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Ferreira CM, Vieites Y, Goldszmidt R, Barros LSG, Andrade EB. Short- and long-term effects of incentives on prosocial behavior: The case of ride vouchers to a blood collection agency. Soc Sci Med 2024; 352:117019. [PMID: 38810507 DOI: 10.1016/j.socscimed.2024.117019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 05/21/2024] [Accepted: 05/22/2024] [Indexed: 05/31/2024]
Abstract
This study addresses the challenge of low blood donation rates in developing countries by examining the effectiveness of a barrier-removal incentive-a one-day transportation voucher-to promote blood donation. Utilizing a longitudinal dataset of 23,750 donors from a Brazilian blood collection agency (BCA) collected between March 2018 and May 2020, we examine the short and long-term effects of this campaign on donation rates. Our results show that the incentive had a large positive influence on both donation attempts and successful donations on the day of the campaign. However, the short-term success of the intervention had an unintended consequence: the significant increase in prospective donors' waiting time at the BCA during the intervention day, which may help explain the negative impact on return rates in the 24-month follow-up. Despite these opposing outcomes, the net effect of the one-day blood donation incentive was still positive, offering valuable insights for BCAs aiming to enhance donor recruitment and retention strategies and emphasizing the need to balance immediate benefits with potential long-term impacts.
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Affiliation(s)
- Claudio M Ferreira
- FGV EBAPE Brazilian School of Public and Business Administration, Fundação Getulio Vargas, Rua Jornalista Orlando Dantas, 30, Botafogo, Rio de Janeiro, RJ, 22231-010, Brazil.
| | - Yan Vieites
- FGV EBAPE Brazilian School of Public and Business Administration, Fundação Getulio Vargas, Rua Jornalista Orlando Dantas, 30, Botafogo, Rio de Janeiro, RJ, 22231-010, Brazil.
| | - Rafael Goldszmidt
- FGV EBAPE Brazilian School of Public and Business Administration, Fundação Getulio Vargas, Rua Jornalista Orlando Dantas, 30, Botafogo, Rio de Janeiro, RJ, 22231-010, Brazil.
| | - Lucia S G Barros
- FGV EAESP Business Administration School of São Paulo, Fundação Getulio Vargas, Av. 9 de julho, 2029, Bela Vista, São Paulo, SP, 01313-902, Brazil.
| | - Eduardo B Andrade
- FGV EBAPE Brazilian School of Public and Business Administration, Fundação Getulio Vargas, Rua Jornalista Orlando Dantas, 30, Botafogo, Rio de Janeiro, RJ, 22231-010, Brazil; Imperial College Business School, Imperial College London, South Kensington Campus, Exhibition Rd, London, SW7 2AZ, United Kingdom.
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2
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Cao C, Wang J, Guo T, Hu X, Li B, Wu C, Liu Z, Pan SW. Voluntary blood donation preferences in China: A discrete choice experiment among experienced and inexperienced donors. Vox Sang 2024; 119:428-438. [PMID: 38389330 DOI: 10.1111/vox.13604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 02/03/2024] [Accepted: 02/05/2024] [Indexed: 02/24/2024]
Abstract
BACKGROUND AND OBJECTIVES Due partly to an ageing population, China faces an increasingly dire blood shortage crisis requiring greater voluntary blood donations. A better understanding of blood donation preferences can inform blood donation policies and potentially increase donations. We used an online survey and discrete choice experiment to achieve our study objective: identify the most influential structural facilitators and barriers to voluntary blood donation in China. MATERIALS AND METHODS First, we identified six structural attributes (travel time, venue, donation volume, paid leave, scheduling and gifts) that were hypothesized to influence voluntary blood donation; attribute selection was based on a literature review and qualitative interviews. Second, a d-efficient design with 36 choice sets and 9 blocks was developed. Participants were asked to complete four choice sets, and in each choice set, they were asked to choose from three options: two voluntary blood donation scenarios and a 'Do not donate blood' option. Study participants were recruited through an online survey platform company in China. Voluntary blood donation preferences and preferences by blood donation history were estimated with random-parameter logit models and interaction terms. RESULTS In 2022, 1185 individuals enrolled in the study. Most participants had college education (92%). Generally, participants preferred longer paid leave, lower blood donation volumes and gifts after donation. Based on interaction analyses, experienced and inexperienced donors exhibited similar preferences. CONCLUSION Campaigns to increase voluntary blood donation rates in China should consider implementing paid leave after voluntary blood donation, lower blood donation volumes and small gifts conferred after donation.
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Affiliation(s)
- Chuqing Cao
- Department of Applied Mathematics, Xi'an Jiaotong-Liverpool University, Suzhou, China
| | - Jing Wang
- School of Public Health, Harvard University, Cambridge, Massachusetts, USA
| | - Tianyu Guo
- Department of Chemistry, Xi'an Jiaotong-Liverpool University, Suzhou, China
| | - Xinwen Hu
- Duke Kunshan University, Suzhou, China
| | - Bo Li
- Wisdom Lake Pharmacy Academy, Xi'an Jiaotong-Liverpool University, Suzhou, China
| | - Caixia Wu
- Department of Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Chengdu, China
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences & Peking Union Medical College, Chengdu, China
- Key Laboratory of Transfusion Adverse Reactions, Chinese Academy of Medical Sciences, Chengdu, China
| | - Zhong Liu
- Department of Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Chengdu, China
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences & Peking Union Medical College, Chengdu, China
- Key Laboratory of Transfusion Adverse Reactions, Chinese Academy of Medical Sciences, Chengdu, China
| | - Stephen W Pan
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, China
- Department of Public Health, The University of Texas at San Antonio, San Antonio, Texas, USA
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3
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Bruers S. Blood Donation and Monetary Incentives: A Meta-Analysis of Cost-Effectiveness. Transfus Med Rev 2021; 36:48-57. [PMID: 34742615 DOI: 10.1016/j.tmrv.2021.08.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 08/04/2021] [Accepted: 08/16/2021] [Indexed: 10/20/2022]
Abstract
The effectiveness of monetary incentives to increase altruistic behavior is in dispute. Paying blood donors might be ineffective, as it could decrease altruistic motivations of voluntary donors (motivational crowding-out) or decrease blood quality (increase transmittable infectious disease risks). In a meta-analysis, including observational studies, natural experiments and field experiments, the cost-effectiveness of monetary incentives (cash payments and quasi-cash material rewards) for blood donation is estimated. The search strategy identified 17 studies as eligible. After screening for relevance and quality, 8 studies were retained and GRADE-rated for quality of evidence, offering 12 estimates of the marginal donation rate. The combined, random-effects estimate of the marginal donation rate of monetary incentives is 0,4 extra blood units collected per 1000 inhabitants per year per dollar incentive, but with large variation due to large heterogeneity of the studies (explained by different contexts and differences in perceived costs for donors). A higher estimate of 1,0 extra blood units per 1000 inhabitants per year per dollar incentive, is obtained with a restricted meta-analysis that only includes the most reliable and more homogeneous studies. With donor payments, it costs an additional $22 to $121 to increase the blood supply with one unit of whole blood, but this strongly varies with context and local conditions. The positive marginal donation rate of donor payments is inconsistent with a crowding-out effect (a reduction in total blood supply caused by a decrease in altruistic motivations when donors are paid), at least in the short-run. The available studies are not suitable to estimate possible long-term crowding-out effects, negative spillover effects (eg, a decrease in other prosocial behavior or altruistic norms) or transmittable infectious disease risks. Whether monetary incentives are the most cost-effective and ethical strategy to increase blood and plasma supply, remains an open question.
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Affiliation(s)
- Stijn Bruers
- Department of Economics, KULeuven, Leuven, Belgium.
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4
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de Corte K, Cairns J, Grieve R. Stated versus revealed preferences: An approach to reduce bias. HEALTH ECONOMICS 2021; 30:1095-1123. [PMID: 33690931 DOI: 10.1002/hec.4246] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 12/17/2020] [Accepted: 01/22/2021] [Indexed: 06/12/2023]
Abstract
Stated preference (SP) survey responses may not predict actual behavior, leading to hypothetical bias. We developed an approach that harnesses large-scale routine data to help SP surveys provide more accurate estimates of revealed preferences (RPs), within a study which elicited preferences for alternative changes to the blood service in England. The SP survey responses were used to predict the mean number of annual whole blood donations. Ex ante, the iterative survey design estimated hypothetical bias by contrasting pilot SP survey responses (N = 1254), with individually linked data on RPs, to inform the main SP survey design (N = 25,187). Ex post, the analysis recognized mediation of the relationship between SP and RP when blood donation is deferred. The pilot survey reported that donors' intended donation frequency of 3.2 (men) and 2.6 (women) times per year, exceeded their actual frequency by 41% and 30% respectively. Choice scenario attributes for the main SP survey were then modified, and over-prediction subsequently decreased to 34% for men and 16% for women. The mediating effect of deferrals explained 29% (men) and 86% (women) of the residual discrepancy between SP and RP. Future studies can use this approach to reduce hypothetical bias, and provide more accurate predictions for decision-making.
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Affiliation(s)
- Kaat de Corte
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - John Cairns
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Richard Grieve
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
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5
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Greffin K, Schmidt S, Schönborn L, Muehlan H. "Blood for Blood"? Personal Motives and Deterrents for Blood Donation in the German Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4238. [PMID: 33923586 PMCID: PMC8072955 DOI: 10.3390/ijerph18084238] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 04/09/2021] [Accepted: 04/13/2021] [Indexed: 11/16/2022]
Abstract
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.
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Affiliation(s)
- Klara Greffin
- Department of Psychology, University of Greifswald, 17489 Greifswald, Germany; (S.S.); (H.M.)
| | - Silke Schmidt
- Department of Psychology, University of Greifswald, 17489 Greifswald, Germany; (S.S.); (H.M.)
| | - Linda Schönborn
- Institute for Immunology & Transfusion Medicine, University Medicine Greifswald, 17489 Greifswald, Germany;
| | - Holger Muehlan
- Department of Psychology, University of Greifswald, 17489 Greifswald, Germany; (S.S.); (H.M.)
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6
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Chandler T, Neumann-Böhme S, Sabat I, Barros PP, Brouwer W, van Exel J, Schreyögg J, Torbica A, Stargardt T. Blood donation in times of crisis: Early insight into the impact of COVID-19 on blood donors and their motivation to donate across European countries. Vox Sang 2021; 116:1031-1041. [PMID: 33835509 PMCID: PMC8250750 DOI: 10.1111/vox.13103] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 03/04/2021] [Accepted: 03/08/2021] [Indexed: 11/27/2022]
Abstract
Background In this survey, we aimed to provide early insight into the impact of COVID‐19 on blood donors and their motivation to donate during the crisis. Study design and methods We asked representative samples in 7 European countries (Denmark, France, Germany, Italy, Portugal, the Netherlands and the UK) about their blood donation activity and motivation to donate using an online survey. We analysed donor turnout during the COVID‐19 period descriptively and using logistic regression. Results Of the 7122 people that responded to the survey, 1205 (16·9%) blood donors were identified, with 33·8% donating during the first 4–5 months of the COVID‐19 period. We observed that around half of donors donated less than normal. The vast majority of donors that did donate made a special effort to do so in response to COVID‐19. The majority of donors were also not aware of their blood being tested for COVID‐19 antibodies. Although the perceived risk of infection among all respondents whilst donating blood was relatively low, those who anticipated a high risk of infection were much less likely to donate (OR = 0·540; P‐value = 0·006). Furthermore, those that were adherent to COVID guidelines were also less likely to donate (OR = 0·583; P‐value = 0·000). Discussion We suggest that blood collection services consider specialist campaigns that focus on the altruistic motivation of donors during the crisis and that they continue to communicate the additional safety measures in place with the aim of reducing the fear of infection whilst donating blood.
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Affiliation(s)
- Torsten Chandler
- Hamburg Center for Health Economics, University of Hamburg, Hamburg, Germany
| | - Sebastian Neumann-Böhme
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Iryna Sabat
- Nova School of Business and Economics, Lisbon, Portugal
| | | | - Werner Brouwer
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, the Netherlands.,Erasmus School of Economics, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Job van Exel
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, the Netherlands.,Erasmus School of Economics, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Jonas Schreyögg
- Hamburg Center for Health Economics, University of Hamburg, Hamburg, Germany
| | - Aleksandra Torbica
- Centre for Research on Health and Social Care Management, Bocconi University, Milan, Italy
| | - Tom Stargardt
- Hamburg Center for Health Economics, University of Hamburg, Hamburg, Germany
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7
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Ferguson E, Hill A, Lam M, Reynolds C, Davison K, Lawrence C, Brailsford SR. A typology of blood donor motivations. Transfusion 2020; 60:2010-2020. [PMID: 32618010 DOI: 10.1111/trf.15913] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 05/14/2020] [Accepted: 05/14/2020] [Indexed: 01/14/2023]
Abstract
BACKGROUND Although the need for whole blood is declining, so too are the number of first-time and repeat blood donors. To develop new recruitment and retention strategies, therefore, we need to draw on as wide a variation in blood donor motivations as possible. The primary aim of this study is to draw on a large survey of donors to develop a broad, theoretically instantiated typology of donor motivations to identify new and less common, yet practically important, motivations that have not been previously reported. STUDY DESIGN AND METHODS Using data from the UK Blood Donor Survey run by NHS Blood and Transplant/Public Health England Epidemiology Unit (N = 61 123 donors), we analyze fixed (N = 52 225) and free (N = 8867) responses to develop a more comprehensive typology of blood donor motivations based on theories from the biology, psychology, philosophy, economics, and sociology of altruism. RESULTS We identified 54 motivations, including a number of newly identified motivations, for blood donations which we organized into 12 superordinate categories (eg, "inspiration via moral elevation," "perceived social closeness," and "fungibility of donations"). These are linked to intervention suggestions such as donating blood in memoriam or donating blood as an alternative to other charitable acts. CONCLUSION We present the most comprehensive account of blood donor motivations to-date. This work also offers a structure for coding free-text responses, developing motivational measures, and identifying tangible interventions. Thus, we feel that this is a valuable resource for blood donor researchers, marketers, and policy makers.
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Affiliation(s)
- Eamonn Ferguson
- School of Psychology, University of Nottingham, Nottingham, UK
| | - Alexandra Hill
- School of Psychology, University of Nottingham, Nottingham, UK
| | - Michael Lam
- School of Psychology, University of Nottingham, Nottingham, UK.,School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Claire Reynolds
- NHS Blood and Transplant/Public Health England Epidemiology Unit, NHS Blood and Transplant, London, UK
| | - Katy Davison
- NHS Blood and Transplant/Public Health England Epidemiology Unit, Public Health England, London, UK
| | - Claire Lawrence
- School of Psychology, University of Nottingham, Nottingham, UK
| | - Susan R Brailsford
- NHS Blood and Transplant/Public Health England Epidemiology Unit, NHS Blood and Transplant, London, UK
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8
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Estrada FGMD, Oliveira CDL, Sabino EC, Custer B, Gonçalez TT, Murphy EL, Teles D, Mendrone-Junior A, Witkin SS, de Almeida-Neto C. Are different motivations and social capital score associated with return behaviour among Brazilian voluntary non-remunerated blood donors? Transfus Med 2020; 30:255-262. [PMID: 32468690 DOI: 10.1111/tme.12684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 04/16/2020] [Accepted: 04/27/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND We examined the association between social capital score, motivator factors and demographic and donation characteristics and donor return at three Brazilian blood centres in Recife, São Paulo and Belo Horizonte. MATERIAL AND METHODS A total of 5974 donors were interviewed about motivation factors to donate and cognitive and structural social capital just before an effective donation in three Brazilians blood centres in 2009. We assessed the return to a new donation within 2 years for each of these donors. Demographic and donation characteristics, motivators and scores of social capital and their association with donors' return were assessed. RESULTS Overall, 3123 (52.3%) of the study subjects returned for a blood donation at least once. Predictors of donors' return were male gender (adjusted odds ratio [AOR] = 1.6, 1.3-1.9, for replacement and AOR = 1.3, 1.2-1.6, for community donors), previous donation (AOR = 2.7, 2.3-3.3, for replacement and AOR = 2.9, 2.5-3.5, for community donors) and high altruism (AOR = 1.3, 1.1-1.7, for replacement and AOR = 1.2, 1.0-1.5, for community donors). Altruism was the only motivator associated with return behaviour. Donors from Recife and São Paulo were more likely to return for replacement and/or for community donations than donors from Belo Horizonte. There was no association between social capital score and donor return behaviour. CONCLUSION The likelihood to return for a subsequent blood donation is dependent upon characteristics of individual donors and also varies in different regions of Brazil. However, social capital was not associated with the likelihood of return behaviour. A better understanding of altruistic categories and appeals may help to improve donor recruitment and retention.
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Affiliation(s)
- Fernanda G M D Estrada
- Disciplina de Ciências Médicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | - Ester C Sabino
- Instituto de Medicina Tropical da Universidade de São Paulo, Universidade de São Paulo, São Paulo, Brazil.,Departamento de Moléstias Infecciosas e Parasitárias, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Brian Custer
- Epidemiology and Health Policy Science, Vitalant Research Institute, San Francisco, California, USA
| | - Thelma T Gonçalez
- Epidemiology and Health Policy Science, Vitalant Research Institute, San Francisco, California, USA
| | - Edward L Murphy
- Epidemiology and Health Policy Science, Vitalant Research Institute, San Francisco, California, USA.,Department of Laboratory Medicine, University of California San Francisco, San Francisco, California, USA
| | - Dahra Teles
- SPA - Urgência, Fundação de Hematologia e Hemoterapia de Pernambuco (HEMOPE), Recife, Brazil
| | - Alfredo Mendrone-Junior
- Diretoria Técnico Científica, Fundação Pró-Sangue-Hemocentro de São Paulo, São Paulo, Brazil
| | - Steve S Witkin
- Instituto de Medicina Tropical da Universidade de São Paulo, Universidade de São Paulo, São Paulo, Brazil.,Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, New York, USA
| | - Cesar de Almeida-Neto
- Disciplina de Ciências Médicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.,Diretoria Técnico Científica, Fundação Pró-Sangue-Hemocentro de São Paulo, São Paulo, Brazil
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9
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Van Dyke N, Chell K, Masser B, Kruse SP, Gemelli CN, Jensen K, Davison TE. Thank you for donating: a survey of Australian donors' and nondonors' orientations toward noncash incentives for blood donation. Transfusion 2020; 60:1454-1462. [PMID: 32339296 DOI: 10.1111/trf.15806] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Revised: 03/13/2020] [Accepted: 03/14/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND The aim of this study was to understand Australian donors' and nondonors' orientations toward 13 noncash incentives for blood and plasma donation and the associations between orientations and intention to donate (nondonors) and subsequent donation (donors). STUDY DESIGN AND METHODS A survey of 1028 donors and 1201 nondonors was conducted online and by telephone. Donors were randomly selected from the Australian Red Cross Lifeblood donor panel; nondonors were selected from randomly generated fixed line and mobile telephone numbers across Australia. Incentives were chosen to reflect a wide array of possible noncash incentives that might be introduced by blood donation organizations (BDOs). Differences between donors and nondonors, as well as other subgroups, were investigated. RESULTS Orientations toward most types of incentives were positive or neutral. No significant differences were observed between incentive orientations for whole blood versus plasma donations. Many subgroup differences were small but statistically significant. There were mostly small, positive, significant associations between nondonors' intention to donate and orientations toward noncash incentives; there were mostly no significant associations between donors' orientations and subsequent donation behaviors. CONCLUSION The findings from this study suggest that BDOs that wish to trial noncash incentives in voluntary nonremunerative systems can be confident that neither donors nor potential donors will react negatively. They also indicate that BDOs have some flexibility in deciding which incentives to trial.
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Affiliation(s)
- Nina Van Dyke
- Research and Development, The Australian Red Cross Lifeblood, Melbourne, Victoria, Australia
| | - Kathleen Chell
- Research and Development, The Australian Red Cross Lifeblood, Melbourne, Victoria, Australia
| | - Barbara Masser
- Research and Development, The Australian Red Cross Lifeblood, Melbourne, Victoria, Australia.,School of Psychology, The University of Queensland, St Lucia, Queensland, Australia
| | - Sarah P Kruse
- Research and Development, The Australian Red Cross Lifeblood, Melbourne, Victoria, Australia
| | - Carley N Gemelli
- Research and Development, The Australian Red Cross Lifeblood, Melbourne, Victoria, Australia
| | - Kyle Jensen
- Research and Development, The Australian Red Cross Lifeblood, Melbourne, Victoria, Australia
| | - Tanya E Davison
- Research and Development, The Australian Red Cross Lifeblood, Melbourne, Victoria, Australia
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10
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Bruhin A, Goette L, Haenni S, Jiang L. Spillovers of prosocial motivation: Evidence from an intervention study on blood donors. JOURNAL OF HEALTH ECONOMICS 2020; 70:102244. [PMID: 31927309 DOI: 10.1016/j.jhealeco.2019.102244] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 09/27/2019] [Accepted: 10/04/2019] [Indexed: 06/10/2023]
Abstract
Blood donations are increasingly important for medical procedures, while meeting demand is challenging. This paper studies the role of spillovers arising from social interactions in the context of voluntary blood donations. We analyze a large-scale intervention among pairs of blood donors who live at the same street address. A quasi-random phone call provides the instrument for identifying the extent to which the propensity to donate spills over within these pairs. Spillovers transmit 41% to 46% of the behavioral impulse from one donor to the peer. This creates a significant social multiplier, ranging between 1.7 and 1.85. There is no evidence that these spillovers lead to intertemporal substitution. Taken together, our findings indicate that policy interventions have a substantially larger effect when targeted towards pairs instead of isolated individuals.
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Affiliation(s)
- Adrian Bruhin
- University of Lausanne, Faculty of Business and Economics (HEC Lausanne), 1015 Lausanne, Switzerland.
| | - Lorenz Goette
- University of Bonn, Department of Economics, 53113 Bonn, Germany; National University of Singapore, Department of Economics, 1 Arts Link, Singapore 117570, Singapore
| | - Simon Haenni
- University of Zurich, Department of Economics, 8001 Zurich, Switzerland
| | - Lingqing Jiang
- University of Essex, Department of Economics, Colchester CO4 3SQ, UK
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11
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Irving AH, Harris A, Petrie D, Mortimer D, Ghijben P, Higgins A, McQuilten Z. A systematic review and network meta-analysis of incentive- and non-incentive-based interventions for increasing blood donations. Vox Sang 2020; 115:275-287. [PMID: 32043603 DOI: 10.1111/vox.12881] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 11/21/2019] [Accepted: 12/05/2019] [Indexed: 11/27/2022]
Abstract
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.
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Affiliation(s)
- Adam H Irving
- Centre for Health Economics, Monash University, Caulfield, Vic, Australia
| | - Anthony Harris
- Centre for Health Economics, Monash University, Caulfield, Vic, Australia
| | - Dennis Petrie
- Centre for Health Economics, Monash University, Caulfield, Vic, Australia
| | - Duncan Mortimer
- Centre for Health Economics, Monash University, Caulfield, Vic, Australia
| | - Peter Ghijben
- Centre for Health Economics, Monash University, Caulfield, Vic, Australia
| | - Alisa Higgins
- Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Caulfield, Vic, Australia
| | - Zoe McQuilten
- Transfusion Research Unit, School of Public Health and Preventive Medicine, Monash University, Caulfield, Vic, Australia
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12
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Bruhin A, Goette L, Haenni S, Jiang L, Markovic A, Roethlisberger A, Buchli R, Frey BM. The Sting of Rejection: Deferring Blood Donors due to Low Hemoglobin Values Reduces Future Returns. Transfus Med Hemother 2019; 47:119-128. [PMID: 32355471 DOI: 10.1159/000500679] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 04/28/2019] [Indexed: 11/19/2022] Open
Abstract
Background Roughly one quarter of short-term temporary deferrals (STTD) of blood donors are low-hemoglobin deferrals (LHD), i.e. STTD due to a hemoglobin (Hb) value falling below a cutoff of 125 g/L for female and 135 g/L for male donors. Since voluntarily donating blood is a prosocial activity, donors may perceive deferral as social exclusion, which can cause social pain, decrease self-esteem, and lead to antisocial behavior. However, little is known about the causal impacts of LHD on donor return. Study Design and Methods We conducted a quasi-experiment with 80,060 donors invited to blood drives in the canton of Zurich, Switzerland, between 2009 and 2014. Within a narrow window of Hb values around the predetermined cutoff, the rate of LHD jumps discontinuously. This discontinuous jump allows us to quantify the causal effects of LHD on donor return, as it is uncorrelated with other unobserved factors that may also affect donor return. Results We found different behavioral reactions to LHD for female and male donors. Female donors do not react to the first LHD. However, after any repeated LHD, they are 13.53 percentage points (p <0.001) less likely to make at least 1 donation attempt within the next 18 months and make 0.389 fewer donation attempts (p <0.001). Male donors react to the first LHD. They are 5.32 percentage points (p = 0.139) less likely to make at least 1 donation attempt over the next 18 months and make 0.227 (p = 0.018) fewer donation attempts. After any repeated LHD, male donors are 13.30 percentage points (p = 0.004) less likely to make at least 1 donation attempt and make 0.152 (p = 0.308) fewer donation attempts. Conclusion LHD have detrimental impacts on donor return, especially if they occur repeatedly - suggesting that avoiding false LHD and helping donors to better cope with them helps to maintain the pool of prospective donors.
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Affiliation(s)
- Adrian Bruhin
- Faculty of Business and Economics (HEC Lausanne), University of Lausanne, Lausanne, Switzerland
| | - Lorenz Goette
- Department of Economics, University of Bonn, Bonn, Germany.,Department of Economics, National University of Singapore, Singapore, Singapore
| | - Simon Haenni
- Department of Economics, University of Zurich, Zurich, Switzerland
| | - Lingqing Jiang
- Department of Economics, University of Essex, Colchester, United Kingdom
| | | | | | - Regula Buchli
- Blood Transfusion Service, Swiss Red Cross, Schlieren, Switzerland
| | - Beat M Frey
- Blood Transfusion Service, Swiss Red Cross, Schlieren, Switzerland
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13
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Grieve R, Willis S, De Corte K, Sadique MZ, Hawkins N, Perra S, Pennington M, Turner J, Moore C, Wickenden C, Koppitz C, Cho G, Roberts DJ, Miflin G, Cairns JA. Options for possible changes to the blood donation service: health economics modelling. HEALTH SERVICES AND DELIVERY RESEARCH 2018. [DOI: 10.3310/hsdr06400] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BackgroundEvidence is required on the cost-effectiveness of alternative changes to the blood collection service.Objectives(1) To estimate the cost-effectiveness of alternative minimum interdonation intervals between whole-blood donations. (2) To investigate donors’ frequency of whole-blood donation according to alternative changes to the blood collection service. (3) To estimate the cost-effectiveness of alternative strategies for maintaining the supply of whole blood.MethodsWe undertook a within-trial cost-effectiveness analysis (CEA) of the INTERVAL trial, stated preference (SP) surveys to elicit donor preferences and a CEA of different strategies for blood collection. The strategies considered were reduced minimum intervals between whole-blood donations, introduction of a donor health report and changes to appointment availability and opening times at blood collection venues. The within-trial CEA included 44,863 donors, with men randomly assigned to 12- versus 10- versus 8-week interdonation intervals, and women to 16- versus 14- versus 12-week interdonation intervals. We undertook a SP survey of non-INTERVAL donors (100,000 invitees). We asked donors to state the frequency with which they would be willing to donate blood, according to the service attribute and level. The CEA compared changes to the blood service with current practice by combining the survey estimates with information from the NHS Blood and Transpant database (PULSE) and cost data. The target population was existing whole-blood donors in England, of whom approximately 85% currently donate whole blood at mobile (temporary) blood collection venues, with the remainder donating at static (permanent) blood collection centres. We reported the effects of the alternative strategies on the number of whole-blood donations, costs and cost-effectiveness.ResultsThe reduced donation interval strategies had higher deferral rates caused by low haemoglobin (Hb), but increased frequency of successful donation. For men in the 8- versus 12-week arm of the INTERVAL trial [Di Angelantonio E, Thompson SG, Kaptoge S, Moore C, Walker M, Armitage J,et al.Efficiency and safety of varying the frequency of whole blood donation (INTERVAL): a randomised trial of 45 000 donors.Lancet2017;390:2360–71], the Hb-related deferral rate was 5.7% per session versus 2.6% per session, but the average number of donations over 2 years increased by 1.71 (95% confidence interval 1.60 to 1.80). A total of 25,187 (25%) donors responded to the SP survey. For static donor centres, extending appointment availability to weekday evenings or weekends, or reduced intervals between blood donations, increased stated donation frequency by, on average, 0.5 donations per year. The CEA found that reducing the minimum interval, extending opening times to weekday evenings and extending opening times to weekends in all static donor centres would provide additional whole blood at a cost per additional unit of £10, £23 and £29, respectively, with similar results for donors with high-demand blood types.LimitationsThe study did not consider the long-term rates at which donors will leave the donation register, for example following higher rates of Hb-related deferral.ConclusionsExtending opening hours for blood donation to weekday evenings or weekends for all static donor centres are cost-effective ways of increasing the supply of high-demand blood types.Future workTo monitor the effects of new strategies on long-term donation frequency.FundingThe National Institute for Health Research Health Services and Delivery Research programme.
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Affiliation(s)
- Richard Grieve
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Sarah Willis
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Kaat De Corte
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - M Zia Sadique
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Neil Hawkins
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
- Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - Silvia Perra
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Mark Pennington
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
- Department of Health Services & Population Research, King’s College London, London, UK
| | - Jenny Turner
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Carmel Moore
- NIHR Blood and Transplant Research Unit in Donor Health and Genomics, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- INTERVAL Coordinating Centre, Department of Public Health and Primary Care, Cambridge, UK
| | | | | | - Gavin Cho
- NHS Blood and Transplant, London, UK
| | - David J Roberts
- NIHR Blood and Transplant Research Unit in Donor Health and Genomics, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- NHS Blood and Transplant, London, UK
- Radcliffe Department of Medicine, John Radcliffe Hospital, University of Oxford, Oxford, UK
| | | | - John A Cairns
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
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14
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Willis S, De Corte K, Cairns JA, Zia Sadique M, Hawkins N, Pennington M, Cho G, Roberts DJ, Miflin G, Grieve R. Cost-effectiveness of alternative changes to a national blood collection service. Transfus Med 2018; 29 Suppl 1:42-51. [PMID: 29767450 PMCID: PMC7379655 DOI: 10.1111/tme.12537] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 04/08/2018] [Accepted: 04/09/2018] [Indexed: 12/04/2022]
Abstract
Objectives To evaluate the cost‐effectiveness of changing opening times, introducing a donor health report and reducing the minimum inter‐donation interval for donors attending static centres. Background Evidence is required about the effect of changes to the blood collection service on costs and the frequency of donation. Methods/Materials This study estimated the effect of changes to the blood collection service in England on the annual number of whole‐blood donations by current donors. We used donors' responses to a stated preference survey, donor registry data on donation frequency and deferral rates from the INTERVAL trial. Costs measured were those anticipated to differ between strategies. We reported the cost per additional unit of blood collected for each strategy versus current practice. Strategies with a cost per additional unit of whole blood less than £30 (an estimate of the current cost of collection) were judged likely to be cost‐effective. Results In static donor centres, extending opening times to evenings and weekends provided an additional unit of whole blood at a cost of £23 and £29, respectively. Introducing a health report cost £130 per additional unit of blood collected. Although the strategy of reducing the minimum inter‐donation interval had the lowest cost per additional unit of blood collected (£10), this increased the rate of deferrals due to low haemoglobin (Hb). Conclusion The introduction of a donor health report is unlikely to provide a sufficient increase in donation frequency to justify the additional costs. A more cost‐effective change is to extend opening hours for blood collection at static centres.
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Affiliation(s)
- S Willis
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - K De Corte
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - J A Cairns
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - M Zia Sadique
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - N Hawkins
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK.,Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - M Pennington
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK.,Department of Health Services and Population Research, King's College London, London, UK
| | - G Cho
- NHS Blood and Transplant, London, UK
| | - D J Roberts
- NHS Blood and Transplant, London, UK.,Radcliffe Department of Medicine and BRC Oxford Haematology Theme, University of Oxford, John Radcliffe Hospital, Oxford, UK.,NIHR Blood and Transplant Research Unit in Donor Health and Genomics, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - G Miflin
- NHS Blood and Transplant, London, UK
| | - R Grieve
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
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15
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Sadler A, Shi L, Bethge S, Mühlbacher A. Incentives for Blood Donation: A Discrete Choice Experiment to Analyze Extrinsic Motivation. Transfus Med Hemother 2018; 45:116-124. [PMID: 29765295 DOI: 10.1159/000481142] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 08/26/2017] [Indexed: 11/19/2022] Open
Abstract
Background: Demographic trends affect size and age structure of populations. One of the consequences will be an increasing need for blood products to treat age-related diseases. Donation services rely on voluntariness and charitable motivation. It might be questioned whether there will be sufficient blood supply with voluntary donation. The present study focused on elicitation of preferences for incentives and aimed to contribute to the discussion on how to increase donation rates. Methods: A self-administered discrete choice experiment (DCE) was applied. Respondents were repeatedly asked to choose between hypothetical blood donation centers. In case of reluctance to receiving incentives a none-option was included. Random parameter logit (RPL) and latent class models (LCM) were used for analysis. Results: The study sample included 416 college students from the US and Germany. Choice decisions were significantly influenced by the characteristics of the donation center in the DCE. Incentives most preferred were monetary compensation, paid leave, and blood screening test. LCM identified subgroups with preference heterogeneity. Small subgroups indicated moderate to strong aversion to incentives. Conclusion: The majority of the sample positively responded to incentives and indicated a willingness to accept incentives. In face of future challenges, the judicious use and appropriate utilization of incentives might be an option to motivate potential donors and should be open to discussion.
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Affiliation(s)
- Andrew Sadler
- Gesundheitsökonomie und Medizinmanagement, Hochschule Neubrandenburg, Neubrandenburg, Germany
| | - Ling Shi
- Department of Nursing, University of Massachusetts Boston, Boston, MA, USA
| | - Susanne Bethge
- Gesundheitsökonomie und Medizinmanagement, Hochschule Neubrandenburg, Neubrandenburg, Germany
| | - Axel Mühlbacher
- Gesundheitsökonomie und Medizinmanagement, Hochschule Neubrandenburg, Neubrandenburg, Germany
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16
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Carver A, Chell K, Davison TE, Masser BM. What motivates men to donate blood? A systematic review of the evidence. Vox Sang 2017; 113:205-219. [DOI: 10.1111/vox.12625] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 11/16/2017] [Accepted: 11/16/2017] [Indexed: 11/29/2022]
Affiliation(s)
- A. Carver
- Mary MacKillop Institute for Health Research; Australian Catholic University; Melbourne Vic. Australia
- Australian Red Cross Blood Service; Melbourne Vic. Australia
| | - K. Chell
- Australian Red Cross Blood Service; Melbourne Vic. Australia
- Queensland University of Technology; Brisbane Qld Australia
| | - T. E. Davison
- Australian Red Cross Blood Service; Melbourne Vic. Australia
| | - B. M. Masser
- Australian Red Cross Blood Service; Melbourne Vic. Australia
- The University of Queensland; St Lucia Qld Australia
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17
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Chell K, Davison TE, Masser B, Jensen K. A systematic review of incentives in blood donation. Transfusion 2017; 58:242-254. [DOI: 10.1111/trf.14387] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 09/04/2017] [Accepted: 09/04/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Kathleen Chell
- Research and Development; Australian Red Cross Blood Service; Kelvin Grove QLD Australia
| | - Tanya E. Davison
- Research and Development; Australian Red Cross Blood Service; St Kilda VIC Australia
| | - Barbara Masser
- Research and Development; Australian Red Cross Blood Service; Kelvin Grove QLD Australia
- School of Psychology; McElwain Building, The University of Queensland; St Lucia QLD Australia
| | - Kyle Jensen
- Research and Development; Australian Red Cross Blood Service; St Kilda VIC Australia
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18
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Suemnig A, Konerding U, Hron G, Lubenow N, Alpen U, Hoffmann W, Kohlmann T, Greinacher A. Motivational factors for blood donation in first-time donors and repeat donors: a cross-sectional study in West Pomerania. Transfus Med 2017; 27:413-420. [PMID: 28786224 DOI: 10.1111/tme.12450] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Revised: 06/29/2017] [Accepted: 07/07/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVES This study aimed to analyse motivational factors for blood donation in different donor groups. BACKGROUND As the demographic change will result in a decrease of the population in age groups of blood donors, the risk of blood product shortage increases. METHODS During a 12-month period, every sixth blood donor presenting at the blood donation centre of the University Hospital was asked to complete a self-administered questionnaire assessing motivational factors for blood donation. Despite the formalised enrolment protocol, frequent donors were over-represented in the study cohort, which was adjusted by weighting donors with different numbers of donations per year in such a way that the distribution of numbers of donations per year was the same in the sample as in the donor population. RESULTS Of 2443 participants, 14·3% were first-time and 85·3% repeat donors. To "help other people" (>90%) and receiving "medical assessment of my blood values" (63-69%) were the strongest motivational factors in all donor groups. Receiving remuneration (49·2% vs 38·1%) was more important for repeat donors than for first-time donors, whereas it was the opposite for "being taken by a friend to the donor clinic" (47·0% vs 15·5%). A potentially important observation is that 33·9% of frequent donors reported feeling physically better after blood donation compared to infrequent donors (29·5%). CONCLUSION Identification of motivational factors can lead to the design of targeted motivation campaigns for blood donation. The underlying cause of the perceived well-being after blood donation requires further studies.
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Affiliation(s)
- A Suemnig
- Institut für Immunologie und Transfusionsmedizin, Ernst-Moritz-Arndt-Universität, Greifswald, Germany
| | - U Konerding
- Trimberg Research Academy, Otto-Friedrich-Universität Bamberg, Bamberg, Germany
| | - G Hron
- Institut für Immunologie und Transfusionsmedizin, Ernst-Moritz-Arndt-Universität, Greifswald, Germany
| | - N Lubenow
- Clinical Immunology and Transfusion Medicine, University Hospital, Uppsala, Sweden
| | - U Alpen
- Institut für Immunologie und Transfusionsmedizin, Ernst-Moritz-Arndt-Universität, Greifswald, Germany
| | - W Hoffmann
- Institut für Community Medicine, Ernst-Moritz-Arndt-Universität Greifswald, Greifswald, Germany
| | - T Kohlmann
- Institut für Community Medicine, Ernst-Moritz-Arndt-Universität Greifswald, Greifswald, Germany
| | - A Greinacher
- Institut für Immunologie und Transfusionsmedizin, Ernst-Moritz-Arndt-Universität, Greifswald, Germany
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19
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Hao J, McAvoy J, Wickberg L, Kerrigan C, Kreiger L, Sikavi C, Swift D, Frenette C, Carney J, Fung MK. Is blood donation an opportunity for hypertension awareness? Transfus Med 2016; 26:89-98. [DOI: 10.1111/tme.12286] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 12/14/2015] [Accepted: 02/10/2016] [Indexed: 11/29/2022]
Affiliation(s)
- J. Hao
- College of Medicine; University of Vermont
| | - J. McAvoy
- College of Medicine; University of Vermont
| | | | | | - L. Kreiger
- College of Medicine; University of Vermont
| | - C. Sikavi
- College of Medicine; University of Vermont
| | - D. Swift
- College of Medicine; University of Vermont
| | - C. Frenette
- Northern New England Region; American Red Cross Blood Services
| | - J. Carney
- College of Medicine; University of Vermont
| | - M. K. Fung
- College of Medicine; University of Vermont
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20
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How Can We Improve Retention of the First-Time Donor? A Systematic Review of the Current Evidence. Transfus Med Rev 2016; 30:81-91. [PMID: 26971186 DOI: 10.1016/j.tmrv.2016.02.002] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2015] [Accepted: 02/15/2016] [Indexed: 11/22/2022]
Abstract
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.
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21
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Bruhin A, Goette L, Roethlisberger A, Markovic A, Buchli R, Frey BM. Call of duty: the effects of phone calls on blood donor motivation. Transfusion 2015; 55:2645-52. [DOI: 10.1111/trf.13236] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 05/13/2015] [Accepted: 05/13/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Adrian Bruhin
- Faculty of Business and Economics (HEC Lausanne); University of Lausanne; Lausanne-Dorigny Switzerland
| | - Lorenz Goette
- Faculty of Business and Economics (HEC Lausanne); University of Lausanne; Lausanne-Dorigny Switzerland
| | | | | | - Regula Buchli
- Blood Transfusion Service; Swiss Red Cross; Schlieren Switzerland
| | - Beat M. Frey
- Blood Transfusion Service; Swiss Red Cross; Schlieren Switzerland
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22
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Dionisio Tavares Niewiadonski V, dos Santos Bianchi JV, de Almeida-Neto C, Gaburo N, Sabino EC. Evaluation of a high throughput method for the detection of mutations associated with thrombosis and hereditary hemochromatosis in Brazilian blood donors. PLoS One 2015; 10:e0125460. [PMID: 25955572 PMCID: PMC4425487 DOI: 10.1371/journal.pone.0125460] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Accepted: 03/24/2015] [Indexed: 11/19/2022] Open
Abstract
Background The aim of this study was to evaluate the OpenArray platform for genetic testing of blood donors and to assess the genotype frequencies of nucleotide-polymorphisms (SNPs) associated with venous thrombosis (G1691A and G20210A), hyperhomocysteinemia (C677T, A1298C), and hereditary hemochromatosis (C282Y, H63D and S65C) in blood donors from Sao Paulo, Brazil. Methods We examined 400 blood donor samples collected from October to November 2011. The SNPs were detected using OpenArray technology. The blood samples were also examined using a real-time PCR–FRET system to compare the results and determine the accuracy of the OpenArray method. Results We observed 100% agreement in all assays tested, except HFE C282Y, which showed 99.75% agreement. The HFE C282Y assay was further confirmed through direct sequencing, and the results showed that OpenArray analysis was accurate. The calculated frequencies of each SNP were FV G1691A 98.8% (G/G), 1.2% (G/A); FII G2021A 99.5% (G/G), 0.5% (G/A); MTHFR C677T 45.5% (C/C), 44.8% (C/T), 9.8% (T/T); MTHFR A1298C 60.3% (A/A), 33.6% (A/C), 6.1% (C/C); HFE C282Y 96%(G/G), 4%(G/A), HFE H63D 78.1%(C/C), 20.3% (C/G), 1.6% (G/G); and HFE S65C 98.1% (A/A), 1.9% (A/T). Conclusion Taken together, these results describe the frequencies of SNPs associated with diseases and are important to enhance our current knowledge of the genetic profiles of Brazilian blood donors, although a larger study is needed for a more accurate determination of the frequency of the alleles. Furthermore, the OpenArray platform showed a high concordance rate with standard FRET RT-PCR.
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Affiliation(s)
| | | | | | - Nelson Gaburo
- Department of Molecular Diagnostics, DASA, São Paulo, Brazil
| | - Ester Cerdeira Sabino
- Institute of Tropical Medicine, University of São Paulo, São Paulo, Brazil
- Department of Infectious Disease, University of Sao Paulo, São Paulo, Brazil
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23
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Masser B, Bagot K. Understanding the current and future contribution of psychology to blood donor recruitment. ACTA ACUST UNITED AC 2014. [DOI: 10.1111/voxs.12075] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- B. Masser
- School of Psychology; The University of Queensland; St Lucia Qld Australia
| | - K. Bagot
- School of Psychology; The University of Queensland; St Lucia Qld Australia
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Masser B, Smith G, Williams LA. Donor research in australia: challenges and promise. ACTA ACUST UNITED AC 2014; 41:296-301. [PMID: 25254025 DOI: 10.1159/000365016] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Accepted: 04/24/2014] [Indexed: 11/19/2022]
Abstract
Donors are the key to the core business of Blood Collection Agencies (BCAs). However, historically, they have not been a focus of research undertaken by these organizations. This model is now changing, with significant donor research groups established in a number of countries, including Australia. Donor research in the Australian Red Cross Blood Service (Blood Service) is concentrated in the Donor and Community Research (DCR) team. Cognizant of the complex and ever-changing landscape with regard to optimal donor management, the DCR team collaborates with academics located at universities around Australia to coordinate a broad program of research that addresses both short- and-long term challenges to the blood supply. This type of collaboration is not, however, without challenges. Two major collaborative programs of the Blood Service's research, focusing on i) the recruitment and retention of plasmapheresis donors and ii) the role of the emotion pride in donor motivation and return, are showcased to elucidate how the challenges of conducting collaborative BCA research can be met. In so doing, these and the other research programs described herein demonstrate how the Blood Service supports and contributes to research that not only revises operational procedures but also contributes to advances in basic science.
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Affiliation(s)
- Barbara Masser
- School of Psychology, University of Queensland, St Lucia, QLD, Australia
| | - Geoff Smith
- The School of Advertising, Marketing and Public Relations, Queensland University of Technology, Brisbane, QLD (paper completed while affiliated with Australian Red Cross Blood Service, Melbourne, VIC), Australia
| | - Lisa A Williams
- School of Psychology, The University of New South Wales, Sydney, NSW, Australia
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Bart T, Volken T, Fischer Y, Taleghani BM. Giving blood and enrolling on the stem cell donor registry: ranking of obstacles and motives in Switzerland. Transfus Med Hemother 2014; 41:264-72. [PMID: 25254022 PMCID: PMC4164091 DOI: 10.1159/000365457] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Accepted: 05/08/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND To obtain a better understanding of factors affecting blood and blood stem cell donation behavior in Switzerland, a series of studies has been performed. In the recent study of this series, which is described here, motivators and barriers in the field of blood and blood stem cell donation were identified. METHODS Web-based survey data from a non-random sample of the Swiss population 2012/2013 (n = 3,153) were used to describe and compare the ranking of motives and obstacles to donate blood and to enroll on the Swiss blood stem cell registry. Wilcoxon rank-sum test and Spearman's rank correlations were used to assess differences and associations between ranks and groups. RESULTS The prospect of saving lives and solidarity were the top two motives to donate blood or to enroll on the blood stem cell registry. The top two obstacles to enroll on the blood stem cell registry were lack of general information on blood stem cell donation and on its risks, whereas the top two obstacles to donate blood were the lack of information where and when to donate and deferral of or exclusion from blood donation. CONCLUSION Classical altruistic motives are top drivers for giving blood as well as registering for blood stem cell donation. Recruitment campaigns should focus on these motivators. Similarities in motivational factors as well as in obstacles regarding blood and blood stem cell donation can be found.
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Affiliation(s)
| | - Thomas Volken
- School of Health Professions, Zurich University of Applied Sciences, Winterthur, Switzerland
| | | | - Behrouz Mansouri Taleghani
- Transfusionsmedizin, Department of Haematology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
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Affiliation(s)
- Nicola Lacetera
- University of Toronto, Toronto, ON M5S 2E9, Canada
- University of Toronto, Mississauga, Mississauga, ON L5L 1C6, Canada
| | - Mario Macis
- Johns Hopkins University, Baltimore, MD 21202, USA
- Institute for the Study of Labor (IZA), Bonn, 53113, Germany
| | - Robert Slonim
- Institute for the Study of Labor (IZA), Bonn, 53113, Germany
- University of Sydney, Sydney, NSW 2006, Australia
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Masser BM, White KM, Terry DJ. Beliefs underlying the intention to donate again among first-time blood donors who experience a mild adverse event. Transfus Apher Sci 2013; 49:278-84. [PMID: 23820434 DOI: 10.1016/j.transci.2013.06.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2012] [Revised: 04/03/2013] [Accepted: 06/04/2013] [Indexed: 11/20/2022]
Affiliation(s)
- Barbara M Masser
- School of Psychology, The University of Queensland, St Lucia, Queensland, Australia.
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Niza C, Tung B, Marteau TM. Incentivizing blood donation: systematic review and meta-analysis to test Titmuss' hypotheses. Health Psychol 2013; 32:941-9. [PMID: 24001244 PMCID: PMC3920088 DOI: 10.1037/a0032740] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Revised: 10/15/2012] [Accepted: 10/24/2012] [Indexed: 11/08/2022]
Abstract
OBJECTIVES Titmuss hypothesized that paying blood donors would reduce the quality of the blood donated and would be economically inefficient. We report here the first systematic review to test these hypotheses, reporting on both financial and nonfinancial incentives. METHOD Studies deemed eligible for inclusion were peer-reviewed, experimental studies that presented data on the quantity (as a proxy for efficiency) and quality of blood donated in at least two groups: those donating blood when offered an incentive, and those donating blood with no offer of an incentive. The following were searched: MEDLINE, EMBASE and PsycINFO using OVID SP, CINAHL via EBSCO and CENTRAL, the Cochrane Library, Econlit via EBSCO, JSTOR Health and General Science Collection, and Google. RESULTS The initial search yielded 1100 abstracts, which resulted in 89 full papers being assessed for eligibility, of which seven studies, reported in six papers, met the inclusion criteria. The included studies involved 93,328 participants. Incentives had no impact on the likelihood of donation (OR = 1.22 CI 95% 0.91-1.63; p = .19). There was no difference between financial and nonfinancial incentives in the quantity of blood donated. Of the two studies that assessed quality of blood, one found no effect and the other found an adverse effect from the offer of a free cholesterol test (β = 0.011 p < .05). CONCLUSION The limited evidence suggests that Titmuss' hypothesis of the economic inefficiency of incentives is correct. There is insufficient evidence to assess their likely impact on the quality of the blood provided.
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Affiliation(s)
- Claudia Niza
- Department of Social Policy, London School of Economics, UK
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Lacetera N, Macis M, Slonim R. Public health. Economic rewards to motivate blood donations. Science 2013; 340:927-8. [PMID: 23704557 DOI: 10.1126/science.1232280] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- Nicola Lacetera
- University of Toronto and University of Toronto-Mississauga, Ontario, Canada.
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Sass RG. Toward a more stable blood supply: charitable incentives, donation rates, and the experience of September 11. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2013; 13:38-45. [PMID: 23641850 DOI: 10.1080/15265161.2013.781703] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Although excess blood collection has characterized U.S. national disasters, most dramatically in the case of September 11, periodic shortages of blood have recurred for decades. In response, I propose a new model of medical philanthropy, one that specifically uses charitable contributions to health care as blood donation incentives. I explain how the surge in blood donations following 9/11 was both transient and disaster-specific, failing to foster a greater continuing commitment to donate blood. This underscores the importance of considering blood donation incentives. I defend charitable incentives as an alternative to financial incentives, which I contend would further extend neoliberal market values into health care. I explain my model's potential appeal to private foundations or public-private partnerships as a means for expanding both the pool of blood donors and the prosocial benefit of each act of blood donation. Finally I link my analysis to the empirical literature on blood donation incentives.
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Affiliation(s)
- Reuben G Sass
- Case Western Reserve University, Cleveland OH 44106, USA.
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Chmielewski D, Bove LL, Lei J, Neville B, Nagpal A. A new perspective on the incentive-blood donation relationship: partnership, congruency, and affirmation of competence. Transfusion 2012; 52:1889-900. [DOI: 10.1111/j.1537-2995.2011.03545.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Blood donors' attitudes towards incentives: influence on motivation to donate. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2011; 10:186-90. [PMID: 22044949 DOI: 10.2450/2011.0039-11] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 04/20/2011] [Accepted: 07/06/2011] [Indexed: 11/21/2022]
Abstract
BACKGROUND Understanding the factors that motivate donors to donate will facilitate improvements in recruitment programmes. Donation incentives are often used to improve the effect of recruitment programmes. This cross-sectional study was designed to understand donors' attitudes toward incentives. MATERIAL AND METHODS Participants (n=421) were recruited among volunteer donors at the Shiraz Blood Transfusion Centre when they registered for blood donation. They completed a questionnaire with items regarding demographic characteristics, donation status (first-time donor or regular donor), and their motivation for donating, their attitude towards incentives, and the best type of incentives. Multiple logistic regression and chi-squared tests were used to analyse the data with Statistical Package for the Social Sciences (SPSS) software. RESULTS The majority of donors (85.6%) donated blood for altruistic reasons. One quarter of the donors (25.3%) believed that incentives should be offered to encourage them to donate. Most donors (84.5%) believed that the most effective incentive was offering specific blood tests. Donors who had donated for non-altruistic reasons were more interested in receiving incentives. The desire to receive incentives was more widespread among younger, married, first-time donors, donors with a lower educational level and donors with a history of more than five donations. The desire to receive incentives decreased as age increased. DISCUSSION Most of the donors (74.7%) had no desire to receive incentives, and this was even more apparent among donors who donated for altruistic reasons. Non-monetary incentives may be effective in attracting younger, married, first-time donors, donors with a lower educational level and donors with a history of more than five donations.
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Shaz BH, Kessler D, Hillyer CD. Evaluating the role of blood collection centers in public health: a status report. Transfus Med Rev 2011; 26:58-67. [PMID: 21871778 DOI: 10.1016/j.tmrv.2011.07.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Blood centers have a central role in the community through recruitment and donation, and these community interactions enable blood centers to have a critical role in public health. Some public health initiatives are inherent in the blood center, such as providing human immunodeficiency virus educational material, whereas other initiatives have been actively created, such as cardiovascular screening, as a means to increase blood donor rates and increase the blood center's community interaction. These public health initiatives have been inconsistently practiced by blood collection centers over many years. An understanding of the current literature and exploring the potential role of blood centers in public health, while considering cost and value of these programs, are necessary for blood centers to evaluate the value of implementing these programs. The studies do not support a significant improvement in donor health or significant increase in donation rates through these public health initiatives. However, no study published thus far has been comprehensive enough or carried out long enough to adequately evaluate the value of providing health initiatives to donors.
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Affiliation(s)
- Beth H Shaz
- New York Blood Center, 310 E 67 St, New York, NY 10065, USA.
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Masser B, France CR. An evaluation of a donation coping brochure with Australian non-donors. Transfus Apher Sci 2010; 43:291-297. [DOI: 10.1016/j.transci.2010.09.017] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Eason S, Goudar S, Centilli J, Sayers M. Experience with routine total nonfasting blood cholesterol screening of volunteer blood and component donors. Transfusion 2010; 51:731-6. [PMID: 20977488 DOI: 10.1111/j.1537-2995.2010.02920.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND There is an increasing number of blood programs giving donors information about health risks for cardiovascular disease based on a total nonfasting cholesterol level measured at donation. STUDY DESIGN AND METHODS Experience with screening 187,714 individual donors for total nonfasting cholesterol was reviewed and results were compared with those for a representative sample of United States adults as published in National Health and Nutrition Examination Surveys. Donors were invited to retrieve their results and were tracked as to whether they used this service or not. RESULTS By comparison with the national surveys, more blood donors have normal total nonfasting cholesterols and fewer have borderline high or high values as defined by the National Cholesterol Education Program Expert Panel. These observations hold for both males and females across all age ranges from 20 to older than 75 years. Only a minority of donors retrieve their results. CONCLUSIONS The blood donor setting can be expanded, by inclusion of total nonfasting cholesterol level, to include screening for cardiovascular disease risk. When compared with the general adult population, donors represent a group at less risk for heart disease.
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Affiliation(s)
- Juergen Ringwald
- Department of Transfusion Medicine and Haemostaseology, University Hospital of Erlangen, Erlangen, Germany.
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Bani M, Giussani B. Gender differences in giving blood: a review of the literature. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2010; 8:278-87. [PMID: 20967170 PMCID: PMC2957494 DOI: 10.2450/2010.0156-09] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/14/2009] [Accepted: 02/18/2010] [Indexed: 11/21/2022]
Abstract
BACKGROUND An overview of European blood donors shows that the distribution of men and women donors is similar in many countries, with Italy being an exception in that women account for only 30% of donors. Gender medicine is a key issue in this context, even though gender studies are very limited in the transfusion field, whether considered broadly or with specific regards to the selection, management and retention of donors. It, therefore, seemed important to compare the presence of women among blood donors in different European countries and examine the roles that gender is reported to play in the donation of blood in order to identify possible implications for communication with and management of the donor. METHODS To determine the proportion of women among donors in European countries, data were collected from annual reports or documents available on the websites of national associations; furthermore, all papers related to giving blood published in the five main journals in the sector (Transfusion, Vox Sanguinis, Transfusion and Apheresis Science, Transfusion Medicine, Blood Transfusion) were considered; about 80 publications were selected and the gender variable was examined. RESULTS The published studies showed that gender plays key roles in the motivation to give blood (women being more altruistic, men being more individualistic) and in adverse reactions, which was a particularly critical problem leading to fewer women become regular donors. A few aspects specific to the management of donors in Italy also emerged. DISCUSSION Gender seems to play an important role in the aspects studied and does, therefore, merit further consideration in relation to strategies to recruit donors and the management of critical events during donation.
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Affiliation(s)
- Marco Bani
- Multimedia Health Communication Laboratory, Facoltà di Medicina e Chirurgia, Università di Milano Bicocca, Monzo, Italy.
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Goette L, Stutzer A, Frey BM. Prosocial Motivation and Blood Donations: A Survey of the Empirical Literature. ACTA ACUST UNITED AC 2010; 37:149-154. [PMID: 20737018 DOI: 10.1159/000314737] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2010] [Accepted: 05/05/2010] [Indexed: 11/19/2022]
Abstract
Recent shortages in the supply of blood donations have renewed the interest in how blood donations can be increased temporarily. We survey the evidence on the role of financial and other incentives in eliciting blood donations among donors who are normally willing to donate pro bono. We present the predictions from different empirical/psychological-based theories, with some predicting that incentives are effective while others predict that incentives may undermine prosocial motivation. The evidence suggests that incentives work relatively well in settings in which donors are relatively anonymous, but evidence indicates also that when image concerns become important, incentives may be counterproductive as donors do not want to be seen as greedy.
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Affiliation(s)
- Lorenz Goette
- Département of Economics, University of Lausanne, Switzerland
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