What motivates men to donate blood? A systematic review of the evidence

Harnessing the potential of blood donors negative for high prevalence Rh antigens: A Database Initiative for Thalassaemia Care

BACKGROUND AND OBJECTIVES

With increasing life expectancy and prevalence of thalassaemia, it has led to a greater need for safe blood, yet the current supply from voluntary donors is insufficient to meet this demand. Thalassaemia recipients face a significant risk of alloimmunization because of repeated exposure to foreign red cell antigens. Study aims to determine high prevalent Rh antigen negative donors in western India donor population along with what percentage of these donors are willing to become dedicated voluntary donors for thalassaemia patients. Study also aims to examine factors influencing their willingness and challenges faced in mobilizing dedicated donors.

METHOD

700 whole blood donors from western India, following screening for inclusion & exclusion criteria as per Drugs and Cosmetic Act (DCA) 2020 amendment guidelines & were sero-negative for transfusion transmitted infections were enrolled for the study. Red cell phenotyping was performed using Conventional Tube Technique (CTT) for "D", "C", "E", "c", "e" and "K" antigen using known antisera. Donors that were "C" AND/OR "e" antigen negative were contacted telephonically and were counseled and motivated for becoming voluntary blood donors. Statistical analysis assessed correlation between donation frequency, donor's occupation and education.

RESULT

Among 700 donors, 96.6% (n=676) were males and 3.4% (n=24) were females. The most predominant blood group was B > O > A > AB. Rh(D) antigen was present in 91.44% (n = 640) and absent in 8.6% (n=60). Prevalence of other Rh antigens is as follows: "e" (99%) > "C" (85.4%) > "c" (59.1%) > "E" (18.0%). Only 1.15% had "K" antigen positive. The commonest Rh phenotype R1R1 (DCe/DCe) was expressed by 40.57% (n=283), and the least common r"r (cE/ce), r''r''(cE/cE) and r'r' (Ce/Ce) was found in 0.14% (n=1), respectively. 'C' negative, 'e' negative, 'C' and 'e' antigen negative donors constituted 14.8% (n = 104) with 93.2% (n=97) C-antigen negative, 1.92% (n=2) e-antigen negative and 4.8% (n=5) both "C" and "e" antigen negative donors. The commonest phenotypes among C-antigen and e-antigen negative donors were rr (50%) and RzR2 (1.94%) respectively. Likewise, the most common phenotype amongst both C- and e-antigens negative donors was R2R2 (3.84%). 61.5% of the donors agreed to enroll for voluntary blood donation following telephonic invitation, while 6.8% of them refused permanently. Approximately, 3.9% of the blood donors were willing to donate blood only when needed and 27.8% of them could not be contacted.

CONCLUSION

Creating a database of voluntary donors with known phenotype, especially who lack very common antigens like "C" and "e" and are willing to become dedicated, regular voluntary donors for thalassemic patients can ensure timely administration of safe blood. One of the major challenges for this noble initiative was lack of awareness which can be circumvent effectively with proper counseling efforts.

Menstrual blood loss is an independent determinant of hemoglobin and ferritin levels in premenopausal blood donors

INTRODUCTION

To prevent blood donors from developing iron deficiency (ferritin <15 μg/L) and subsequent anemia (hemoglobin <120 g/L), blood services rely on information about known risk factors, including the donor's sex and age. For example, while Finnish women are able to donate whole blood with a minimum donation interval of 91 days, women in the 18 to 25-year-old age group are recommended to donate no more than once per year. Menstrual blood loss is not accounted for in blood donation interval recommendations, despite being a known risk factor of iron deficiency. We aim to investigate to what extent menstrual bleeding is associated with ferritin and hemoglobin levels in female blood donors, and quantify the association of other menstruation-related variables not currently accounted for by blood services (i.e., use of hormonal contraception, heavy menstrual bleeding) with iron deficiency or anemia.

MATERIAL AND METHODS

The study population consisted of 473 premenopausal and 491 postmenopausal Dutch whole blood donors. Exclusion criteria were current pregnancy, BMI ≥50, ferritin ≥200, pictorial blood assessment chart (PBAC) ≥400, and age <18 or ≥70 years. Menstrual blood loss was quantified using a PBAC, a semiquantitative method to evaluate the number of used menstrual products and the degree of staining. We identified predictors of log(ferritin)/hemoglobin and iron deficiency/anemia using Bayesian linear and logistic regression models and quantified the average percentage of variance in log(ferritin) and hemoglobin explained by the covariates.

RESULTS

Menstrual blood loss accounted for most of the explained variance in hemoglobin (8%) and second only to the number of days since last donation for ferritin (8%). Heavy menstrual bleeding (PBAC ≥150, OR = 3.56 [1.45-8.85], prevalence 13%) was associated with anemia, and use of levonorgestrel-releasing intrauterine device was negatively associated with iron deficiency (OR = 0.06 [0.01-0.44]). After statistical control for menstrual blood loss, age was not associated with iron status.

CONCLUSIONS

Menstrual blood loss and blood donation were the most important determinants of iron status in premenopausal women. Thus, results suggest that accounting for menstrual blood loss in donation interval guidelines may benefit blood donors.

A rapid review of motives and barriers for living substance of human origin donation and an extended typology

Our objective is to review motives and barriers for non-reproductive, living substance of human origin (SoHO) donation, and to extend existing typologies beyond blood. The expansion of SoHO collection is currently unmatched by increased living donors. Thus, there is a critical need to understand how to effectively recruit and retain donors to ensure a sustainable supply of SoHO. We undertook a rapid review and narrative synthesis of published, peer-reviewed literature reporting on motives and/or barriers for living SoHO donation (whole-blood, blood products [2009-2023], bone marrow/stem cells, cord blood, organ, human breast milk, intestinal microbiota [2000-2023]). Results were interpreted through directed qualitative content analysis using an extended typology of motives/barriers largely drawn from blood donation research, and subsequently refined based on results to be inclusive of other SoHO. 234 articles with 237 studies met review criteria. Most were quantitative (74.3%), conducted in Western countries (63.8%), focused on blood donation (64.2%), reported motives and barriers (51.9%) and did not examine differences by donor characteristics or history (74%). We present a revised typology inclusive of motives/barriers for donation of substances beyond blood. This shows while broader motives and barriers are shared across substances donated, there are critical differences at the subcategory level that may account for heterogeneity in results of prior interventions. The nuances in how broad categories of motives and barriers manifest across different SoHO are critical for blood collection agencies to consider as they attempt to expand collection of products beyond whole-blood, plasma, and platelets. WHAT IS KNOWN ABOUT THE TOPIC?: Blood collection agencies (BCAs) continue to expand SoHO product collection beyond whole-blood, plasma, and platelets. The demand for SoHO is currently unmatched by increased living donors. The need to understand how to recruit new and retain existing living donors to ensure a sustainable supply of SoHO remains critical. However, there is no available synthesis of the factors, such as motives/facilitators and barriers/deterrents, to inform our understanding. WHAT IS NEW?: Comprehensively reviewed evidence for motives and barriers of willing/actual donors and nondonors across all types of non-reproductive living SoHO donation. Explored variations in motives and barriers based on substance, donor history and demographic differences (gender, age, ethnicity or culture). Extended typology of motives and barriers inclusive of all non-reproductive living SoHO, beyond solely whole-blood and blood products. Identified that while there are commonalities in the overarching motive and barrier categories across substances (e.g., prosocial motivation, low self-efficacy), within these broader constructs there are differences at the subcategory level (e.g., low-self efficacy was about eligibility, lifestyle barriers, or lack/loss of financial or material resources depending on the substance donated) that are crucial for development of future interventions and for BCAs to consider as they expand SoHO product collection. Highlighted the continued focus on motives and barriers for whole-blood and blood product donation to the exclusion of other, particularly newer, SoHO; lack of qualitative work for newer SoHO; and lack of consideration of differences based on donor characteristics (especially ethnicity/culture) and donor history, which limits our understanding. WHAT ARE THE KEY QUESTIONS FOR FUTURE WORK ON THE TOPIC?: What are the motives and barriers (in both qualitative and quantitative studies) for donation of newer SoHO such as stem cells, cord blood, human milk, and intestinal microbiota? Are there differences in motives and barriers within and across SoHO that are informed by individual and contextual-level factors? How can we develop interventions that respond to the nuances of motives and barriers present across different forms of SoHO that are effective in encouraging new and maintaining continuing donors?

Characteristics and Motivational Factors of Whole Blood and Convalescent Plasma Donors during the SARS-CoV-2 Pandemic in Israel

Demands for whole blood (WB) and COVID-19 convalescent plasma (CCP) donations during the SARS-CoV-2 (COVID-19) pandemic presented unprecedented challenges for blood services throughout the world. This study aims to understand the motivating factors that drive WB and CCP donations in the context of the pandemic. This cross-sectional study is based on data extracted from surveys of the two volunteer donor cohorts. The findings reveal that when compared to CCP donors, WB donors were more likely to view donation as a form of social engagement (97.7% vs. 87.1%, p < 0.01), advantageous in the workplace (46.4% vs. 28.6%, p < 0.01), advantageous in their social network (58.6% vs. 47.0%, p = 0.01), and view their donation in the context of positive self-satisfaction (99% vs. 95.1%, p = 0.01). The average age of CCP donors was 7.1 years younger than those who donated WB (p < 0.01). Motivational factors were also analyzed by sex and religiosity. In conclusion, whereas both donor groups showed a high motivation to partake in these life-saving commitments, WB donors were more likely to be motivated by factors that, when better-understood and implemented in policies concerning plasma donations, may help to increase these donations.

Advancing Understandings of Blood Donation Motivation and Behavior

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.

Frequency and distribution of ABO and Rh blood group systems among blood donors at the Northern Zone Blood Transfusion Center in Kilimanjaro, Tanzania: a retrospective cross-sectional study

OBJECTIVES

ABO and Rh blood group systems are the major factors affecting the blood transfusion safety. The frequency and distribution of these blood group systems vary worldwide. We aimed to determine the frequency and distribution of ABO and Rh blood group systems among first-time blood donors at the Northern Zone Blood Transfusion Center in Kilimanjaro, Tanzania.

DESIGN

Cross-sectional descriptive population-based study.

SETTING

Data on ABO and Rh blood group systems were obtained and analysed from the Northern Zone Blood Transfusion Center among first-time blood donors.

PARTICIPANTS

There were 65 535 first-time blood donors aged 15-55 years who donated at the Northern Zone Blood Transfusion Center from January 2017 to December 2019.

OUTCOME MEASURES

The percentage of ABO and Rh blood group systems among different categories of blood donors was calculated.

RESULTS

Retrospective data from Blood Establishment Computer System of 65 535 first-time blood donors were analysed in the present study. The mean age of the blood donors was 30.6±11.2 years (range: 15-55 years). The vast majority of the blood donors 84.2% (n=55 210) were men. Also, the majority 69.6% (n=45 595) were aged ≥35 years. Blood group O was the most common blood group which was found in over half 52.4% (n=34 333) of the blood donors and majority 95.3% (n=62 461) of the donors were Rh positive. Moreover, the majority 78.3% (n=51 336) were voluntary donors and the remaining 21.7% (n=14 199) were replacement donors.

CONCLUSION

Majority of the donors had blood group O and also the vast majority of the donors were Rh positive. Considering the large size of our study population, this has provided a more comprehensive information regarding the frequency and patterns of ABO and Rh blood group systems in Tanzania. The observed association of blood group A with one of the regions from which donors were coming from, is intriguing and further studies may confirm possible related genetic evolution.

Trends in unsuitability for blood donation in the Brazilian Amazon

Introduction

Sociodemographic and behavioral factors are usually associated with the unsuitability to donate blood. Understanding the reasons behind the exclusion of blood bags is crucial for reducing donor deferral rates. This study aimed to characterize the profile of unsuitable donors in the Blood Center of the northern Brazilian state of Amazonas.

Methods

This is a retrospective study, based on documentary analysis of electronic medical records obtained in the Hematology and Hemotherapy Foundation of the state of Amazonas. This study included all individuals with complete medical records (n = 87,463) who tried to donate blood between 2017 and 2019.

Results

The overall rate of donor unsuitability was 19.12% (n = 16,627) and the main reason was poor nutritional status (15.17%), followed by chronic health problems (11.40%), risky sexual behavior (9.5%) and exposure to risk (8.83%). High blood pressure figured as the leading cause of unsuitability among chronic health conditions (85.19%), while having sex with multiple partners (92.63%) was the main sexual risk behavior. The risk of exposure to malaria was responsible for 99.45% of unsuitability among those who were unsuitable due to exposure to risk factors. Deferral rates were associated with increasing age and replacement donation, which was the predominant type of donation. Women had the highest rates of unsuitability, mainly during the first donation (37.04%).

Discussion

This study provides the first known profile of blood donor unsuitability in the Brazilian Amazon and raises awareness of the region-specific needs that must be met to reduce blood donor unsuitability.

Blood donation behaviour and attitudes towards the 12-month deferral policy among gay and bisexual men in New Zealand

BACKGROUND AND OBJECTIVES

Gay and bisexual men (GBM) are deferred from donating blood in many countries. Perceptions by GBM that blood donor deferral policies are unjustifiably discriminatory, especially due to advances in HIV prevention, could contribute to non-compliance and need to be understood. We explore blood donation interest and history among GBM and attitudes towards donor deferral policies for the first time in New Zealand (NZ).

MATERIALS AND METHODS

Data from a cross-sectional online survey of GBM in NZ were examined. We constructed three groups: (1) never donated blood and not interested; (2) never donated but expressed interest; and (3) previously donated blood. We tested these for association with demographic and behavioural variables, as well as attitudes towards blood donation policy.

RESULTS

A total of 607 GBM were eligible for the study, of whom 32.9% reported having donated blood previously, 44.3% had never donated blood but expressed interest and 22.7% expressed no interest in donating. Among previous donors, a third (8.6% of the total sample) reported non-compliance with the deferral policy. Most participants found the 12-month deferral policy to be too strict (81.8%), unfair (75.4%) and homophobic (68.8%).

CONCLUSION

We estimate that, for the first time in NZ, almost 10% of the sample did not report compliance with the 12-month deferral policy for men who have sex with men (MSM). Negative attitudes towards the deferral policy were common and could potentially increase the risk to the blood supply if compliance reduces. Further work is needed to inform a deferral policy that is accepted by GBM while maintaining the safety of NZ's blood supply.

Level and correlates of empathy and altruism during the Covid-19 pandemic. Evidence from a representative survey in Germany

Aim

Our purpose was to clarify the level and correlates of empathy and altruism in the German population during the Covid-19 pandemic.

Methods

A nationally representative survey (n = 3,075) was conducted in August/September 2021. To measure empathy, a short scale based on the Interpersonality Reactivity Index (IRI; German version: Saarbrucken personality questionnaire, SPF) was used (SPF-K). Based on the International Personality Item Pool (IPIP; IPIP-5F30F-R1), the subscale altruism was used to quantify altruism.

Results

The average altruism score was 3.3 (SD: 0.7), ranging from 1 to 5. Moreover, the average empathy score was 13.1 (SD: 2.8), ranging from 4 to 20. The level of empathy significantly differed between the subgroups. For example, high levels of empathy were identified among women (average: 13.7, SD: 2.7), individuals with children (average: 13.5, SD: 2.8), and individuals with migration background (average: 13.6, SD: 2.8). Effect sizes were mostly small. Similar differences (in terms of effect size) were identified between these groups regarding altruism. Additionally, regressions showed that higher levels of both empathy and altruism were associated with being female, younger age, having children, sports activities and having at least one chronic disease. Moreover, vaccination against Covid-19 was only associated with higher altruism, but not with higher empathy.

Conclusion

Our study emphasized the moderately high level of empathy and altruism in Germany during times of the pandemic. Identifying the correlates of these factors may help to address individuals with very low levels of these factors.

Impact of disasters on blood donation rates and blood safety: A systematic review and meta-analysis

Background and Objectives

Timely and adequate access to safe blood forms an integral part of universal health coverage, but it may be compromised by natural or man‐made disasters. This systematic review provides an overview of the best available scientific evidence on the impact of disasters on blood donation rates and safety outcomes.

Materials and Methods

Five databases (The Cochrane Library, MEDLINE, Embase, Web of Science and CINAHL) were searched until 27 March 2020 for (un)controlled studies investigating the impact of disasters on blood donation rates and/or safety. Risk of bias and overall certainty of the evidence were assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach.

Results

Eighteen observational studies were identified, providing very low certainty of evidence (due to high risk of bias, inconsistency and/or imprecision) on the impact of natural (12 studies) and man‐made/technological (6 studies) disasters. The available evidence did not enable us to form any generalizable conclusions on the impact on blood donation rates. Meta‐analyses could not detect any statistically significant changes in transfusion‐transmissible infection (TTI) rates [hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV)‐1/2, human T‐lymphotropic virus I and II (HTLV‐I/II) and syphilis] in donated blood after a disaster, either in first‐time or repeat donors, although the evidence is very uncertain.

Conclusion

The very low certainty of evidence synthetized in this systematic review indicates that it is very uncertain whether there is an association between disaster occurrence and changes in TTI rates in donated blood. The currently available evidence did not allow us to draw generalizable conclusions on the impact of disasters on blood donation rates.

Awareness, Motivation, and Fear towards Canine Blood Donation-A Survey of Dog Owners in Lithuania

Simple Summary

Canine blood transfusions and blood donations are integral to veterinary medicine. Currently, the supply of canine blood products is not meeting the demand, and veterinarians find it difficult to recruit blood donors, especially when animal welfare is a priority. The general aim of our study was to determine how to improve the effectiveness of canine blood donor recruitment. To do this, we conducted a survey to identify the level of dog owners’ awareness about canine blood donation and to help us understand what would motivate people to become a part of the donation process as well as what people are afraid of. The results of our study suggest that donor recruitment could be increased by dispelling the myths about possible complications and by improving communication between veterinary doctors and dog owners, as the awareness of canine blood donation is poor. In conclusion, recruitment strategies should focus on the management of fear regarding canine blood donation, as well as animal welfare and the education of clients, as motivational strategies come second.

Abstract

The recruitment of canine blood donors remains a challenge, especially in countries where blood donation and veterinary medicine are still emerging medical fields. There are few previous studies that have discussed canine blood donation strategies, and the subject of fear and its influencing factors have not been investigated. The main purpose of our study was to investigate dog owners’ awareness, motivation, and fear regarding canine blood donation in order to improve donor recruitment strategies. We created a six-page questionnaire and submitted it to dog owners (n = 207) in person. Two-thirds of the respondents (65.7%) were not aware that canine blood donation exists in Lithuania. We did not find any factors that would significantly affect the motivation of respondents toward donation. We found an association between the fear of the owner and the health status of the owned dog (p = 0.008), as well as if their animal had needed urgent care in the past (p = 0.031). The fact that some participants were blood donors themselves did not affect their motivation, but they were 19.76% less afraid of canine blood donation (p = 0.001), as were respondents who were aware of canine blood donation (p = 0.004). In conclusion, the recruitment strategy should focus on the management of fear toward canine blood donation and the education of clients, and donor welfare must remain a priority.

Male partners' participation in birth preparedness and complication readiness in low- and middle-income countries: a systematic review and meta-analysis

BACKGROUND

Maternal and neonatal health outcomes remain a challenge in low- and middle-income countries (LMICs) despite priority given to involving male partners in birth preparedness and complication readiness (BPCR). Men in LMICs often determine women's access to and affordability of health services. This systematic review and meta-analysis determined the pooled magnitude of male partner's participation in birth preparedness and complication readiness in LMICs.

METHODS

Literature published in English language from 2004 to 2019 was retrieved from Google Scholar, PubMed, CINAHL, Scopus, and EMBASE databases. The Joanna Briggs Institute's critical appraisal tool for prevalence and incidence studies were used. A pooled statistical meta-analysis was conducted using STATA Version 14.0. The heterogeneity and publication bias were assessed using the I2 statistics and Egger's test. Duval and Tweedie's nonparametric trim and fill analysis using the random-effect analysis was carried out to validate publication bias and heterogeneity. The random effect model was used to estimate the summary prevalence and the corresponding 95% confidence interval (CI) of birth preparedness and complication readiness. The review protocol has been registered in PROSPERO number CRD42019140752. The PRISMA flow chart was used to show the number of articles identified, included, and excluded with justifications described.

RESULTS

Thirty-seven studies with a total of 17, 148 participants were included. The pooled results showed that 42.4% of male partners participated in BPCR. Among the study participants, 54% reported having saved money for delivery, whereas 44% identified skilled birth attendants. 45.8% of male partners arranged transportation and 57.2% of study participants identified health facility as a place of birth. Only 16.1% of the male partners identified potential blood donors.

CONCLUSIONS

A low proportion of male partners were identified to have participated in BPCR in LMICs. This calls countries in low- and middle-income setting for action to review their health care policies, to remove the barriers and promote facilitators to male partner's involvement in BPCR. Health systems in LMICs must design and innovate scalable strategies to improve male partner's arrangements for a potential blood donor and transportation for complications that could arise during delivery or postpartum haemorrhage.

Repeat donation and deferral rates in US source plasma donors: Exploratory analysis from the IMPACT trial

Background

The IMPACT trial demonstrated the safety of a new personalized nomogram for plasma donation and provided an opportunity to explore short‐ to mid‐term impact on repeat donation and deferral rates, and factors affecting these.

Study Design and Methods

In the IMPACT trial, participants were randomized to donate plasma using an established weight‐based nomogram (control) versus a new personalized nomogram incorporating height, weight, and hematocrit (experimental). In this exploratory analysis, repeat donations (per donor, by study arm) were analyzed using negative binomial generalized linear regression models and descriptive statistics. The mean number of donor deferral events was compared between the two arms using logistic regression and count data modeling approaches and were analyzed by lead cause.

Results

The predicted mean number of repeat donations was similar between the control and experimental arms (6.82 vs. 6.62, respectively; p = .22). Overall, the predicted mean number of repeat donations was significantly higher in males compared with females (p < .0001). Naïve donors had on average 2.8/2.7 (control/experimental) fewer repeat donations compared with experienced donors. In 23, 137 donations from 3443 donors, 798 donors (376 control, 422 experimental, p = .80) had at least one deferral (for any cause). The predicted mean number of deferrals in all categories of interest was not statistically different between the study arms.

Conclusion

Similar repeat donation and deferral rates between arms suggest that the new nomogram did not result in disruptions to subsequent donation. Further longitudinal research on mid‐ to long‐term effects is warranted.

A branded bandage is worth a thousand words: blood branded bandages signal men's generosity and morality

BACKGROUND AND OBJECTIVE

Recruiting and retaining male donors remain an ongoing challenge for blood collection agencies. Research suggests that interventions based on costly signalling theory that allows donors to unobtrusively but publicly signal their donor status may be effective. However, what functions as such a signal and how it is interpreted has not been determined.

MATERIALS AND METHODS

A total of 242 Australian residents (127 female; 115 male) recruited through an online research platform rated their perceptions of a male target wearing (a) no bandage, (b) a regular unmarked bandage or (c) a blood donor branded bandage.

RESULTS

The target wearing a blood donor branded bandage was rated as significantly more generous by female participants and moral compared to both the target who wore no bandage and the target wearing a regular unmarked bandage. The target wearing the unmarked bandage was perceived as significantly less healthy and competent compared to the target not wearing a bandage.

CONCLUSION

A public signal of public donor status conveys the generosity and morality of the wearer. The bandage applied to donors after they have donated can act as such an effective signal, but only when these bandages are clearly branded as resulting from donating blood.

Are different motivations and social capital score associated with return behaviour among Brazilian voluntary non-remunerated blood donors?

BACKGROUND

We examined the association between social capital score, motivator factors and demographic and donation characteristics and donor return at three Brazilian blood centres in Recife, São Paulo and Belo Horizonte.

MATERIAL AND METHODS

A total of 5974 donors were interviewed about motivation factors to donate and cognitive and structural social capital just before an effective donation in three Brazilians blood centres in 2009. We assessed the return to a new donation within 2 years for each of these donors. Demographic and donation characteristics, motivators and scores of social capital and their association with donors' return were assessed.

RESULTS

Overall, 3123 (52.3%) of the study subjects returned for a blood donation at least once. Predictors of donors' return were male gender (adjusted odds ratio [AOR] = 1.6, 1.3-1.9, for replacement and AOR = 1.3, 1.2-1.6, for community donors), previous donation (AOR = 2.7, 2.3-3.3, for replacement and AOR = 2.9, 2.5-3.5, for community donors) and high altruism (AOR = 1.3, 1.1-1.7, for replacement and AOR = 1.2, 1.0-1.5, for community donors). Altruism was the only motivator associated with return behaviour. Donors from Recife and São Paulo were more likely to return for replacement and/or for community donations than donors from Belo Horizonte. There was no association between social capital score and donor return behaviour.

CONCLUSION

The likelihood to return for a subsequent blood donation is dependent upon characteristics of individual donors and also varies in different regions of Brazil. However, social capital was not associated with the likelihood of return behaviour. A better understanding of altruistic categories and appeals may help to improve donor recruitment and retention.

Attitudes and willingness to donate blood among gay and bisexual men in Australia

BACKGROUND

Men who have sex with men in Australia are currently ineligible to donate blood (are "deferred") for 12 months since last oral or anal sexual contact with another man. In Australia and overseas, there has been limited research on attitudes and perceptions related to blood donation in this population.

STUDY DESIGN AND METHODS

Questions on blood donation histories and attitudes toward the deferral policy were included in the questionnaire of an online prospective cohort of gay and bisexual men (GBM) living in Australia.

RESULTS

In 2018, 1595 GBM responded to the survey. In this sample, 28.7% reported previously donating blood. Among the remaining men who had never donated blood, 64.5% expressed an interest in doing so. Nearly all men indicated they were not willing to abstain from sex with another man for 12 months in order to donate, and the vast majority believed the rule was unfair, too strict, and homophobic. Three-quarters (77.7%) said that if the policy changed, they would likely donate blood. Age and openness about one's sexuality were independently associated with one's willingness to donate blood in the absence of the deferral.

CONCLUSION

There was a high level of willingness and desire to donate blood among GBM. However, rather than abstaining from sex in order to donate, many men comply with the deferral policy and do not donate. A less conservative deferral policy may increase donations from GBM.

Knowledge level and motivation of Hong Kong young adults towards blood donation: a cross-sectional survey

OBJECTIVES

This study aimed to (1) determine the knowledge level of young adults towards blood donation, and (2) to understand their donor identity and the meanings of blood donation to them.

DESIGN

A questionnaire-based cross-sectional survey.

SETTING AND PARTICIPANTS

Undergraduate students of a university in Hong Kong recruited by convenience sampling, at public facilities in campus such as student canteens and the Campus Blood Donor Centre of the university.

OUTCOME MEASURES

The questionnaire which consisted of three parts was used for data collection. Part 1 collected sociodemographic information and items associated with blood donation; part 2 related to knowledge on blood donation and part 3 focused on blood donor identity. Univariate and multivariate logistic regression analyses were conducted to determine the OR and identify the predictors for blood donation.

RESULTS

Among the 542 respondents, 274 were non-blood donors and 268 were blood donors. Blood donors generally have a better knowledge towards blood donation than non-blood donors. The results of univariate analyses indicated that being a female (OR=1.99, p<0.001), aged 22 years or above (OR=234, p<0.001), studying at year 4 or 5 (OR=2.12, p=0.003), studying health-related programmes (OR=1.96, p<0.001), being registered as an organ donor (OR=6.59, p<0.001), had prior experience of receiving blood (OR=7.60, p<0.001) or prior experience of being refused for blood donation (OR=5.14, p<0.001) were significantly associated with being a blood donor. Having prior experience of receiving blood was the strongest predictor for being a blood donor, followed by being registered as an organ donor, after controlling for all other factors in the logistic regression model.

CONCLUSIONS

The findings are consistent with self-determination theory, which hypothesises that people are more likely to abide with blood donation behaviours that are internally rather than externally motivated.

A descriptive phenomenological analysis of the experience of blood donation as a regular donor

Maintaining adequate blood supplies requires the recruitment of a significant number of regular donors. However, research examining the first-hand experience of blood donation from the perspective of regular donors is very limited. This study sought to describe the essential features of this experience from the accounts of 10 regular donors, analysed using Colaizzi's descriptive phenomenological method. Eight essential themes contributed to the fundamental structure of the experience, emphasising issues of blood donor identity, comfortable routine, feeling good helping others and human connectedness and interaction in the donation process. Implications for future research and practice are discussed.

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.

Altruistic decisions are influenced by the allocation of monetary incentives in a pain-sharing game

Background

Altruistic behavior is essential to the sustainability of society, but our current understanding of its underlying motivation is limited. In addition to the intrinsic motives to help others, based on empathy, extrinsic motives such as monetary incentives and social reputation influence prosociality. The purpose of this study was to examine the underlying motivations of prosocial behavior under constant or increasing extrinsic motivation settings.

Methods

An experimental task, Altruistic Pain Sharing, was developed in which the participants were asked to share the other participants’ pain. In the session with monetary incentives, the incentives were given either constantly (CONSTANT condition) or proportionally (INCREASING condition), to the amount of shared pain. In addition, monetary incentives were not provided in the NO session. The participants experienced different amounts of mechanical pain at the beginning of the task and chose the number of pain stimulations to share, based on their experiences.

Results

Compared to the NO session, the INCREASING session exhibited a rise in the mean of shared pain, but not the CONSTANT session. Furthermore, there was a distinct tendency to receive less pain than the other participant in the CONSTANT session, and a tendency to receive more pain than the other participant in the INCREASING session.

Conclusion

Prosocial behavior was influenced by the presence, as well as the form, of the extrinsic monetary incentives. Our study shows that rewards incentivize individuals to demonstrate a higher level of prosocial behavior, implying that prosocial behavior is itself a mixture of intrinsic and extrinsic motivations, and that an effectively designed rewards system may function to enhance prosocial behavior.