}  = 2.63, SD = 1.73 vs. intention_{afterTreatment}  = 3.28, SD = 1.92). Furthermore, 31% of participants expressed willingness to be forwarded to the appointment-scheduling system of the blood donation service for further information. Only the mechanism of response efficacy was significantly associated with the intention to donate plasma (β_Efficacy  = .254, p = .001; β_{Awareness of Need}  = .126, p = .070).

DISCUSSION

A conversion strategy based on making donors aware of their response efficacy is a promising way to optimize donor panels by shifting them to where they have the greatest impact. However, this study also substantiates the difficulty of such an effort. Blood donation services should invest in persuasion efforts and build personalized integrated marketing communications.

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.

Supplemental findings of the 2017 National Blood Collection and Utilization Survey

INTRODUCTION

This report provides supplemental results from the 2017 National Blood Collection and Utilization Survey on characteristics of the donor population, autologous and directed donations and transfusions, platelets, plasma and granulocyte transfusions, pediatric transfusions, severe donor-related adverse events, cost of blood units, hospitals policies and practices, and inventory, dosing, and supply.

METHODS

Weighting and imputation were used to generate national estimates including number of donors, donations, donor deferrals, autologous and directed donations and transfusions, severe donor-related adverse events, platelet and plasma collections and transfusions, number of cross-match procedures, irradiation and leukoreduction, and pediatric transfusions.

RESULTS

Between 2015 and 2017, successful donations decreased slightly by 2.1% with a 10.3% decrease in donations by persons aged 16-18 years and a 14.4% increase in donations by donors aged >65 years. The median price paid for blood components by hospitals decreased from $211 to $207 for leukoreduced red blood cell units, from $523 to $517 for leukoreduced apheresis platelet units, and from $54 to $51 for fresh frozen plasma units. Plasma transfusions decreased 13.6%, but group AB plasma units transfused increased 24.7%.

CONCLUSION

Between 2015 and 2017, blood donations declined slightly because of decreases in donations from younger donors, but the number of donations from older donors increased. The price hospitals pay for blood has continued to decrease. Plasma transfusions have decreased, but the proportion of plasma transfusions involving group AB plasma have increased.

Adapting to supply-and-demand emerging trends for antigen-negative red blood cell units

BACKGROUND

A global downtrend in blood usage has been observed by many countries, while the demand for antigen-negative red blood cell (RBC) units used in antigen-matched transfusions keeps increasing. The declining number of units collected exposes blood providers to a rapidly evolving supply challenge.

METHODS

This study was conducted retrospectively with use of internal data analysis to weigh Québec's situation regarding global and antigen-negative RBC demand, to measure the effects of community-directed recruitment and blood drives, and to evaluate the benefits of mass-scale RBC genotyping.

RESULTS

Our findings confirm a global RBC usage downtrend of over 20% total in the past 10 years with a steady antigen-negative usage and highlight the most requested negative antigen combinations. Our data also show our +39.5% progress regarding the number of Black donors recruited for antigen matching of patients with sickle cell disease in the past 3 years, as well as a constantly growing number of just-in-time blood collection for complex orders. Finally, our data summarize the efficiency of our mass-scale RBC genotyping efforts.

CONCLUSION

Altogether, this study confirms the demand trends for regular and antigen-negative RBC units in Québec and the efficient effects of our recruitment and typing strategies.

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

Blood products are critical to health systems and donations by voluntary nonremunerated donors are recommended. Worldwide, however, only around 5% of those eligible to donate do so and around half of those never return to donate again. This review focuses on what deters first-time donors, what predicts their retention, and what interventions may promote retention of this group. A comprehensive search of relevant databases identified 9 studies investigating motives and deterrents of first-time donors, 14 studies investigating predictors for first-time donors (13 whole blood [WB] and 2 plasmapheresis), and 15 studies (in 14 published articles) detailing interventions conducted on first-time donors. Drawing on an established blood donation taxonomy, studies were classified by 2 independent raters. Interventions were also classified into traditional, behavioral, or social science interventions. With only 2 eligible studies among first-time plasmapheresis donors, analyses focused on WB donors. First-time WB donors reported benevolent and collectivistic motivations, as well as personal benefits to commence WB donation. Self-reported deterrents have typically not been examined. Intention predicted first-time donor retention with intention determined by attitudes and a sense of (perceived behavioral) control. However, anxiety, adverse events, and deferrals all deterred retention. Traditional interventions, such as reminders and incentives, are widespread yet had only a small effect on return of first-time donors. Although behavioral science interventions such as fluid loading are effective, the strongest effect for the return of first-time donors was found when individual psychological support was provided. The purpose of this analysis was to identify the factors associated with the commencement and continuation of first WB donations. The current review revealed that self-reported motivators are typically not effective, and most successful predictive factors identified have not been translated into interventions. Future work would do well to identify, manage, and meet donors' expectations along with developing more individualized donation experiences. Blood donor research should delineate donor career stages; addressing first-time donor retention will support stable panels for blood collection agencies.

Prospects for the provision of genotyped blood for transfusion

Blood group genotyping is gaining widespread adoption in blood centres and transfusion services. The current interest for a blood centre is its use as a screening tool to accurately predict donor phenotypes. However, not only is blood group genotyping used to screen for uncommon and rare types on a mass-scale, it can be used to optimize the inventory of multiple antigen-negative screened units. In addition, blood group genotyping provides blood types when antisera are not available, it can predict weak and variant antigens, and can aid in the resolution of ABO discrepancies. There are quality improvement benefits in blood group genotyping because it can screen for RHD alleles in Rh-negative blood donors and can be used to confirm that donors are suitable for reagent red cell production. It is possible that blood group genotyping information may be used as a donor recruitment tool. Given that genotyping can convey much more information about the expression of some complex antigens, e.g. hrB, Uvar, and Duffy, clinical trials are probably needed to show that genotyped or 'dry matched' transfusions are superior to phenotyped blood.

Predicting the retention of first-time donors using an extended Theory of Planned Behavior

BACKGROUND

Donor retention is vital to blood collection agencies. Past research has highlighted the importance of early career behavior for long-term donor retention, yet research investigating the determinants of early donor behavior is scarce. Using an extended Theory of Planned Behavior (TPB), this study sought to identify the predictors of first-time blood donors' early career retention.

STUDY DESIGN AND METHODS

First-time donors (n=256) completed three surveys on blood donation. The standard TPB predictors and self-identity as a donor were assessed 3 weeks (Time 1) and at 4 months (Time 2) after an initial donation. Path analyses examined the utility of the extended TPB to predict redonation at 4 and 8 months after initial donation.

RESULTS

The extended TPB provided a good fit to the data. Post-Time 1 and 2 behavior was consistently predicted by intention to redonate. Further, intention was predicted by attitudes, perceived control, and self-identity (Times 1 and 2). Donors' intentions to redonate at Time 1 were the strongest predictor of intention to donate at Time 2, while donors' behavior at Time 1 strengthened self-identity as a blood donor at Time 2.

CONCLUSION

An extended TPB framework proved efficacious in revealing the determinants of first-time donor retention in an initial 8-month period. The results suggest that collection agencies should intervene to bolster donors' attitudes, perceived control, and identity as a donor during this crucial post-first donation period.

The effects of a phone call prompt on subsequent blood donation among first-time donors

BACKGROUND

A strategy used by blood centers to retain donors is to place phone call reminders. However, among first-time donors, no studies have tested the effect of this strategy. This was the aim of this study among individuals who had recently given their first lifetime blood donation.

STUDY DESIGN AND METHODS

A quasi-experimental study using a nonequivalent control group was adopted; participants in the control group were donors with blood types B+ and AB+, since these individuals are not phoned by the blood agency. A total of 1604 first-time donors aged 18 to 70 years from the province of Quebec, Canada, were assigned to the experimental (n = 870) or the control (n = 734) group. Participants in the experimental group were phoned a few days before they had a new opportunity to give blood while those in the control condition were not phoned.

RESULTS

In the experimental condition, 48.3% of the donors attempted to give blood during the 12-month follow-up period compared to 38.0% in the control condition. The hazards of the first blood donation attempt among donors who were phoned were 32% higher compared to the hazards of those who were not phoned (p = 0.0004).

CONCLUSION

The results of this study indicate that a first phone call reminder about the upcoming opportunity to give blood again has a significant positive effect on return rates among first-time donors.

Interdonation intervals and patterns of return among blood donors in Brazil

BACKGROUND

In Brazil, most donations come from repeat donors, but there are little data on return behavior of donors.

STUDY DESIGN AND METHODS

Donors who made at least one whole blood donation in 2007 were followed for 2 years using a large multicenter research database. Donation frequency, interdonation intervals, and their association with donor demographics, status, and type of donation were examined among three large blood centers in Brazil, two in the southeast and one in the northeast.

RESULTS

In 2007, of 306,770 allogeneic donations, 38.9% came from 95,127 first-time donors and 61.1% from 149,664 repeat donors. Through December 31, 2009, a total of 28.1% of first-time donors and 56.5% of repeat donors had donated again. Overall, the median interdonation interval was approximately 6 months. Among men it was 182 and 171 days for first-time and repeat donors, and among women, 212 and 200 days. Predictors of return behavior among first-time donors were male sex (odds ratio [OR], 1.17; 95% confidence interval [CI], 1.13-1.20), community donation (OR, 2.26; 95% CI, 2.20-2.33), and age 24 years or less (OR, 0.62-0.89 for donors ≥ 25 years). Among repeat donors predictors were male sex (OR, 1.35; 95% CI, 1.32-1.39), age 35 years or more (OR, 1.08-1.18 vs. ≤ 24 years), and community donation (OR, 2.39; 95% CI, 2.33-2.44). Differences in return by geographic region were evident with higher return rates in the northeast of Brazil.

CONCLUSION

These data highlight the need to develop improved communication strategies for first-time and replacement donors to convert them into repeat community donors.

Investigating the factors affecting blood donation among Israelis

AIM

This study examined whether the Theory of Planned Behavior adds significantly to the prediction of intention and actual blood donation of the general Israeli population.

BACKGROUND

In most developed countries and in Israel in particular there is a chronic shortage of blood for transfusions. This raises questions about methods of increasing blood donations.

DESIGN

This is a correlational quantitative study.

METHODS

A questionnaire was created based on a review of the literature and the Theory of Planned Behavior. The questionnaire was distributed among a convenience sample of 190 Israeli Jewish men and women, aged 17-60.

RESULTS

Israelis' perceived behavioral control of their blood donations, their subjective norms and their attitude regarding blood donation, predicted their intention to donate blood. It seems that intention predicted actual blood donations. A conspicuous finding is that members of the Ethiopian Jewish community displayed an extremely limited intention to donate blood.

CONCLUSIONS

The results of this study show that a number of various educational and practical strategies may be used to encourage the population to donate blood. These include: reducing perceived barriers, directing interventions specifically at the population most likely to donate blood and forming a reserve of regular donors.

Demographic profile of blood donors at three major Brazilian blood centers: results from the International REDS-II study, 2007 to 2008

BACKGROUND

The profile of blood donors changed dramatically in Brazil over the past 20 years, from remunerated to nonremunerated and then from replacement to community donors. Donor demographic data from three major blood centers establish current donation profiles in Brazil, serving as baseline for future analyses and tracking longitudinal changes in donor characteristics.

STUDY DESIGN AND METHODS

Data were extracted from the blood center, compiled in a data warehouse, and analyzed. Population data were obtained from the Brazilian census.

RESULTS

During 2007 to 2008, there were 615,379 blood donations from 410,423 donors. A total of 426,142 (69.2%) were from repeat (Rpt) donors and 189,237 (30.8%) were from first-time (FT) donors. Twenty percent of FT donors returned to donate in the period. FT donors were more likely to be younger, and Rpt donors were more likely to be community donors. All were predominantly male. Replacement donors still represent 50% of FT and 30% of Rpt donors. The mean percentage of the potentially general population who were donors was approximately 1.2% for the three centers (0.7, 1.5, and 3.1%). Adjusting for the catchment's area, the first two were 2.1 and 1.6%.

CONCLUSIONS

Donors in the three Brazilian centers tended to be younger with a higher proportion of males than in the general population. Donation rates were lower than desirable. There were substantial differences in sex, age, and community/replacement status by center. Studies on the safety, donation frequencies, and motivations of donors are in progress to orient efforts to enhance the availability of blood.

The psychology of blood donation: current research and future directions

With an ever-increasing demand on blood supplies worldwide, there is an immense need to ensure a safe and sufficient supply of blood products. However, recruiting and retaining blood donors remain key challenges for blood agencies. In an attempt to address these problems, researchers have identified a range of sociodemographic, organizational, physiological, and psychological factors that influence people's willingness to donate blood. Although past research has largely focused on donor recruitment, in particular, demographic variables associated with blood donation behavior, the issue of donor retention has become increasingly important. A growing number of studies have also highlighted the role of psychological factors in explaining, predicting, and promoting blood donation behavior. In line with recent trends in blood donation research, the present article reviews the contributions of, and current directions in, psychological research on blood donation attitudes and behavior, with special emphasis on donor return and repeat blood donation behavior. Although there is overlap between factors that predict the initiation and the maintenance of blood donation behavior, it is suggested that changes in motivation and the development of self-identity as a blood donor are crucial for understanding the processes whereby first-time donors become repeat donors.