Easy come, easy go. Retention of blood donors

Pre-screening donor eligibility to avoid a deferral in the blood donation center: A retrospective cohort study

BACKGROUND

The application of a temporary deferral when attempting to donate has a negative impact on retention. Little has been done to reduce the likelihood of a donor attending to donate, only to be found to be ineligible. The aim of this study was to determine the effectiveness of pre-screening donors when making an appointment, to prevent in-center deferrals.

STUDY DESIGN AND METHODS

Donation attempts were collated between July and December 2020. Two segments were identified: (1) those who had a deferral applied and (2) those who successfully donated. Donor and donation characteristics examined included age, sex, prior donation history, deferral history, and appointment booking channel (pre-screened vs. not pre-screened). We also explored the impact of pre-screening on the subsequent donation behavior of those who were deferred.

RESULTS

Overall, 3.2% of donation attempts resulted in a deferral being applied. Most donors booked an appointment via a pre-screening channel (69.9%), with the mobile app being the most popular (31.9%). Donors who booked via a pre-screening channel had lower odds of receiving a deferral (aOR: 0.86). Strongest effects were observed for new donors (aOR: 0.79), those aged ≤40 years. (aOR: 0.84) and those deferred in the past (aOR: 0.87). Deferred donors who booked by a pre-screening channel were more likely to return at 6 months (aHR: 1.09) and 12 months (aHR: 1.12) compared to those who did not book through a pre-screening channel.

DISCUSSION

Pre-screening donors is a simple and effective approach to reduce the number of donors deferred when presenting to donate in the donation center, with a longer-term impact on donor retention.

The relationship between blood test results and vasovagal reactions: An intra-individual comparative retrospective analysis of blood donor data in Japan

BACKGROUND AND OBJECTIVES

To determine whether intra-individual differences in pre-donation blood test results were associated with vasovagal reactions (VVRs).

MATERIALS AND METHODS

The study included donors who voluntarily donated 400 mL of whole blood at least twice during a 5-year blood collection period of the Japanese Red Cross, including both donations with and without a VVR. A conditional logistic regression analysis by age group and sex was conducted, using each donor as a stratum, together with an analysis of deviance to test the significance of including an interaction term between age group and blood data in the regression model.

RESULTS

A total of 1873 donors were included in the analysis. Haemoglobin, haematocrit, total protein and albumin values prior to donation were higher when a VVR was observed than when it was not for each age group and sex. The regression analysis showed significant positive associations between each of these blood parameters and VVR in all combinations of age groups and sex. A particularly strong positive association between haemoglobin and VVRs is seen in women aged ≥50 years (odds ratio, OR [95% confidence interval, CI]: 1.844 [1.457, 2.333]).

CONCLUSION

Haemoglobin, haematocrit, total protein and albumin levels within individual donors were significantly higher at donation with a VVR. This was most notable in women aged ≥50 years. Comparing the pre-donation haemoglobin value with past values in the same donor at the donation site would help raise awareness of the risk of VVRs.

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

BACKGROUND

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

STUDY DESIGN AND METHODS

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

RESULTS

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

DISCUSSION

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

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

BACKGROUND

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

'Yeah, this is my donation': An application of psychological ownership in blood donation

To meet the priority healthcare needs of any population there must be a consistently available blood supply donated by willing donors. Due to this universal need for blood, retaining blood donors remains an ongoing challenge for blood services internationally. Encouraging psychological ownership, or the feeling of ownership one experiences over a possession, provides a potential novel solution to donor retention. This study, based on semi-structured interviews with blood donors, investigates how donors perceive and develop psychological ownership in the context of blood donation. Interviews were conducted in Australia with 20 current blood donors (10 men, 10 women; Mage = 41.95). Through thematic analysis, six themes were identified based primarily on the theoretical framework of psychological ownership. This research offers a novel perspective on donor retention, suggesting that donors' ownership over their individual donation practices, and not the blood service, may contribute to maintaining a stable blood supply.

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

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

Predicting Vasovagal Reactions to Needles from Facial Action Units

BACKGROUND

Merely the sight of needles can cause extreme emotional and physical (vasovagal) reactions (VVRs). However, needle fear and VVRs are not easy to measure nor prevent as they are automatic and difficult to self-report. This study aims to investigate whether a blood donors' unconscious facial microexpressions in the waiting room, prior to actual blood donation, can be used to predict who will experience a VVR later, during the donation.

METHODS

The presence and intensity of 17 facial action units were extracted from video recordings of 227 blood donors and were used to classify low and high VVR levels using machine-learning algorithms. We included three groups of blood donors as follows: (1) a control group, who had never experienced a VVR in the past (n = 81); (2) a 'sensitive' group, who experienced a VVR at their last donation (n = 51); and (3) new donors, who are at increased risk of experiencing a VVR (n = 95).

RESULTS

The model performed very well, with an F1 (=the weighted average of precision and recall) score of 0.82. The most predictive feature was the intensity of facial action units in the eye regions.

CONCLUSIONS

To our knowledge, this study is the first to demonstrate that it is possible to predict who will experience a vasovagal response during blood donation through facial microexpression analyses prior to donation.

Improving donor retention following a temporary deferral: A cluster randomized controlled trial of deferral educational materials

BACKGROUND

Providing educational materials to deferred donors has been shown to increase their understanding about their deferral and knowledge about their return. The aim of this study was to determine the effectiveness of educational materials in increasing the retention of deferred donors.

STUDY DESIGN AND METHODS

A three-arm cluster randomized controlled trial was conducted, with the following conditions: (a) Incenter Brochure plus Email; (b) Email Only; (c) Control. The Incenter Brochure plus Email condition also included a guided conversation led by staff at the point of deferral. Donors were followed up for 3 months after their deferral had ended to determine if they had attempted to donate.

RESULTS

Compared with the Control condition, donors in the Incenter Brochure plus Email condition had increased odds of return at 3 months after their deferral ended (OR: 1.16; 95% CI 1.00-1.33). Subgroup analysis highlighted that novice (OR: 1.38; 95% CI 1.04-1.83) and established donors (OR: 1.36; 95% CI 1.13-1.64) had increased odds of return if they received the incenter materials. Donors who were deferred to maintain their well-being (OR: 1.28; 95% CI 1.03-1.60) and donors with a prior deferral history (OR: 1.55; 95% CI 1.15-1.55) had increased odds of return if they received the incenter materials. No significant differences were found between the Email Only and Control conditions.

DISCUSSION

This trial demonstrates the benefits of providing onsite educational materials to donors at the point of deferral. This is a simple, effective strategy to increase the return behavior of donors within 3 months of their deferral ending.

The impact of COVID-19 on blood donations

During a crisis, society calls for individuals to take prosocial actions that promote crisis management. Indeed, individuals show higher willingness to help after a disaster. However, the COVID-19 pandemic presents significant differences as it is an ongoing crisis that affects all individuals and has the potential to pose a direct health threat to anyone. Therefore, we propose that the pandemic may also negatively affect willingness to help, specifically blood donation intentions. It requires a high level of willingness to donate blood beyond the crisis outbreak, as more blood will be needed when postponed surgeries resume. When comparing blood donation intentions from a pre-pandemic study to results from a six-wave (bi-weekly) panel study conducted in Germany during the first pandemic phase (April to June 2020), we find lower medium and long-term blood donation intentions. While active donors show increased awareness of ability and eligibility to donate at the beginning of the pandemic compared to pre-pandemic, they feel significantly less able to donate as the pandemic progresses. Furthermore, inactive donors’ perceived ability to donate significantly decreases in the pandemic phase compared to the pre-pandemic phase. Crucially, both active and inactive donors feel less responsible and less morally obliged to donate, resulting in an overall negative pandemic effect on blood donation intentions. The COVID-19 pandemic compromises blood donations endangering the life-saving blood supply. These alarming results offer evidence-based grounds for practical implications for driving donations in the event of a pandemic.

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

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

Assessment of levels of awareness towards blood donation in Saudi Arabia

Background

blood products is an interesting term as all blood and blood transfusion procedures carry risk even with advance screening of donors and donated blood. In Saudi Arabia voluntary donors are either the only source or not, the other source is paid donors and the lack of volunteers represents a major challenge. This is usually attributed to low community awareness regarding voluntary blood donation. Therefore, the objective of this study was to assess the levels of awareness towards blood donation in northern Saudi Arabia.

Methodology

in this descriptive cross sectional survey, data about blood donation were obtained from 717 Saudi volunteers living in the city of Hail, Saudi Arabia. A Purposeful questionnaire was designed and used for obtaining of the necessary data.

Results

When asking the participants to rate the level of awareness about blood donation in Saudi Society, the majority of participants categorized the levels as good followed by very good and poor, representing 48.8%, 29.3%, and 22% participants, respectively.

Conclusion

the broad concept of blood donation is still poor in Saudi Arabia. Further educational plans are needed to raise the level of awareness and increase the perception of blood donation among Saudi population. Efforts should be made to involve females in blood donation duties.

A novel case-control subsampling approach for rapid model exploration of large clustered binary data

In many settings, an analysis goal is the identification of a factor, or set of factors associated with an event or outcome. Often, these associations are then used for inference and prediction. Unfortunately, in the big data era, the model building and exploration phases of analysis can be time-consuming, especially if constrained by computing power (ie, a typical corporate workstation). To speed up this model development, we propose a novel subsampling scheme to enable rapid model exploration of clustered binary data using flexible yet complex model set-ups (GLMMs with additive smoothing splines). By reframing the binary response prospective cohort study into a case-control-type design, and using our knowledge of sampling fractions, we show one can approximate the model estimates as would be calculated from a full cohort analysis. This idea is extended to derive cluster-specific sampling fractions and thereby incorporate cluster variation into an analysis. Importantly, we demonstrate that previously computationally prohibitive analyses can be conducted in a timely manner on a typical workstation. The approach is applied to analysing risk factors associated with adverse reactions relating to blood donation.

Motivational factors for blood donation in first-time donors and repeat donors: a cross-sectional study in West Pomerania

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.

A motivational interview promotes retention of blood donors with high internal motivation

BACKGROUND

Based on the hypothesis that self-determined motivation is associated with an increased likelihood of future behavior, the present study examined the ability of a motivational interview to promote internal motivation for giving blood and future donation attempts.

STUDY DESIGN AND METHODS

A sample of 484 recent whole-blood and double red blood cell donors (62.4% female; age = 30.2 ± 11.8 years) were randomly assigned to either a telephone-delivered motivational interview or a control call approximately 6 weeks after donating. Several weeks before the call and again 1 week after the call, participants completed the Blood Donor Identity Survey, a multidimensional measure of donor motivation, to derive indices of amotivation, external motivation, and internal motivation to give blood. Repeat donation attempts were tracked using blood center records.

RESULTS

Relative to controls, participants in the motivational interview group showed a shift toward more self-determined motivation, as indicated by significant decreases in amotivation (p = 0.01) and significant increases in external (p = 0.009) and internal (p = 0.002) motivation. Furthermore, those with initially high levels of autonomous motivation were more likely to make a donation attempt in the subsequent year if they completed the motivational interview (71.1%) versus the control call (55.1%).

CONCLUSION

Motivational interviewing is a potentially useful strategy to enhance retention of existing blood donors, particularly among those who express a greater sense of internal motivation for giving.