The Blood Donation Ambivalence Survey: measuring conflicting attitudes about giving blood

The Polish adaptation of the blood donation fears inventory

BACKGROUND AND OBJECTIVES

Given the decline in the number of voluntary blood donors in Poland and the lack of psychological research on blood donors and the donation system in the country, there is a need to develop a tool to measure barriers to recruiting new donors and retaining active donors. One significant barrier is the presence of specific fears associated with the blood donation process. Therefore, the main objective of this study was to perform the Polish adaptation of the Blood Donation Fears Inventory (the BDFI).

MATERIALS AND METHODS

The Polish adaptation of the BDFI was developed and tested on a sample of 409 individuals, consisting of 194 (47.5%) voluntary blood donors and 214 (52.5%) non-donors. The original tool comprises an 18-item scale that measures four different types of fears related to the blood donation process: (1) Fear of Syncopal Symptoms, (2) Fear of Blood and Needles, (3) Fear of Social Evaluation, and (4) Fear of Health Screen Results.

RESULTS

To determine the psychometric properties of the scale, exploratory factor analysis, confirmatory factor analysis (RMSEA =.098; CFI =.958; TLI =.935; SRMR =.035), second-order factor analysis (RMSEA =.097; CFI =.958; TLI =.936; SRMR =.036; NNFI =.936; NFI =.938), and bifactor analysis (RMSEA =.093; CFI =.969; TLI =.942; SRMR =.036; NNFI =.942; NFI =.952) were conducted. The reliability of the tool was assessed using Cronbach's Alpha and McDonald's Omega, resulting in high coefficients (ranging from.92 to.97) for each scale. Internal consistency was examined using the State-Trait Anxiety Inventory (STAI), while external consistency was examined using the Scale of Positive and Negative Experience (SPANE) and the Self-esteem Scale (SES).

CONCLUSION

Satisfactory results were obtained, establishing the Polish adaptation of the BDFI. This tool represents a novel contribution to the research on the blood donation system in Poland.

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.

Socio-economic inequalities in children's nutritional status in Democratic Republic of the Congo in 2017-2018: an analysis of data from a nationally representative survey

Objective:

The Democratic Republic of the Congo (DRC) has one of the highest levels of child undernutrition globally; however, little information exists on the underlying socio-economic inequalities resulting in undernutrition. This study aims to examine the differences in the nutritional statuses of children across different wealth quintiles and explores the association between malnutrition in children and related factors.

Design:

We utilised the 2018 Multiple Indicator Cluster Survey data. We estimated the prevalence of malnutrition across all twenty-six provinces. The study used the WHO 2006 child growth standards to measure stunting, underweight and wasting. We employed a mixed-effect linear model to analyse the association between nutritional status and healthcare accessibility, domestic sanitation, and socio-demographic factors.

Setting:

Twenty-six provinces in the DRC.

Participants:

21 477 children under 5 years of age and 21 828 women of childbearing age in the DRC.

Results:

The national prevalence of underweight, stunting and wasting was found to be 23·33 %, 42·05 % and 5·66 %, respectively. Household wealth and mother’s education level were significantly positively associated with the nutritional statuses of children. Among households in the lowest wealth quintile, residence in urban areas was a protective factor against undernutrition.

Conclusion:

The findings of this study indicate considerable socio-economic inequalities in the nutritional statuses of children under 5 years of age in the DRC, highlighting the need for nutrition promotion as part of maternal and child healthcare. Interventions and policies should include improving nutrition education for less-educated mothers, in particular, in the central provinces of the DRC.

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.

Assessing the impact of an automated Web-based motivational interview on the intention and return behavior of Australian O-negative donors

BACKGROUND

O-negative donors are a critical resource for blood collection agencies, and their recruitment and retention provides an ongoing challenge. Motivational interviewing shows promise as a tool to promote donor retention, although concerns about scalability remain. The current study examined the effect of an automated Web-based interview drawing on motivational interviewing and self-determination theory on O-negative donors' motivation, intention, and behavior.

STUDY DESIGN AND METHODS

Within 13 days of donating, 2820 O-negative donors completed baseline measures of motivation and intention before being randomly assigned to complete either a motivational interview (MI) or active control interview (ACI). Motivation and intention were assessed at 2 days and at 7 weeks after participation in the MI or ACI, with return behavior tracked for 6 months following trial completion.

RESULTS

Changes in donor motivation and intention, rate, and time to return did not vary by participation in the MI or ACI. When compared with O-negative donors who experienced business-as-usual practices, donors completing the MI or ACI returned to donate more, and they returned more quickly. However, subsequent exploratory analyses considering the behavior of those who did not accept the invitation to participate and those who completed only baseline measures showed that the improved return behavior of donors in the MI or ACI conditions was likely not due to any specific properties of the MI or ACI activities.

CONCLUSIONS

Australian O-negative donors were highly internally motivated and committed to donating. An automated Web-based motivational interview appears to be of limited effectiveness in promoting the return of such donors.

Eligible blood donors' decisions about donating stool for fecal microbiota transplantation: Does ambivalence play a role?

Blood collection agencies (BCAs) are expanding core business by inviting blood donors to donate stool for fecal microbiota transplantation (FMT). However, whether blood donors also want to donate stool is unclear since, despite its benefits, stool donation is viewed by many as unpleasant. This study examined the prevalence, contributors to, and role of these mixed feelings (ambivalence) in stool donation intentions.

STUDY DESIGN AND METHODS

This cross-sectional study surveyed Australian residents aged 18 years or more who believed themselves eligible to donate blood and met broad criteria for prescreening as a stool donor (eg, healthy, not taking medication). Survey questions assessed attitude, norms, self-efficacy, motives, disgust, ambivalence, and intentions to donate stool.

RESULTS

A total of 382 eligible blood donors aged not more than 50 years (mean, 28.71 years; 48% female, 62% "healthy" body mass index) participated. Six percent indicated no ambivalence about donating stool. In regression, significant determinants of ambivalence were less awareness of FMT, lower self-efficacy, motivated by ensuring that stool is available for loved ones, and more disgust about stool donation. Higher ambivalence contributed to decreased donation intention. Self-efficacy and disgust differentiated participants with moderate ambivalence, a group likely responsive to intervention, from those with low or high ambivalence.

CONCLUSION

Ambivalence about donating stool was common among eligible blood donors. BCAs should raise awareness about stool donation and FMT before requesting donation. BCAs may increase cost savings and donor retention by giving clear guidance about donation requirements and implementing processes that build confidence. Early screening of potential donors for ambivalence and disgust will enable BCAs to provide decision support.