Enhancing blood donation intentions using multimedia donor education materials

Exploring the determinants of risk behavior for transfusion transmissible infections among first-time blood donors in Mandalay General Hospital, Myanmar

INTRODUCTION

Blood donation is vital to healthcare, but it must be kept safe by mitigating the risk of transfusion transmissible infections (TTIs). The objective of this study was to investigate the factors that influence risk behavior for transfusion transmissible infections among first-time blood donors at Mandalay General Hospital, Myanmar.

METHODS

This study utilized a cross-sectional study design using secondary data. Mandalay city and Mandalay Blood Bank in Mandalay General Hospital were purposely selected and a total of 406 first-time blood donors participated. A structured questionnaire administered by an interviewer was used. The questionnaire contained background characteristics, knowledge on TTIs, attitude toward TTIs, and TTIs risk behaviors. To examine the determinants (background characteristics, knowledge, and attitude) that affect risk behavior, inferential statistics techniques that included the chi-squared test, bivariable logistic regression, and multivariable logistic regression were applied. A p-value of less than 0.05 signified statistical significance.

RESULTS

Among 406 first-time blood donors, 52.9% were under 20 years old, and 53.7% were male. Most had undergraduate education (77.6%), were married (84.2%), and were students (55.7%). Additionally, 76.8% hadn't received the hepatitis B vaccine. Blood groups were distributed as follows: B (40.0%), O (33.8%), A (23.4%), AB (8.9%). About 15.8% showed high knowledge level, and 63.6% had high attitude. Notably, 29.3% exhibited high-risk behavior for TTIs. Age was associated with lower risk behavior (OR = 1.54, 95% CI: 0.99, 2.38, p = 0.049), but lost significance in multivariable regression (p = 0.214). Knowledge on TTIs didn't show significance. However, high attitudes were significantly associated with lower risk behavior (OR = 11.4, 95% CI: 1.25, 103.83, p = 0.017, retained in multivariable regression, p = 0.012).

CONCLUSION

Findings of this study contribute in the development of programs that ensure a safe and reliable blood supply chain. To improve blood safety standards among first-time blood donors, this study highlights the value of targeted education and screening processes, placing particular emphasis on acquiring knowledge and positive attitude toward blood donation and risk behavior.

Incentives for plasma donation

BACKGROUND AND OBJECTIVES

This work provides an overview of the incentives used for plasma donation in Europe and beyond. The overview can provide new ideas to blood establishments.

MATERIALS AND METHODS

We conducted a systematic online search of incentives used and asked national experts to validate the data across all European Union countries as well as other European and non-European countries. We categorized the data into level of incentive (using the Nuffield Council on Bioethics' rungs [2011]) and country.

RESULTS

We analysed more than 490 organizations across 26 countries. Our findings reveal different incentives used in these countries. Snacks and pre-donation health checks are commonly provided. In addition, loyalty programmes, small gifts, vouchers, lotteries, travel compensations and time off from work extend the strategic incentive portfolio. Only seven countries offer financial compensation ranging from the equivalent of 10-35€ for European countries. In countries with a decentralized model, where more than one organization collects plasma, we observe that more diversified incentive strategies are generally used, including monetary and non-monetary incentives. In countries with a centralized model, where only one organization is allowed to collect plasma, financial compensation is usually not offered. Centralized plasma collection without financial compensation relies on a wider range of non-monetary incentives than with financial compensation.

CONCLUSION

The country group analysis offers valuable insights into the relationship between incentive strategies and the prevailing centralized versus decentralized plasma collection model. This overview provides a broader understanding of incentives used by blood establishments and offers avenues for future practice.

How anxiety relates to blood donation intention of non-donors: the roles of moral disengagement and mindfulness

Blood donation anxiety is a major psychological obstacle for blood donation. However, it remains unclear what the mechanism underlying the relationship between anxiety and blood donation intention is and what factor(s) will buffer the negative effects of anxiety. Based on social cognitive theory, we theorized a model delineating the mechanism with which blood donation anxiety was related to blood donation intention. Data were collected in a three-wave online survey including 425 individuals and was analyzed using hierarchical multiple regression with SPSS 24.0 software. The results indicated that the negative relationship between blood donation anxiety and blood donation intention was mediated by moral disengagement. Meanwhile, mindfulness was found to play a buffering role in the relationship between blood donation anxiety and moral disengagement as well as the indirect relationship between blood donation anxiety and blood donation intention via moral disengagement. Our findings advanced the understanding of the detrimental consequences of blood donation anxiety and demonstrated that while blood donation anxiety came at a high cost, it can be managed.

COVID-19 convalescent plasma donors: Unique motivations in unique times?

BACKGROUND

Early in the SARS-CoV-2 pandemic, many blood collection organizations (BCOs) were asked to collect and distribute COVID-19 convalescent plasma (CCP) as a potential treatment for this new virus and resulting disease. However, recruiting CCP donors presented unique challenges for BCOs, as there were few recovered patients at this time, and like the general population, most potential CCP donors had no blood donation experience. Thus, many CCP donors were new donors, and their donation motivations were unknown.

MATERIALS AND METHODS

Donors who gave CCP at least once between April 27th and September 15th, 2020, were emailed a link to an online survey regarding their experience with COVID-19 and their motivations for donating CCP and blood.

RESULTS

Of the 14,225 invitations sent, 3471 donors responded (24.4%). Most donors had never donated blood before (n = 1406), followed by lapsed donors (n = 1050), and recent donors (n = 951). There was a significant relationship between self-reported donation experience and fear of CCP donation (X²  = 119.2, p < .001). Motivations ranked "very important" by responding donors were wanting to help someone in need, a feeling of responsibility, and feeling a duty to donate. Donors with more severe disease were more likely to respond with feelings of a sense of duty to donate CCP (Χ²  = 8.078, p = .044) or altruism (Χ²  = 8.580, p = .035).

CONCLUSIONS

Overwhelmingly, altruism and a sense of duty and responsibility were the reasons that CCP donors decided to donate. These insights can be useful for motivating donors for specialized donation programs or if wide scale CCP recruitment is needed in the future.

Blood donation motivators and barriers reported by young, first-time whole blood donors: Examining the association of reported motivators and barriers with subsequent donation behavior and potential sex, race, and ethnic group differences

BACKGROUND

A greater understanding of young, first-time donor motivators and barriers is needed to address the ongoing challenge of retaining these essential donors.

STUDY DESIGN AND METHODS

Structured interviews conducted with 508 young, first-time whole blood donors [66.1% female; Mean Age = 19.4 (SD = 2.5) years] were coded to identify reported motivators and barriers. Reported motivators and barriers were then examined for their association with attempted donation behavior over a 14-month follow-up, and for potential sex, race, and ethnic group differences in the frequency of endorsement.

RESULTS

Prosocial motivation (e.g., altruism) was the most commonly reported motivator and fear (e.g., fainting, needles) was the most commonly reported barrier. Donation behavior was unrelated to reported motivators, but was significantly related to four reported barriers including fear of fainting/dizziness, fear of needles/pain, having personal commitments that conflict with donating, and perceiving oneself as unsuited to donate for health reasons. Sex, racial, and ethnic differences were noted with respect to the percentages of donors reporting several donation-related motivators and barriers.

CONCLUSION

The present findings identify donation-related barriers that could be important targets to address in the effort to encourage new young donors and to retain these new donors for the long term. Importantly, these data also highlight the importance of considering individual differences in donor motivation as a function of sex, race, and ethnicity.

Fear is associated with attrition of first-time whole blood donors: A longitudinal examination of donor confidence and attitude as potential mediators

BACKGROUND

Elevated fear and anxiety regarding donation-related stimuli (e.g., needles, pain, blood, fainting) has been associated with reduced blood donor recruitment and retention. The present longitudinal study tests the notion that this inverse relationship may be accounted for by lower donation confidence and more negative donation attitudes among fearful first-time donors.

STUDY DESIGN AND METHODS

In a sample of 1479 first-time whole blood donors [67.9% female; mean age = 19.3 (standard deviation (SD) = 2.5) years], path analyses were conducted to examine relationships among donor ratings of fear of blood draw and donation anxiety obtained approximately 1 week after donation, donation confidence and attitudes assessed approximately 6 weeks later, and donation attempts over the 14 months following the original donation.

RESULTS

Path analyses indicated that both fear of blood draws and donation anxiety were associated with fewer attempted donations, and that these effects were indirectly mediated by a combination of lower donor confidence and more negative donation attitudes.

CONCLUSION

Because retention of new blood donors is essential to maintain a healthy blood supply, the results of the present study suggest that first-time donors should be assessed for fear and anxiety so that appropriate strategies can be provided to address their concerns, bolster their confidence and attitudes, and ultimately promote their long-term retention.

Motivators, barriers and communication channels for blood donation in relation to students at a university in Spain

BACKGROUND

Targeting young people to donate blood is a particularly promising option. The aim of this work was to know the motivators, barriers and preferred communication channels for blood donation among university students, and to determine the factors that explain why donors give blood.

MATERIALS AND METHODS

A questionnaire was distributed to 420 students (response rate: 88.3 %) attending the University of Huelva (Spain). Data were gathered on sociodemographic variables, blood donation history, motivators and barriers to donation, and communication channels. Non-parametric contrasts were used to determine possible differences in the sociodemographic characteristics or donation history, and logistic regression to determine the factors associated to donation.

RESULTS

67.38 % of the students surveyed were non-donors, 12.94 % were first-time donors, 11.05 % were infrequent donors and 8.63 % were frequent donors. "Solidarity" was the main motivator for donating blood (40 %). "Lack of information on where and how to give blood" was the main barrier for non-donors (26.4 %), with "medical reasons" cited by first-time donors (22.2 %). 93.8 % of donors wished to be notified about their next donation appointment. The majority of those surveyed preferred e-mail to receive alerts and information on donation campaigns. The factors that explained blood donation were over 26 years of age and place of residence.

CONCLUSION

The study identified differences in the motivators, barriers and choice of communication channel among the university students in terms of blood donation, and the factors that explain blood donation. This knowledge is a useful source of information when designing blood donation campaigns that target young people.

Results from the blood donor competence, autonomy, and relatedness enhancement (blood donor CARE) randomized trial

BACKGROUND

This study aimed to promote competence, autonomy, and relatedness among first-time whole blood donors to enhance intrinsic motivation and increase retention.

STUDY DESIGN AND METHODS

Using a full factorial design, first-time donors (N = 2002) were randomly assigned to a no-treatment control condition or to one of seven intervention conditions designed to promote donation competence, autonomy, relatedness, a combination of two (e.g., competence and autonomy), or all three constructs. Participants completed donor motivation measures before the intervention and 6 weeks later, and subsequent donation attempts were assessed for 1 year.

RESULTS

There was no significant group difference in the frequency of donation attempts or in the number of days to return. Significant effects of group were observed for 10 of the 12 motivation measures, although follow-up analyses revealed significant differences from the control group were restricted to interventions that included an autonomy component. Path analyses confirmed direct associations between interventions involving autonomy and donor motivation, and indirect mediation of donation attempts via stronger donation intentions and lower donation anxiety.

CONCLUSION

Among young, first-time, whole blood donors, brief interventions that include support for donor autonomy were associated with direct effects on donor motivation and indirect, but small, effects on subsequent donation behavior.

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

BACKGROUND

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

STUDY DESIGN AND METHODS

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

RESULTS

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

CONCLUSION

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

Using Digital Platforms to Promote Blood Donation: Motivational and Preliminary Evidence from Latin America and Spain

The lack of blood donors is a global problem that prevents the demand for blood prompted by an ageing population and increased life expectancy from being met. The aim of this study was to conduct an initial exploration of the reasons for using digital platforms in blood donation. Using a Theory of Planned Behaviour (TPB) framework, microdata for 389 participants from Latin American countries and Spain, and Partial Least Square-Structural Equation Modelling (PLS-SEM), the study obtained three main prediction paths. The first two started from feelings of trust in the digital community and a positive mood state associated with a modern lifestyle, and they were linked to attitudes and behavioural control in the explanation of the intention to donate and actual blood donation. The third path started from modern lifestyles, and was linked to the subjective norm in the prediction of intention and actual donation. These paths represent one of the very first attempts to predict intentions of donation and collaborative donation by taking a PLS-SEM approach. By determining the paths underpinning collaborative blood donors' motives, the results of this study provide strong support for the usefulness of the TPB model within the context of digital platform use and blood donation.

Donation related fears predict vasovagal reactions and donor attrition among high school donors

BACKGROUND

This longitudinal study of high school whole blood donors examined relationships among donation-related fears assessed prior to donation, vasovagal reactions to donation, and the proportion of donors who attempted another donation over the subsequent 60 weeks.

STUDY DESIGN AND METHODS

Data regarding vasovagal reactions and attempted donation were obtained from donor records of 530 female and 342 male high school donors who answered questions about five types of fear (ie, of blood draw, needles, seeing blood, feeling pain, or fainting) prior to their index donation.

RESULTS

Each type of fear was associated with an increased risk of vasovagal reactions (all P < .001) and a smaller percentage of attempted donations was seen among those who reported at least one type of fear (53%) as compared to those who did not report any fear (62.1%); P = .022; β = -0.374, OR = 0.69; 95% CI, 0.50-0.94. Path analyses of the relationships among fear, vasovagal reaction, and attempted donation revealed significant indirect effects for each type of fear. Specifically, donors who reported fear were at increased odds of experiencing a vasovagal reaction, which, in turn, was associated with decreased odds of attempting a repeat donation.

CONCLUSION

Donation-related fears are associated with reduced donor return rates, and this effect is mediated through an increased risk for vasovagal reactions. For both practical and ethical reasons, blood collectors are encouraged to identify and intervene with fearful donors to reduce the likelihood of negative donation-related symptoms and enhance donor retention.

Evaluation and improvement of blood donor educational materials: results from a multicenter randomized controlled trial

BACKGROUND

Blood collection centers are charged with creating donor educational materials (DnEM) that are easily understood across all prospective donor populations, while addressing mandates and recommendations from regulatory agencies and professional standard setting organizations. Donors must have sufficient information to understand the donation process with its risks and benefits, time to consider options before deciding, and opportunity to choose whether to proceed with or decline donating. The goal of this multisite randomized controlled trial was to evaluate knowledge acquired using standardized DnEM. America's Blood Centers' Working Group (WG) for Donor Education and Communication was formed to evaluate and suggest modifications of these documents. Based on pilot work, a randomized clinical trial was designed to test donor knowledge across a variety of populations. The WG identified several shortcomings in the current DnEM and proposed new DnEM. The new DnEM were tested against the same, current DnEM being used at all three sites (Blood Donor Educational Material, 2016 version 2.0, published in conjunction with the AABB uniform donor history questionnaire).

METHODS AND MATERIALS

One-hundred sixty-five first time and returning donors were randomized in a 2x2 model to review either new DnEM or current DnEM. Every participant completed a pre- and post-quiz that tested their understanding of the DnEM.

RESULTS

Returning donors had greater baseline knowledge compared to new donors, but new donors improved more versus returning donors. Donors using the new DnEM showed greater improvement in knowledge than those using current DnEM.

CONCLUSION

Comprehension of DnEM can be improved. With this sample size the results suggest that the findings are independent of demographic characteristics, but a larger study would be necessary to confirm this.

Population-based projections of blood supply and demand, China, 2017-2036

Objective

To estimate the long-term effect of the changing demography in China on blood supply and demand.

Methods

We developed a predictive model to estimate blood supply and demand during 2017–2036 in mainland China and in 31 province-level regions. Model parameters were obtained from World Population Prospects, China statistical yearbook 2016, China’s report on blood safety and records from a large tertiary hospital. Our main assumptions were stable age-specific per capita blood supply and demand over time.

Findings

We estimated that the change in demographic structure between 2016 (baseline year) and 2036 would result in a 16.0% decrease in blood supply (from 43.2 million units of 200 mL to 36.3 million units) and a 33.1% increase in demand (from 43.2 million units to 57.5 million units). In 2036, there would be an estimated shortage of 21.2 million units. An annual increase in supply between 0.9% and 1.8% is required to maintain a balance in blood supply and demand. This increase is not enough for every region as regional differences will increase, e.g. a blood demand/supply ratio ≥ 1.45 by 2036 is predicted in regions with large populations older than 65 years. Sensitivity analyses showed that increasing donations by 4.0% annually by people aged 18–34 years or decreasing the overall blood discard rate from 5.0% to 2.0% would not offset but help reduce the blood shortage.

Conclusion

Multidimensional strategies and tailored, coordinated actions are needed to deal with growing pressures on blood services because of China’s ageing population.

Estimating the risk of blood donation fainting for self versus others: the moderating effect of fear

BACKGROUND

People overestimate the likelihood that blood donors will experience faint and prefaint reactions, particularly if they are themselves fearful of having blood drawn. This study investigated the influence of making a risk assessment for oneself versus others, and examined whether providing information about the low base rates of reactions affected donation attitude, anxiety, and intention.

STUDY DESIGN AND METHODS

An anonymous online survey was completed by 3702 individuals (53.9% female; mean age, 36.9 years; standard deviation, 12.1 years; range, 18-84) that included questions about fear of having blood drawn and estimation of the risk of donation-related faint and prefaint symptoms for themselves and others. A random one-half of the respondents received accurate information about the proportion of whole blood donors who experience such reactions before all participants completed questions concerning their donation attitude, anxiety, and intention.

RESULTS

Estimates of both faint and prefaint reactions revealed a pattern of lower perceived risk for self versus others among individuals with low fear, and higher perceived risk for self versus others among those with high fear. Provision of accurate information about risk of reactions was associated with more positive donation attitudes (F[1, 3692] = 8.182, p = 0.004) and intentions (F[1, 3692] = 10.137, p = 0.001) but did not significantly affect anxiety.

CONCLUSION

Donation-related fear is associated with inflated expectancies of adverse events, especially regarding oneself. Such fear may be particularly important to address, as it has both a direct and indirect negative effect on donor retention.

Are future doctors ready to donate blood and encourage blood donation?

BACKGROUND

Blood donation is the most common method of supplying blood. For maintaining the reliability of the blood supply through donation, the blood should be provided by voluntary, non-profit and regularly donating individuals. It is critical to be aware of the attitudes, behaviors and knowledge levels of the doctors about this issue who will inform and lead people to donate blood. The aim of this study was to determine the current knowledge levels, attitudes, and behaviors of the medical faculty students, who will be future doctors, on blood donation and to investigate whether a change occurs in the these parameters with the initiation of clinical education and training.

METHOD

This descriptive study was conducted by using a questionnaire including a total of 40 questions about blood donation. Chi-square and Mann-Whitney U tests were performed.

RESULTS

The study included 120 students in the third year of the faculty, which is the last preclinical year, and 100 students in the fifth year, which is the second year of clinical education. Of the students, 44.1% were trained for blood donation. The rates of blood donation and promoting people to donate blood were significantly higher in students who had received blood donation training compared to those who had not received such training. Willingness to donate blood and the knowledge levels regarding blood donation were significantly greater among the fifth year students.

CONCLUSION

Efforts for raising the awareness of blood donation together with its training should be increased and popularized in medical faculties.

Video-based patient decision aids: A scoping review

OBJECTIVE

This study reviews the published literature on the use of video-based decision aids (DA) for patients. The authors describe the areas of medicine in which video-based patient DA have been evaluated, the medical decisions targeted, their reported impact, in which countries studies are being conducted, and publication trends.

METHOD

The literature review was conducted systematically using Medline, Embase, CINAHL, PsychInfo, and Pubmed databases from inception to 2016. References of identified studies were reviewed, and hand-searches of relevant journals were conducted.

RESULTS

488 studies were included and organized based on predefined study characteristics. The most common decisions addressed were cancer screening, risk reduction, advance care planning, and adherence to provider recommendations. Most studies had sample sizes of fewer than 300, and most were performed in the United States. Outcomes were generally reported as positive. This field of study was relatively unknown before 1990s but the number of studies published annually continues to increase.

CONCLUSION

Videos are largely positive interventions but there are significant remaining knowledge gaps including generalizability across populations.

PRACTICE IMPLICATIONS

Clinicians should consider incorporating video-based DA in their patient interactions. Future research should focus on less studied areas and the mechanisms underlying effective patient decision aids.

The official websites of blood centers in China: A nationwide cross-sectional study

Background

Blood collection agencies worldwide are facing ongoing and increasing medical demands for blood products. Many potential donors would search related information online before making decision of whether or not to donate blood. However, there is little knowledge of the online information and services provided by blood centers in China, despite the constantly increase of internet users. Our research investigates the number of blood centers’ official websites and their quality, and highlights the deficiencies that required future advances.

Methods

Identified official websites of blood centers were scored using a newly developed evaluation instrument with 42 items concerning technical aspects, information quality, information comprehensiveness and interactive services. Scores of websites were compared between blood centers with different level (provincial vs. regional blood centers) and location (blood centers located in economically developed vs. developing region).

Results

For the 253 working official websites all the 350 blood centers in China, and the mean overall score of websites was 24.7 out of 42. 79.1% websites were rated as fair (50–75% of maximum), 5.5% as good (≥75% of maximum) and 15.4% as poor(25–50% of maximum;). Websites got very low sub-scores in information quality (mean = 3.8; range 1–8; maximum = 9) and interactive services (3.3; 0–10; 10). Higher proportions of provincial (vs. regional) blood centers and economically developed (vs. developing) blood centers had official websites (p = 0.044 and p = 0.001; respectively) with better overall quality (p<0.001 and p <0.01) and better sub-scores (in all of the four sections and in technical aspects and information quality). Website overall scores was positively correlated with the number of people served by each blood center (p< 0.001) and the donation rate of each province (p = 0.046).

Conclusions

This study suggests there is a need to further develop and improve official websites in China, especially for regional and inland blood centers. The poor information quality and interactive services provided by these websites is of particular concern, given the challenges in blood donor counselling and recruitment.

Applying self-determination theory to the blood donation context: The blood donor competence, autonomy, and relatedness enhancement (Blood Donor CARE) trial

The Blood Donor Competency, Autonomy, and Relatedness Enhancement (Blood Donor CARE) project was designed as a practical application of self-determination theory to encourage retention of first-time donors. Self-determination theory proposes that people are more likely to persist with behaviors that are internally-motivated, and that externally-motivated behavior can evolve and become internalized given the appropriate socio-environmental conditions. According to self-determination theory, motivation to engage in blood donation may become increasingly self-determined if the behavior satisfies fundamental human needs for competence (a sense of self-efficacy to achieve specific goals), autonomy (a sense of volitional control over one's behavior), and relatedness (a sense of connection to a larger group). The primary aim of this randomized controlled trial is to examine the effect of competence, autonomy, and/or relatedness interventions on donor retention. Using a full factorial design, first-time donors will be assigned to a control condition or one of seven intervention conditions. Donation competence, autonomy, and relatedness, along with additional constructs associated with return donation, will be assessed before and after the intervention using online surveys, and donation attempts will be tracked for one-year using blood center donor databases. We hypothesize that, compared to the control condition, the interventions will increase the likelihood of a subsequent donation attempt. We will also examine intervention-specific increases in competence, autonomy, and relatedness as potential mediators of enhanced donor retention. By promoting first-time donor competence, autonomy, and relatedness our goal is to enhance internal motivation for giving and in so doing increase the likelihood of future donation.

Attitude toward blood donation among medical and nonmedical students across Karachi

Aim:

To evaluate the factors that motivate and discourage medical and nonmedical students from donating blood voluntarily and to assess the level of awareness and knowledge regarding blood donation.

Materials and Methods:

We conducted a cross-sectional descriptive study from August 2011 to May 2012 across different universities of Karachi covering both private and public sector. Predesigned questionnaires were filled by students. A total of 690 students participated in the study, 345 from each. Data collected was analyzed using SPSS Version 17.0. Simple frequencies and percentages were calculated, and Pearson Chi-square and Fisher's exact tests were applied to calculate association between different variables with P value set as significant when <0.05.

Results:

Mean age of the students was found to be between 21 and 23 (64.6%) in medical, whereas in nonmedical, 66.7% fell in this age group. Astonishingly, blood donors in nonmedical (27%) were quite more than that in medical group, where they were only 18%. Males constituted the majority in both of the groups. Most commonly reported factor that motivated blood donation in medical group was feeling of self-satisfaction (40.2%), whereas in nonmedical group, 32.9% reported that they had only donated blood when their friends/family were in need. When asked about the adverse effects after blood donation, weakness was common among both medical and nonmedical, i.e. 46.8% and 46.7%, respectively. Among the factors that impeded our subjects from donating blood were primarily health concerns in medical students (19%), whereas in nonmedical students they claimed they were not approached by anyone and were unaware of the importance of blood donation (34.8%).

Conclusion:

Proportion of blood donors was significantly low in both medical and nonmedical students, especially in females. Most important motivating factor in medical students was feeling of self–satisfaction, whereas in nonmedical students, it was family/friend in need of blood transfusion. Never approached by anyone/awareness about the importance of donating blood was the major discouragement factor seen in both medical and nonmedical groups.

Family donors are critical and legitimate in developing countries

INTRODUCTION

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

AIMS OF THE STUDY

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

METHODS

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

RESULTS AND DISCUSSION

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

CONCLUSIONS

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

Improving first-time donor attendance rates through the use of enhanced donor preparation materials

BACKGROUND

Many nondonors are positive about blood donation and this motivates booking an appointment to donate. However, as their appointment approaches barriers to donating-such as anxiety-may become salient and deter attendance. Building on research of France and colleagues demonstrating the positive effect of enhanced preparation materials on donor recruitment, this study sought to determine whether these materials could effectively boost first donation appointment attendance.

STUDY DESIGN AND METHODS

A field study comprising a 3 (brochure: none, e-mail, hard copy) × 2 (national call center [NCC] contact: none, call) between-subjects design was conducted with 3646 nondonors who had scheduled their first appointment. Participants in the brochure conditions received either a hard copy or an e-mailed link to electronic materials modeled on the donor preparation research of France and colleagues. Participants in the NCC call condition also received a call scripted in line with these preparation materials. The key outcome was new donor attendance rate.

RESULTS

Although first-appointment attendance rates were high in the control (no additional contact) condition at 85.07% of those not canceling in advance, dual exposure to the preparation materials through a NCC call and an electronic brochure boosted attendance. The relative risk of attending in the NCC call and electronic brochure condition was 1.0836 (95% confidence interval, 1.0352-1.1343; p = 0.0006), with attendance 8.36% higher than in the control. This gain in attendance came at a relative increase in recruitment costs of 2%.

CONCLUSION

The use of tailored communication to address new donors' concerns and prepare them for donating bolsters attendance rates.

Effects of a pain self-management intervention combining written and video elements on health-related quality of life among people with different levels of education

Combining written and video material could increase the impact of health education for people with less education, but more evidence is needed about the impact of combined materials in different formats, especially in the context of chronic pain self-management. This study tested the impact of combining written information about self-managing chronic joint pain, which used language at a high reading level, with a DVD containing narrative video material presented directly by patients, using language at a lower reading level. Physical and mental health-related quality of life (36-Item Short Form Health Survey) was measured among 107 men with hemophilia before and 6 months after being randomly assigned to receive an information booklet alone or the booklet plus the DVD. Analysis of covariance was used to compare health outcomes between randomized groups at follow-up, using the baseline measures as covariates, with stratified analyses for groups with different levels of education. The DVD significantly improved mental health-related quality of life among those with only high school education. Video material could therefore supplement written information to increase its impact on groups with less education, and combined interventions of this type could help to achieve health benefits for disadvantaged groups who are most in need of intervention.

Donor research in australia: challenges and promise

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.

Management of young blood donors

The emphasis on high-school blood drives and acceptance of 16-year-old blood donors led to more research on physiologic and psychological ways to decrease vasovagal reaction rates in young blood donors and to increase donor retention. Research on how to accomplish this has been advantageous for the blood collection industry and blood donors. This review discussed the current situation and what can be done psychologically, physiologically, and via process improvements to decrease vasovagal reaction rates and increase donor retention. The donation process can be significantly improved. Future interventions may include more dietary salt, a shorter muscle tension program to make it more feasible, recommendations for post-donation muscle tension / squatting / laying down for lightheadedness, more donor education by the staff at the collection site, more staff attention to donors with fear or higher risk for a vasovagal reaction (e.g. estimated blood volume near 3.5 l, first-time donor), and a more focused donation process to ensure a pleasant and safer procedure.

Norm perception and communication for vasovagal symptoms in blood donation

BACKGROUND

Blood is a valuable resource, but most people do not donate. One deterrent to blood donation is the anticipation of vasovagal symptoms (e.g., dizziness, nausea, and fainting), despite the fact that such symptoms typically affect a small proportion of donors. The current research examined norm perceptions regarding vasovagal symptom experiences and used a message-framing paradigm to communicate accurate norm information and increase future donation intentions.

STUDY DESIGN AND METHODS

Three studies were conducted using young adult samples. In Study 1, donors and nondonors estimated the percentage of people who experience vasovagal symptoms. In Studies 2 and 3, nondonors and donors (respectively) were provided with accurate, positively framed, or negatively framed norm messages and indicated their intentions to donate.

RESULTS

In Study 1 we found that participants vastly overestimated how normative it was to experience vasovagal symptoms and this overestimation was stronger among nondonors. In Studies 2 and 3, we showed that positively framed normative messages ("90% of donors do not experience vasovagal symptoms") were generally more influential than negatively framed messages ("10% of donors do experience vasovagal symptoms"), except among past donors who had unfavorable donation experiences.

CONCLUSION

These findings suggest that targeting and correcting norm perception may be a critical step toward improving blood donation rates.

Challenges in the management of the blood supply

Although blood suppliers are seeing short-term reductions in blood demand as a result of initiatives in patient blood management, modelling suggests that during the next 5-10 years, blood availability in developed countries will need to increase again to meet the demands of ageing populations. Increasing of the blood supply raises many challenges; new approaches to recruitment and retainment of future generations of blood donors will be needed, and care will be necessary to avoid taking too much blood from these donors. Integrated approaches in blood stock management between transfusion services and hospitals will be important to minimise wastage--eg, by use of supply chain solutions from industry. Cross-disciplinary systems for patient blood management need to be developed to lessen the need for transfusion--eg, by early identification and reversal of anaemia with haematinics or by reversal of the underlying cause. Personalised medicine could be applied to match donors to patients, not only with extended blood typing, but also by using genetically determined storage characteristics of blood components. Growing of red cells or platelets in large quantities from stem cells is a possibility in the future, but challenges of cost, scaling up, and reproducibility remain to be solved.

Donor anxiety, needle pain, and syncopal reactions combine to determine retention: a path analysis of two-year donor return data

BACKGROUND

Efforts to expand the donor pool by recruiting younger donors have resulted in higher numbers of initial donations, but retention of young donors continues to be challenging.

STUDY DESIGN AND METHODS

Path analysis was used to examine the simultaneous relationships among syncopal reactions, donation anxiety, needle pain, donor satisfaction, and donation intention in predicting repeat donation. Participants included 421 first- and second-time donors recruited for a study comparing the effects of predonation water loading with and without the use of applied muscle tension during donation (52% female, 60.8% first-time donor, mean age 20.3 years). For this longitudinal follow-up study, donor database records were accessed 2 years after the index donation to assess repeat donation.

RESULTS

Results of a series of path analyses demonstrated the influential role of donor anxiety in shaping donor retention (final model χ(2) = 35.75, root mean square error of approximation 0.03, comparative fit index 0.98, weighted root mean square residual 0.74). First, anxiety exerted a direct negative influence on donation intention, the proximal and sole direct predictor of repeat donation. Second, anxiety increased the likelihood of donor-reported needle pain, adversely affecting donation satisfaction and, subsequently, donation intention. Finally, anxiety was associated with donor ratings of syncopal reactions through its impact on needle pain, which also contributed to decreased donation intention.

CONCLUSION

These results provide novel evidence that donation anxiety plays a central role in shaping future donation behavior. Individual differences in anxiety must be considered when developing and testing strategies to enhance blood donor retention.