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Ruiz JM, Hughes SD, Flores M, Custer B, Ingram M, Carvajal S, Rosales C, Kamel H, Vassallo R, France CR. Neighborhood ethnic density and disparities in proximal blood donation opportunities. Transfusion 2024; 64:1008-1015. [PMID: 38660952 DOI: 10.1111/trf.17847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 04/05/2024] [Accepted: 04/07/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Despite being the largest racial/ethnic minority group in the United States, Hispanic/Latinos (H/L) are significantly underrepresented among blood donors. A lack of proximal blood donation opportunities may be one factor contributing to these disparities. However, few studies have investigated this possibility. STUDY DESIGN AND METHODS Proprietary data on mobile blood collections in Maricopa County, Arizona, were gathered for the period of January 01, 2022 to April 30, 2022 and paired with census tract information using ArcGIS. Maricopa County encompasses the city of Phoenix with a total population of approximately 4.5 million people, including 1.5 million H/L residents. Blood drive count was regressed on H/L ethnic density and total population, and model estimates were exponentiated to obtain odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS During the specified period, approximately 27,000 red blood cell units were collected through mobile drives. Consistent with expectations, when controlling for total neighborhood population, each 10% increase in H/L ethnic density lowered the odds of having a blood drive in the corresponding neighborhood by 12% (OR = 0.88, 95% CI (0.83, 0.92), p < .001). DISCUSSION These findings provide initial evidence of fewer proximal donation opportunities in areas with greater H/L population density which may contribute to H/L underrepresentation in blood donation and the need for more inclusive collection efforts. Improved access to blood collection is modifiable and could help to increase the overall blood supply, enhance the ability to successfully match specific blood antigen needs of an increasingly diverse population, and bring about a more resilient blood system.
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Affiliation(s)
- John M Ruiz
- Department of Psychology, University of Arizona, Tucson, Arizona, USA
| | - Shana D Hughes
- Vitalant Research Institute, San Francisco, California, USA
| | - Melissa Flores
- Department of Psychology, University of Arizona, Tucson, Arizona, USA
| | - Brian Custer
- Vitalant Research Institute, San Francisco, California, USA
| | - Maia Ingram
- School of Public Health, University of Arizona, Tucson, Arizona, USA
| | - Scott Carvajal
- School of Public Health, University of Arizona, Tucson, Arizona, USA
| | - Cecilia Rosales
- School of Public Health, University of Arizona, Tucson, Arizona, USA
| | - Hany Kamel
- Vitalant, Medical Affairs, Scottsdale, Arizona, USA
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Hughes SD, France CL, West-Mitchell KA, Pina T, McElfresh D, Sayers M, Bryant BJ. Advancing Understandings of Blood Donation Motivation and Behavior. Transfus Med Rev 2023; 37:150780. [PMID: 37996288 DOI: 10.1016/j.tmrv.2023.150780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 10/23/2023] [Accepted: 10/23/2023] [Indexed: 11/25/2023]
Abstract
In this review, we provide critical analysis of social science research into blood donation motivation and behavior. We first share an understanding of the existing literature and recommendations for future research collectively developed by members of the Working Group on Blood Donors and the Supply: Diversifying while Maintaining the Donor Pool, Donor Selection, and Optimizing Blood Availability and Safety, as part of the National Heart, Lung, and Blood Institute's 2022 State of the Science in Transfusion Medicine symposium. Then, rather than aim for a comprehensive treatment, we review 4 newer manuscripts that exemplify aspects of the group's recommendations and report results from countries where the blood supply is based on voluntary, nonremunerated donations. From the substantial existing literature, we selected: (1) a study that employed motivational interviewing techniques, thematic analysis, and surveys to link donation motivations and barriers reported by diverse young donors in the United States to actual donation behavior over a year of subsequent eligibility; (2) a survey regarding donation motivations and barriers and monetary amounts associated with willingness to participate in whole blood, plasma, or platelet collection; (3) a survey-based assessment of various emotional states reported by donors at 2 time points during donation and the relationship between emotional experience and subsequent vasovagal reactions; and (4) an interpretive discourse analysis of blood collection agency messaging to donors and the public in the beginning of the COVID-19 pandemic. We close by noting several challenges posed by the structure of the United States blood system and the current funding environment to conducting rigorous research and translating findings into practice.
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Affiliation(s)
- Shana D Hughes
- Vitalant Research Institute, University of California San Francisco, San Francisco, CA, USA; Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA, USA.
| | | | - Kamille A West-Mitchell
- Department of Transfusion Medicine, NIH Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Theresa Pina
- Gulf Coast Regional Blood Center, Houston, TX, USA
| | - Duncan McElfresh
- Department of Medicine, Stanford University, Stanford, CA, USA; US Department of Veterans Affairs, Program Evaluation Resource Center, Office of Mental Health and Suicide Prevention, Menlo Park, CA, USA
| | - Merlyn Sayers
- University of Texas Southwestern Medical Center, Dallas, TX, USA; Carter BloodCare, Bedford, TX, USA
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3
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Patel EU, Bloch EM, Grabowski MK, Goel R, Lokhandwala PM, Brunker PAR, White JL, Shaz B, Ness PM, Tobian AAR. Sociodemographic and behavioral characteristics associated with blood donation in the United States: a population-based study. Transfusion 2019; 59:2899-2907. [PMID: 31222779 DOI: 10.1111/trf.15415] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 05/22/2019] [Accepted: 05/22/2019] [Indexed: 01/28/2023]
Abstract
BACKGROUND Contemporary population-based data on characteristics associated with blood donation in the United States (U.S.) are limited. STUDY DESIGN AND METHODS A cross-sectional analysis was performed among 28,739 persons aged 18 years and older who participated in the 2016 National Health Interview Survey, a household survey of the noninstitutionalized U.S. civilian population. Analyses were weighted and accounted for the complex survey design. Adjusted prevalence ratios (aPR) were estimated by multivariable log-binomial regression. RESULTS The percentage of individuals reporting a past-year history of blood donation was 5.7% (95% confidence interval [CI], 5.3%-6.1%) and was highest in the youngest age group (18-24 years, 8.4%). A past-year history of blood donation was more common in males compared to females (6.3% vs. 5.1%; aPR, 1.12 [95% CI, 0.99-1.27]) and those born in the U.S. compared to individuals born outside the U.S. (6.4% vs. 2.4%; aPR, 1.92 [95% CI, 1.49-2.47]). The percentage of individuals with a past-year history of blood donation was significantly lower in blacks (3.9%; aPR, 0.60 [95% CI, 0.47-0.75]) and Hispanics (3.0%; aPR, 0.63 [95% CI, 0.48-0.83]) in comparison to whites (6.9%). Being a college graduate, being employed, being physically active, and never being a cigarette smoker were factors positively associated with blood donation. The percentage of individuals with a past-year history of blood donation varied by geographic census region, with prevalence being higher in the Midwest (7.3%) and South (6.0%) compared to the Northeast (4.7%) and West (4.4%). CONCLUSION Continued differences in the blood donor population with reference to the U.S. population underscore the need to understand barriers or deterrents to blood donation. Evidence-based donor recruitment and related policies remain imperative to ensure that there is a sustainable blood supply.
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Affiliation(s)
- Eshan U Patel
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Evan M Bloch
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Mary K Grabowski
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Ruchika Goel
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Division of Hematology/Oncology, Simmons Cancer Institute at SIU School of Medicine, Springfield, Illinois
| | - Parvez M Lokhandwala
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Patricia A R Brunker
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Biomedical Services, Greater Chesapeake and Potomac Region, The American Red Cross, Baltimore, Maryland
| | - Jodie L White
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Beth Shaz
- New York Blood Center, New York, New York
| | - Paul M Ness
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Aaron A R Tobian
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Klinkenberg EF, Huis In't Veld EMJ, de Wit PD, van Dongen A, Daams JG, de Kort WLAM, Fransen MP. Blood donation barriers and facilitators of Sub-Saharan African migrants and minorities in Western high-income countries: a systematic review of the literature. Transfus Med 2019; 29 Suppl 1:28-41. [PMID: 29493019 PMCID: PMC7379919 DOI: 10.1111/tme.12517] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 01/24/2018] [Accepted: 01/27/2018] [Indexed: 12/26/2022]
Abstract
OBJECTIVES The present study aimed to gain more insight into, and summarise, blood donation determinants among migrants or minorities of Sub-Saharan heritage by systematically reviewing the current literature. BACKGROUND Sub-Saharan Africans are under-represented in the blood donor population in Western high-income countries. This causes a lack of specific blood types for transfusions and prevention of alloimmunisation among Sub-Saharan African patients. METHODS/MATERIALS Medline, EMBASE, PsycINFO and BIOSIS were searched for relevant empirical studies that focused on barriers and facilitators of blood donation among Sub-Saharan Africans in Western countries until 22 June 2017. Of the 679 articles screened by title and abstract, 152 were subsequently screened by full text. Paired reviewers independently assessed the studies based on predefined eligibility and quality criteria. RESULTS Of the 31 included studies, 24 used quantitative and 7 used qualitative research methods. Target cohorts varied from Black African Americans and refugees from Sub-Sahara Africa to specific Sub-Saharan migrant groups such as Comorians or Ethiopians. Main recurring barriers for Sub-Saharan Africans were haemoglobin deferral, fear of needles and pain, social exclusion, lack of awareness, negative attitudes and accessibility problems. Important recurring facilitators for Sub-Saharan Africans were altruism, free health checks and specific recruitment and awareness-raising campaigns. CONCLUSION The findings of this review can be used as a starting point to develop recruitment and retention strategies for Sub-Saharan African persons. Further research is needed to gain more insight in the role of these determinants in specific contexts as socioeconomic features, personal histories and host country regulations may differ per country.
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Affiliation(s)
- E. F. Klinkenberg
- Department of Donor StudiesSanquin ResearchAmsterdamThe Netherlands
- Department of Public HealthAcademic Medical Center, University of AmsterdamAmsterdamThe Netherlands
| | - E. M. J. Huis In't Veld
- Department of Donor StudiesSanquin ResearchAmsterdamThe Netherlands
- Department of Medical and Clinical PsychologyTilburg UniversityTilburgThe Netherlands
| | - P. D. de Wit
- Department of Donor StudiesSanquin ResearchAmsterdamThe Netherlands
- Department of Public HealthAcademic Medical Center, University of AmsterdamAmsterdamThe Netherlands
| | - A. van Dongen
- School of Psychology, University of New South WalesSydneyAustralia
| | - J. G. Daams
- Medical LibraryAcademic Medical Center, Univeristy of AmsterdamAmsterdamThe Netherlands
| | - W. L. A. M. de Kort
- Department of Donor StudiesSanquin ResearchAmsterdamThe Netherlands
- Department of Public HealthAcademic Medical Center, University of AmsterdamAmsterdamThe Netherlands
| | - M. P. Fransen
- Department of Public HealthAcademic Medical Center, University of AmsterdamAmsterdamThe Netherlands
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Kashimura M, Goto A, Nollet KE, Ohto H, Yasumura S, Konno K. Who returns and becomes a regular blood donor? Analysis of a donor database in Fukushima, Japan. ACTA ACUST UNITED AC 2017. [DOI: 10.1111/voxs.12363] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- M. Kashimura
- Fukushima Blood Center; Japanese Red Cross Society; Fukushima Japan
- Department of Blood Transfusion and Transplantation Immunology; Fukushima Medical University School of Medicine; Fukushima Japan
| | - A. Goto
- Center for Integrated Science and Humanities; Fukushima Medical University; Fukushima Japan
- Department of Public Health; Fukushima Medical University School of Medicine; Fukushima Japan
| | - K. E. Nollet
- Department of Blood Transfusion and Transplantation Immunology; Fukushima Medical University School of Medicine; Fukushima Japan
| | - H. Ohto
- Department of Blood Transfusion and Transplantation Immunology; Fukushima Medical University School of Medicine; Fukushima Japan
| | - S. Yasumura
- Department of Public Health; Fukushima Medical University School of Medicine; Fukushima Japan
| | - K. Konno
- Fukushima Blood Center; Japanese Red Cross Society; Fukushima Japan
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Merz EM, Zijlstra BJH, de Kort WLAM. Blood donor show behaviour after an invitation to donate: The influence of collection site factors. Vox Sang 2017; 112:628-637. [PMID: 28833262 DOI: 10.1111/vox.12562] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 06/10/2017] [Accepted: 07/09/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND OBJECTIVES Show behaviour after invitation to donate varies considerably across donors. More insight into this variation is important for blood banks in achieving stable stocks. This study examined individual factors determining intended show behaviour. Most importantly, however, this study is the first study to account for variation in donor behaviour across different collection sites. MATERIALS AND METHODS We applied a multilevel approach to data from Donor InSight, including 11 889 donors from 257 fixed and mobile collection sites in the Netherlands. The aim of the multilevel models was to account for variance at two levels, that is donors and collection sites. We estimated the likelihood of showing after invitation based on individual predictors, including demographics, donation history and attitude. At the collection site level, we included satisfaction with the blood bank aggregated from individual responses by donors who donate at this site, opening hours and collection site type, that is fixed/mobile. RESULTS Most importantly, show behaviour varied considerably across collection sites and depended on characteristics of these sites. Moreover, women, older and more experienced donors had higher odds of showing after invitation than men, younger and less experienced donors. Donors higher on warm glow, self-efficacy and donor identity more likely showed after an invitation. Higher aggregate satisfaction and donating at fixed collection sites increased the odds of show. CONCLUSION In addition to individual factors, collection site characteristics are important in explaining variation in donor show behaviour, thus presenting clues for blood bank policies and interventions to improve donor show.
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Affiliation(s)
- E-M Merz
- Sanquin Research, Amsterdam, The Netherlands.,Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - W L A M de Kort
- Sanquin Research, Amsterdam, The Netherlands.,Academic Medical Center, Amsterdam, The Netherlands
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Individual, contextual and network characteristics of blood donors and non-donors: a systematic review of recent literature. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2017; 15:382-397. [PMID: 28686151 DOI: 10.2450/2017.0064-17] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 04/20/2017] [Indexed: 11/21/2022]
Abstract
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.
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George PE, Vidal J, Garcia PJ. An Analysis of and Recommendations for the Peruvian Blood Collection and Transfusion System. ACTA ACUST UNITED AC 2016; 1. [PMID: 27761524 PMCID: PMC5067018 DOI: 10.16966/2471-8211.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Background Peru experienced a crisis in its blood collection and supply system in the mid-2000s, as contaminated blood led to several transfusion-transmitted infections (TTI), occurring in the backdrop of extremely low voluntary donation rates and a national blood supply shortage. Thus, the Peruvian Ministry of Health (MINSA) implemented a national investigation on the safety and quality of the Peruvian blood collection/transfusion network. Methods Every Peruvian blood bank was evaluated by MINSA from 2007–2008. These evaluations consisted of an update of the national registry of blood banks and visits to each blood bank from MINSA oversight teams. Information was collected on the condition of the blood bank personnel, equipment, supplies, and practices. Further, previously-collected blood at each blood bank was randomly selected and screened for TTI-causing pathogens. Results Uncovered in this investigation was a fragmented, under-equipped, and poorly-staffed blood collection and transfusion network, consisting of 241 independent blood banks and resulting in suboptimal allocation of resources. Further, blood with evidence of TTI-causing pathogens (including Hepatitis B, Hepatitis C, and syphilis) and set for transfusion was discovered at three separate blood banks as part of the random screening process. Conclusion Using the successful reorganizations of national blood supply systems in other Latin American countries as examples, Peru would be well-served to form large, high-volume, regional blood collection and transfusion centers, responsible for blood collection and screening for the entire country. The small, separate blood banks would then be transformed into a network of blood transfusion centers, not responsible for blood collection. This reorganization would allow Peru to better utilize its resources, standardize the blood collection and transfusion process, and increase voluntary donation, resulting in a safer, more abundant national blood product.
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Affiliation(s)
- Paul E George
- Division of Infectious Diseases, UCLA David Geffen School of Medicine, Los Angeles, California, USA
| | - Julio Vidal
- National Hospital Cayetano Heredia, Lima, Peru
| | - Patricia J Garcia
- Unit of Epidemiology, STDs and HIV, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
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Ouhbi S, Fernández-Alemán JL, Toval A, Idri A, Pozo JR. Free Blood Donation Mobile Applications. J Med Syst 2015; 39:52. [DOI: 10.1007/s10916-015-0228-0] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Accepted: 02/09/2015] [Indexed: 11/28/2022]
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