Predicting blood donation maintenance: the importance of planning future donations

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.

Motivations and deterrents of blood donation among blood donors during the COVID-19 pandemic in Hong Kong

BACKGROUND

The COVID-19 pandemic has resulted in a reduction in blood donations and limited blood supply in many countries. The theory of planned behaviour has been widely used in past studies to understand the factors influencing blood donation. However, this theory limits analyses to the individual level. Furthermore, most research on the determinants of blood donation during the COVID-19 pandemic is quantitative in nature, with relevant qualitative research being rare.

OBJECTIVES

To investigate the motivators and demotivators for donating blood among current blood donors during COVID-19 pandemic.

DESIGN

Forty in-depth, individual semistructured interviews were conducted with current blood donors from December 2020 to March 2021 in Hong Kong. Thematic content analysis was adopted in the data analysis.

RESULTS

The majority of the participants (n = 37) were demotivated from donating blood during the COVID-19 pandemic. Factors at the perceptual, social and institutional levels interacted to cause this reluctance. Only three participants felt more motivated to donate blood. The data revealed that sociocultural forces and government pandemic prevention policies strongly affected the participants' motivations to donate blood during the pandemic.

CONCLUSION

This study presents a macro understanding of blood donation behaviour by investigating the institutional, social and perceptual factors influencing current blood donors during the COVID-19 pandemic. This adds a more comprehensive understanding of blood donation where the theory of planned behaviour is widely used in past studies.

PUBLIC CONTRIBUTION

The participants shared their experiences in the interviews. Their experiences provide hints for explaining the decreasing blood donation during the pandemic times.

Blood donors' usage intentions of donation appointment‐scheduling systems during the COVID‐19 pandemic and beyond

During the COVID‐19 pandemic, online appointment‐scheduling systems have become standard procedure in blood donation practice. This study develops and empirically tests a comprehensive conceptual model of blood donors' usage intentions of a donation appointment‐scheduling system during the COVID‐19 pandemic. Online survey data are collected from blood donors (n = 3269) and analyzed using the partial least squares structural equation modeling (PLS‐SEM) approach. The results provide evidence that intentions to use the system in the post‐COVID‐19 future are high. Together with high‐perceived usefulness and ease of use, this indicates generally high‐system acceptance among active donors during the pandemic and beyond. The study identifies a number of factors that influence this acceptance. The results show that different aspects of service quality perceptions in the context of the system drive its acceptance. The strongest positive effect is exerted by blood donors' pre‐donation planning convenience, followed by an enhanced actual donation experience. Reduced flexibility as a result of the system has a strong negative effect. The authors derive managerial implications for blood donation services regarding preserving the acceptance level and suggest future research prospects.

Too many zeros and/or highly skewed? A tutorial on modelling health behaviour as count data with Poisson and negative binomial regression

Background: Dependent variables in health psychology are often counts, for example, of a behaviour or number of engagements with an intervention. These counts can be very strongly skewed, and/or contain large numbers of zeros as well as extreme outliers. For example, 'How many cigarettes do you smoke on an average day?' The modal answer may be zero but may range from 0 to 40+. The same can be true for minutes of moderate-to-vigorous physical activity. For some people, this may be near zero, but take on extreme values for someone training for a marathon. Typical analytical strategies for this data involve explicit (or implied) transformations (smoker v. non-smoker, log transformations). However, these data types are 'counts' (i.e. non-negative whole numbers) or quasi-counts (time is ratio but discrete minutes of activity could be analysed as a count), and can be modelled using count distributions - including the Poisson and negative binomial distribution (and their zero-inflated and hurdle extensions, which alloweven more zeros). Methods: In this tutorial paper I demonstrate (in R, Jamovi, and SPSS) the easy application of these models to health psychology data, and their advantages over alternative ways of analysing this type of data using two datasets - one highly dispersed dependent variable (number of views on YouTube, and another with a large number of zeros (number of days on which symptoms were reported over a month). Results: The negative binomial distribution had the best fit for the overdispersed number of views on YouTube. Negative binomial, and zero-inflated negative binomial were both good fits for the symptom data with over-abundant zeros. Conclusions: In both cases, count distributions provided not just a better fit but would lead to different conclusions compared to the poorly fitting traditional regression/linear models.

Blood Donation Practice among Undergraduate Students in a Tertiary Care Hospital: A Descriptive Cross-sectional Study

Introduction:

Voluntary blood donation is a reliable source of increasing the demand for blood transfusion. Medical students are the potential pool of blood donors. This study aims to find the prevalence of blood donation practice among medical students of a medical college in Nepal.

Methods:

This is a descriptive cross-sectional study conducted in a medical college of Nepal among students studying from the first year to final year MBBS. Ethical approval was obtained from the Institutional Review Committee of the Nepalese Army Institute of Health Sciences (Ref no. 245). A stratified random sampling technique was used to collect data. A self-administered pre-tested questionnaire was used to collect data. Data were analyzed using Microsoft Excel 2016.

Results:

The prevalence of blood donation practice among medical students of the medical college is 41 (22.20%) (17.35-27.05 at 95% Confidence Interval). The practice of blood donation is seen more among students of the final year 15 (35.71%) and the least among first year 3 (8.57%). Most of the donors, 24 (58.54%), have donated blood only once before. The most common reasons for donating and not donating blood before are ‘behavior of altruism’ 12 (29.27%) and ‘I am not fit/disapproved’ 44 (30.56%) respectively.

Conclusions:

This study shows less prevalence of blood donation practice among medical students. It points to the need for more extensive studies to explore the factors deterring medical students from donating blood. Definitive strategies are also needed to encourage medical students to increased voluntary participation in blood donation.

Problems and challenges: development of blood transfusion services in Mainland China within the context of health-care system reform

OBJECTIVE

To evaluate the development of blood transfusion services in Mainland China within the context of health-care system reform.

BACKGROUND

China launched a health-care reform program in 2009 to redistribute health-care resources, which are currently over-concentrated in well-developed cities. A geographically equitable blood transfusion service is key to achieving this goal.

METHODS

Based on the national survey of blood establishments in July 2015, total blood collection, whole-blood donations per 1000 population and the supply and demand relationship were analysed at the administrative region level. Areas at different developmental levels were compared in terms of total blood collection and human resources.

RESULTS

In 2014, Mainland China's 31 provinces showed wide variation, with total blood collection in blood facilities ranging from about 1000 units to over 600 000 units (each 200 mL), and the whole-blood donation rate per 1000 population, ranging from 1·48 to 17·09. 69% of the country's total collection, was concentrated in 29 provincial capitals, and 31% was in 311 non-capital cities. Of 97 personnel with doctorates, 74 worked in 32 provincial blood establishments, whereas the remaining 23 worked at the other 318 blood stations. In most provinces, per permanent resident donation was within 2-4 mL, and blood volume per inpatient was 10-35 mL regardless of the development of the transfusion service.

CONCLUSION

In 2014, China had an imbalanced development and insufficient access to blood transfusion services. This service must be redeployed at the national level to facilitate health-care reform in China.

Segmenting Active Blood Donors According to Their Barriers to Develop Retention Programs

Given the lack of a consensus on a catalogue of donation barriers, this study proposes a holistic scale of barriers which was used to segment Spanish active blood donors to define specific retention and loyalty strategies. A sample of 26 626 active donors from 14 of the 17 Spanish blood transfusion centers assessed a total of 25 barriers through an online survey. This scale was validated and 4 barrier categories were defined: Informative, Intrinsic, Time-space and Procedural. Segmentation was performed through k-means clustering. Four active donor clusters were created: (1) "Very Inhibited" (13.2%), who experienced a high number of barriers in all categories; (2) "Uninhibited" (46.9%), which was the largest cluster with fewer barriers; (3) "Apprehensive" (16.9%), whose most prevalent barriers were Informative and Intrinsic in nature; and (4) "Busy" (23.0%), who experienced mainly Time-space and Informative barriers. Afterward, depending on the size of the cluster, the presence of barriers, and the greater ease or difficulty to act on them, the attractiveness of each cluster was established to propose specific marketing actions.

Psychosocial characteristics of blood donors influence their voluntary nonmedical lapse

BACKGROUND

Approximately 10% of Dutch donors lapse yearly. Common reasons are nonvoluntary medical issues (e.g., low hemoglobin), reaching the upper age limit, and voluntary (e.g., own request, nonresponse). Little is known about predictors of voluntary noncompliance (lapses). Psychosocial characteristics have been linked to various health behaviors, including voluntary noncompliance. Hence, we investigated whether psychosocial characteristics, measured before the first donation, similarly predict subsequent voluntary nonmedical lapse.

STUDY DESIGN AND METHODS

New donors (n = 4861) randomly received a blood donation survey between July 2008 and March 2009, before their first appointment at the blood bank. Voluntary lapses included personal reasons, nonresponse to invitations, donor who could not be reached, and no show. Univariate and multivariate Cox regression models of lapse on psychosocial characteristics and confounders (e.g., demographics) were estimated.

RESULTS

Of 2964 donors who took the questionnaire, more than one-third (36.5%) had voluntarily lapsed due to nonmedical reasons by 2016. Univariate regression showed that lapse negatively associated with norms, attitudes, and intentions toward blood donation; self-efficacy; and more donation experience. Lapse positively associated with anxiety. Multivariate Cox models showed that lapse was primarily driven by anxiety and need for information.

CONCLUSION

Certain psychosocial characteristics increase risks of voluntary lapse. Especially donors with higher donation anxiety had increased lapsing risks. They might benefit from extra attention during donation. Donors with more information need or wish about procedure and patients were less likely to lapse, indicating that binding with the blood bank might prevent lapse. Generally, this study showed that donor lapse and donor return are determined by different psychosocial factors not just the reverse of each other.

Individual, contextual and network characteristics of blood donors and non-donors: a systematic review of recent literature

BACKGROUND

The ageing population and recent migration flows may negatively affect the blood supply in the long term, increasing the importance of targeted recruitment and retention strategies to address donors. This review sought to identify individual, network and contextual characteristics related to blood donor status and behaviour, to systematically discuss differences between study results, and to identify possible factors to target in recruitment and retention efforts.

METHODS

The systematic review was conducted in accordance with a predefined PROSPERO protocol (CRD42016039591). After quality assessments by multiple independent raters, a final set of 66 peer-reviewed papers, published between October 2009 and January 2017, were included for review.

RESULTS

Individual and contextual characteristics of blood donor status and behaviour were categorised into five main lines of research: donor demographics, motivations and barriers, adverse reactions and deferral, contextual factors, and blood centre factors. Results on donor demographics, motivations and barriers, and contextual factors were inconclusive, differing between studies, countries, and sample characteristics. Adverse reactions and deferral were negatively related to blood donor behaviour. Blood centre factors play an important role in donor management, e.g., providing information, reminders, and (non-)monetary rewards. No studies were found on network characteristics of (non-)donors.

DISCUSSION

Although individual and contextual characteristics strongly relate to blood donor status and behaviour, mechanisms underlying these relations have not been studied sufficiently. We want to stress the importance of longitudinal studies in donor behaviour, exploring the role of life events and network characteristics within blood donor careers. Increased understanding of donor behaviour will assist policy makers of blood collection agencies, with the ultimate goal of safeguarding a sufficient and matching blood supply.

How to reverse first time donors to become regular donors? A questionnaire survey in Estonia

BACKGROUND

Donating blood in Estonia is non-remunerated and voluntary. Estonian Blood Service system has four independent regional blood centres that are responsible for blood collection, processing, screening and distribution of blood components to hospitals for clinical use.

STUDY DESIGN

This research was carried out as a questionnaire survey. A questionnaire was developed to study lapsing first time donors' (FTD) blood donation experience, intention and willingness to donate again.

METHODS

A thousand five hundred and forty-six questionnaires were posted to donors who had one successful donation in 2010 and who had not returned to second donation till the year 2012. For data analysis routine statistical methods were used. To evaluate the most appropriate number of classes, based on previous experience and future expectations, latent class analysis was used.

RESULTS

There were 453 respondents (29.3%). For the majority of aspects of blood donation experience the emotions were positive. Results of the study suggested that blood collection agencies should intervene to bolster donors' attitudes, perceived control, and identity as a donor during this crucial post-first donation period.

CONCLUSION

First blood donation seems to have been a positive experience. Reasons leading to stopping blood donation should be studied further. Establishing a donor registry for Estonia would be essential to keep track of donors.

Translation strategies, contradiction, and the theory of social representations: Why discussing needles may improve blood donor retention

Retaining blood donors is a cost-effective way of ensuring a safe blood supply, yet despite the plethora of research, only 5.1% of the eligible population in Australia donate blood and 40% of these do not make a second donation. We offer an alternative to traditional approaches by conceptualizing blood donation within social representations theory as socially derived symbolic knowledge with a specific focus on cognitive polyphasia and Guimelli's (1998) normative and functional dimensions. An online survey, completed by 703 residents from NSW Australia, comprised a blood donation word association task, Likert-style questions constructed from previous word association data and contextualized blood donation statements. Individual difference scaling analysis revealed all donor groups (including non-donors) associated blood donation with a few central, albeit contradictory ideas/beliefs. Exploratory factor analysis and confirmatory factor analysis performed on a split data set of the Likert-style items reiterated this finding. Interpreted through Guimelli's dichotomy, all donor groups were aware of these contradictory normative and functional ideas/beliefs but when explicitly asked, it was the functional aspect that differentiated the groups. We argue the key to retaining donors is understanding the interdependence between how blood donation is socially understood at the societal level of discourse and donor behaviour. Translational strategies for recruitment and retention are discussed.

Translation into Portuguese and validation of the Blood Donation Reactions Inventory

Background

the Blood Donation Reactions Inventory (BDRI) scale was proposed as part of a study about the predictors of psychological reactions in volunteer blood donors, as uncomfortable reactions are associated with a lower probability to return for further donations.

Objective

to translate the Inventory into Brazilian Portuguese and evaluate its psychometric properties (validity and reliability). The inventory has 11 items, but the literature suggests that shorter inventories, of four or six items, should be used.

Methods

this study was carried out at the blood center of Franca, Brazil. Three people with knowledge of English and familiarity with medical terms translated the Blood. Donation Reactions Inventory into Brazilian Portuguese. Aiming to evaluate the objectivity and relevance of the items of the translated instrument, its content was independently evaluated by a panel of eight assessors. After this, data on 1,001 blood donors was collected. Internal consistency was assessed by Cronbach’s alpha coefficient. An exploratory factor analysis with varimax rotation was used to analyze the measure for construct validity.

Results

the sample consisted of 65.8% men, and 27.3% first time donors. Internal consistency determined by Cronbach’s alpha coefficient was satisfactory for the 11, 6 and 4-item scales. Considering the factor analysis, the 11-item scale seems to measure more than one construct as three factors were identified with eigenvalues greater than 1. These factors correspond to ‘vasovagal adverse reactions’, ‘fear’ ‘anxiety/excitation’.

Conclusion

the Portuguese version of the Blood Donation Reactions Inventory is a valid and reliable instrument for collecting information regarding systemic reactions experienced by blood donors. The 6-item scale seems to be useful when the objective is to measure only vasovagal adverse reactions.

© 2014 Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular. All rights reserved.