Blood donation motivators and barriers reported by young, first-time whole blood donors: Examining the association of reported motivators and barriers with subsequent donation behavior and potential sex, race, and ethnic group differences.

BACKGROUND: A greater understanding of young, first-time donor motivators and barriers is needed to address the ongoing challenge of retaining these essential donors. STUDY DESIGN AND METHODS: Structured interviews conducted with 508 young, first-time whole blood donors [66.1% female; Mean Age = 19.4 (SD = 2.5) years] were coded to identify reported motivators and barriers. Reported motivators and barriers were then examined for their association with attempted donation behavior over a 14-month follow-up, and for potential sex, race, and ethnic group differences in the frequency of endorsement. RESULTS: Prosocial motivation (e.g., altruism) was the most commonly reported motivator and fear (e.g., fainting, needles) was the most commonly reported barrier. Donation behavior was unrelated to reported motivators, but was significantly related to four reported barriers including fear of fainting/dizziness, fear of needles/pain, having personal commitments that conflict with donating, and perceiving oneself as unsuited to donate for health reasons. Sex, racial, and ethnic differences were noted with respect to the percentages of donors reporting several donation-related motivators and barriers. CONCLUSION: The present findings identify donation-related barriers that could be important targets to address in the effort to encourage new young donors and to retain these new donors for the long term. Importantly, these data also highlight the importance of considering individual differences in donor motivation as a function of sex, race, and ethnicity.

What would it take to convince you to donate? A survey study of the relationship between motivators, barriers, and payment for whole blood, plasma, and platelet donation.

BACKGROUND: With growing discussion about blood donor remuneration, the present study examined the level of payment that may be required to convince individuals to engage in whole blood, plasma, and platelet donations. STUDY DESIGN AND METHODS: Anonymous online surveys were completed by a college sample [n = 490; 76.9% female; Mean Age = 20.3 (SD = 4.9) years; 32.9% whole blood donors] and a ResearchMatch sample [n = 323; 70.6% female; Mean Age = 50.7 (SD = 16.6) years; 82.7% whole blood donors]. Level of payment needed to motivate whole blood, plasma, and platelet donation was examined as a function of donation history, sample, and gender. In addition, path analyses examined associations between donation motivators, barriers, and payment level. RESULTS: Across all types of donation, history of whole blood donation was related to a greater willingness to donate without payment. At the same time, however, sizeable portions of prior donors indicated that monetary payment would convince them to donate whole blood (24%), plasma (51%), or platelets (57%). Across all types of donation, donation-related barriers (i.e., anxiety, fear) were indirectly related to higher payment levels via lower self-efficacy and more negative donation attitudes. Donation-related motivators (i.e., warm glow, regret, and altruism) were indirectly related to lower payment levels via higher self-efficacy and more positive donation attitudes. CONCLUSION: Despite reporting a strong commitment to nonremunerated blood donation, many respondents with and without a history of blood donation indicated that money would convince them to engage in whole blood, plasma, and platelet donation.

Assessing motivations for non-living and living organ donation among individuals with and without a history of blood donation.

OBJECTIVES: The current study investigated relationships between a history of blood donation, registration as a non-living and living organ donor, and differential motivations. BACKGROUND: Motivational commonalities exist between blood and organ donors, but there is no prior data on the relationships between blood donation history and both living and non-living organ donor registration and motivation. METHODS/MATERIALS: Participants completed online surveys assessing blood donation history, organ donor registration and interest, and motivations related to donation behaviour. RESULTS: Blood donation history was not significantly related to registration as either a non-living organ donor (blood donors = 81.4%; non-blood donors = 76.4%) or as a living organ donor (blood donors = 14.0%; non-blood donors = 10.9%). Further, blood donation history was not related to interest in learning more about being an organ donor. Compared to those not registered as an organ donor, those who were registered reported more positive organ donation motivations, but these relationships were unrelated to prior blood donation history. CONCLUSION: The present findings are consistent with existing research on attitudes, warm glow, and identity as organ donation motivators, and provide novel information regarding the importance of independent assessment of motivations for non-living and living organ donation.

Promoting awareness of donation-related iron depletion among high risk blood donors.

BACKGROUND: The potential for iron deficiency is a known blood donor health concern and suggests the need to inform donors about the potential risks of low iron levels as well as strategies to address these risks. STUDY DESIGN AND METHODS: Frequent (n = 904) and young (n = 629) donors were randomly assigned within risk group to either a control (n = 548) or an intervention (n = 985) group. The control group answered questions at baseline and 6-month follow-up regarding their awareness of the risk of donation-related iron depletion and whether they were taking actions to address their iron status. The intervention group answered the same questions at baseline and follow-up, but after completing the baseline survey, they received information regarding their risk of iron depletion and behaviors they could adopt to mitigate this risk. Intervention group participants were also offered the opportunity to develop an action plan to help them supplement their iron intake. RESULTS: The intervention enhanced overall awareness of donation-related iron loss (OR = 1.5, 95% CI 1.171-1.864, p = .001), with no negative impact on retention. Reported iron health behaviors (iron supplementation, speaking with a doctor) showed significant increases when action planning was paired with the educational information. CONCLUSION: These findings suggest that it is possible to increase awareness of donation-related risk for iron depletion without negatively influencing retention, and combining education with encouragement to develop an action plan may increase the likelihood of both retention and behavioral changes to promote healthy iron levels.

Fear is associated with attrition of first-time whole blood donors: A longitudinal examination of donor confidence and attitude as potential mediators.

BACKGROUND: Elevated fear and anxiety regarding donation-related stimuli (e.g., needles, pain, blood, fainting) has been associated with reduced blood donor recruitment and retention. The present longitudinal study tests the notion that this inverse relationship may be accounted for by lower donation confidence and more negative donation attitudes among fearful first-time donors. STUDY DESIGN AND METHODS: In a sample of 1479 first-time whole blood donors [67.9% female; mean age = 19.3 (standard deviation (SD) = 2.5) years], path analyses were conducted to examine relationships among donor ratings of fear of blood draw and donation anxiety obtained approximately 1 week after donation, donation confidence and attitudes assessed approximately 6 weeks later, and donation attempts over the 14 months following the original donation. RESULTS: Path analyses indicated that both fear of blood draws and donation anxiety were associated with fewer attempted donations, and that these effects were indirectly mediated by a combination of lower donor confidence and more negative donation attitudes. CONCLUSION: Because retention of new blood donors is essential to maintain a healthy blood supply, the results of the present study suggest that first-time donors should be assessed for fear and anxiety so that appropriate strategies can be provided to address their concerns, bolster their confidence and attitudes, and ultimately promote their long-term retention.

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.

Pain resilience, pain catastrophizing, and executive functioning: performance on a short-term memory task during simultaneous ischemic pain.

Among pain researchers there is a growing interest in the relationship between psychological resilience and pain experience. Whereas much of this work has focused on individual differences in pain perception or sensitivity, an equally important dimension of resilience is the capacity to persist with goal-directed activity despite experiencing pain. Consistent with this latter focus, the current study examined how pain resilience and pain catastrophizing combine to moderate the effects of ischemic pain on short-term memory task performance. Using a within-subjects design, 121 healthy participants completed four trials of a Corsi block-tapping task with pain exposure during the second and fourth trials. Results indicated that a combination of high pain resilience and low pain catastrophizing was associated with better task performance during the second pain exposure. These findings confirm existing evidence that resilience can moderate performance during pain, and offer new evidence that resilience and catastrophizing interact to shape this effect.

Donation related fears predict vasovagal reactions and donor attrition among high school donors.

BACKGROUND: This longitudinal study of high school whole blood donors examined relationships among donation-related fears assessed prior to donation, vasovagal reactions to donation, and the proportion of donors who attempted another donation over the subsequent 60 weeks. STUDY DESIGN AND METHODS: Data regarding vasovagal reactions and attempted donation were obtained from donor records of 530 female and 342 male high school donors who answered questions about five types of fear (ie, of blood draw, needles, seeing blood, feeling pain, or fainting) prior to their index donation. RESULTS: Each type of fear was associated with an increased risk of vasovagal reactions (all P < .001) and a smaller percentage of attempted donations was seen among those who reported at least one type of fear (53%) as compared to those who did not report any fear (62.1%); P = .022; ß = -0.374, OR = 0.69; 95% CI, 0.50-0.94. Path analyses of the relationships among fear, vasovagal reaction, and attempted donation revealed significant indirect effects for each type of fear. Specifically, donors who reported fear were at increased odds of experiencing a vasovagal reaction, which, in turn, was associated with decreased odds of attempting a repeat donation. CONCLUSION: Donation-related fears are associated with reduced donor return rates, and this effect is mediated through an increased risk for vasovagal reactions. For both practical and ethical reasons, blood collectors are encouraged to identify and intervene with fearful donors to reduce the likelihood of negative donation-related symptoms and enhance donor retention.

Examination of the relationship between iron status and cognitive function among healthy young women with and without a recent history of blood donation.

BACKGROUND: With growing awareness of the prevalence of nonanemic iron deficiency among blood donors, there is a need to explore the extent of potential negative consequences. This study examined the relationship between various measures of iron status, blood donation history, and neuropsychological and psychosocial functioning in healthy young women. STUDY DESIGN AND METHODS: Using a cross-sectional design, 160 female undergraduates completed neuropsychology tests and measures of sleep, fatigue, quality of life, and depression before providing a blood sample. Correlational analyses examined the relationship between iron status (ferritin, iron, hemoglobin, and zinc protoporphyrin) and cognitive and psychosocial functioning. Performance on these measures was also examined as a function of recent blood donation history (zero, one, more than one donation in the past year). RESULTS: Iron status (low ferritin, iron, or hemoglobin or high zinc protoporphyrin) was not associated with poorer performance on the cognitive tasks. Further, participants who reported donating once in the previous year performed better, rather than worse, than those with no recent donation history on several measures of executive function, even when controlling for ferritin levels. Although there was some evidence of greater fatigue among those who had donated more than once in the past year, this effect was not accounted for by ferritin levels. CONCLUSION: The present findings are consistent with prior evidence that nonanemic iron deficiency is not associated with cognitive impairment or psychosocial dysfunction in healthy young females. Because these results are based on cross-sectional evidence, further study using longitudinal research is needed to confirm these findings.

Emotional mechanisms and format effects of motivational questions for blood donation.

Prior studies suggest that responding to online motivational questions increases blood donation intention. The present studies were designed to extend these findings by (a) exploring the impact of methodologic variations in the content and order of administration of specific questions on donation intention and (b) examining anticipated positive and negative emotional reactions as potential mediators. STUDY DESIGN AND METHODS: In the first study, 4709 respondents (51.2% female; mean ± SD age, 38.4 ± 12.1 years) were randomly assigned to one of four motivational questions or a no-question control. In the second study, 5291 respondents (52.7% female; mean ± SD age, 37.3 ± 11.9 years) were randomly assigned to one of six motivational questions or a no-question control. In both studies, the motivational questions were followed by measures of donation intention, anticipated warm glow, and anticipated regret. RESULTS: In Study 1, three of the four questions were associated with higher donation intentions, with anticipated warm glow being a potential partial mediator for two of the questions. In Study 2, five of the six questions were associated with higher donation intentions, with anticipated warm glow and anticipated regret being potential partial mediators for three of the questions. These effects were largely consistent among donors and nondonors. CONCLUSION: These studies expand our understanding of the association between particular motivational questions and donation intentions and provide preliminary support for the notion that specific questions may influence donation intention by increasing anticipated positive and negative emotional reactions to the thought of giving or not giving, respectively.

Preference for whole blood versus plasma donation among university students.

BACKGROUND AND OBJECTIVES: Debate continues about whether monetary payments encourage or discourage self-motivated behaviour such as blood donation. With the growing number of paid plasma donation centres in the United States, and the ongoing challenge to recruit and retain volunteer blood donors, a better understanding of the impact of compensation on donation preferences is essential. MATERIAL AND METHODS: A sample of 459 undergraduate students (73·9% female, mean age =18·9, SD = 1·3 years) completed an anonymous online survey that included a question about their preference for donating blood, donating plasma or neither. Preferences were re-assessed after providing information regarding current differential compensation for blood and plasma donations, and in the context of a hypothetical scenario where both blood and plasma donors could receive payment. RESULTS: Participants initially expressed a clear preference for donating blood (73·7%) relative to plasma (3·9%), but these preferences shifted in favour of plasma donation (47·7%) versus blood donation (39·4%) after learning that plasma donors can be paid. However, when asked to consider a hypothetical future wherein payment was offered for either type of donation, participants again reported a strong preference for donating blood (79·3%) relative to plasma (6·3%). These preferences did not differ as a function of sex or donation history. CONCLUSION: These results suggest that a significant proportion of young adults are positively motivated to donate blood or blood products by the opportunity for payment.

A randomized controlled trial of a tablet-based intervention to address predonation fears among high school donors.

BACKGROUND: Prior studies have shown donation-related fear to be associated with decreased donor confidence and an increased risk for vasovagal reactions. This study examined the effects of a predonation intervention that provided fearful donors with suggestions for coping. STUDY DESIGN AND METHODS: Using a tablet-based application, high school donors (49.4% female) answered a question regarding their fear of having blood drawn. Those who reported fear were randomly assigned to either a control (n = 930) or an intervention (n = 911) group. Donors in the control group rated their confidence in dealing with their fear and then donated as usual. Donors in the intervention group received a brief audiovisual presentation on coping strategies, rated their confidence, and then donated as usual. RESULTS: A higher proportion of fearful versus nonfearful donors experienced a vasovagal reaction, even after controlling for other demographic and health predictors (OR, 2.3; 95% CI, 1.655-3.185, p < 0.001). Fearful donors who received the intervention reported greater confidence than controls, but the proportion of vasovagal reactions did not differ significantly between the intervention (6.1%) and control (6.8%) groups. CONCLUSION: Although the current tablet-based intervention may have some psychological benefit in that it was associated with greater donor confidence, the observed effect was small and did not translate into a lower risk for vasovagal reactions. However, greater confidence among young donors may lead to an increased willingness to donate again-a potential outcome that we will revisit among these donors as part of a planned 2-year follow-up.

Predonation fears identify young donors at risk for vasovagal reactions.

BACKGROUND: Extending existing research on the relationship between predonation fear of having blood drawn and risk for vasovagal reactions among young donors, this study assessed the predictive power of specific donation-related fears. STUDY DESIGN AND METHODS: After the health screening, high school whole blood donors (59.5% female) were randomly assigned into one of three groups. Group 1 (n = 881) answered a control question about their prior night's sleep. Group 2 (n = 911) answered the sleep question and a question about fear of having blood drawn. Group 3 (n = 924) answered the sleep question, the fear of having blood drawn question, and four questions about specific donation-related fears (seeing blood, needles, pain, and fainting). RESULTS: The proportion of vasovagal reactions did not differ significantly among the groups, indicating that asking one or more fear questions before donation did not promote reactions. Fearful donors were more likely to have a vasovagal reaction, even after controlling for other important demographic and health predictors, with odds ratios ranging from 2.17 (95% confidence interval [CI], 1.44-3.27) for fear of fainting to 3.50 (95% CI, 2.34-5.23) for fear of seeing blood. Hours of sleep was not significantly related to vasovagal reaction risk. CONCLUSION: Predonation fear identifies donors who are more likely to experience a vasovagal reaction and does so without increasing the risk of such reactions. Accordingly, fear should be assessed during screening to identify those who could benefit from instruction in anxiety management and who might require greater attention to help prevent donor injury.

An automated motivational interview promotes donation intention and self-efficacy among experienced whole blood donors.

BACKGROUND: Interventions intended to motivate donors to return can be costly and time consuming. The current study examined the effect of a Web-based automated interview, informed by motivational interviewing and self-determination theory, on donor intention, motivation, and behavior in a sample of highly experienced donors. STUDY DESIGN AND METHODS: Approximately 1 week after donating, 1177 highly experienced whole blood donors (mean prior donations, 35.5; mean age, 46.9 years; 66.3% female) participated in a study in which they were randomly assigned to either a donor motivational interview (n = 544) or knowledge interview (n = 633). Measures of donor motivation and psychological need support were obtained before the interviews, and again at postinterview assessments conducted approximately 2 days later and 7 weeks later. Blood center records were used to assess repeat donation attempts for 1 year after the interviews. RESULTS: Relative to the knowledge interview, participants in the motivational interview had larger increases in donation intention and self-efficacy from preinterview to the first follow-up. Among women only, the motivational interview was associated with greater competence and relatedness increases at both follow-up assessments. CONCLUSION: An automated motivational interview appears to be a feasible way to promote donation intention and self-efficacy. Although the observed effects were small among highly experienced donors, we are currently assessing the potential effect of this intervention among less experienced donors.

Estimating the risk of blood donation fainting for self versus others: the moderating effect of fear.

BACKGROUND: People overestimate the likelihood that blood donors will experience faint and prefaint reactions, particularly if they are themselves fearful of having blood drawn. This study investigated the influence of making a risk assessment for oneself versus others, and examined whether providing information about the low base rates of reactions affected donation attitude, anxiety, and intention. STUDY DESIGN AND METHODS: An anonymous online survey was completed by 3702 individuals (53.9% female; mean age, 36.9 years; standard deviation, 12.1 years; range, 18-84) that included questions about fear of having blood drawn and estimation of the risk of donation-related faint and prefaint symptoms for themselves and others. A random one-half of the respondents received accurate information about the proportion of whole blood donors who experience such reactions before all participants completed questions concerning their donation attitude, anxiety, and intention. RESULTS: Estimates of both faint and prefaint reactions revealed a pattern of lower perceived risk for self versus others among individuals with low fear, and higher perceived risk for self versus others among those with high fear. Provision of accurate information about risk of reactions was associated with more positive donation attitudes (F[1, 3692] = 8.182, p = 0.004) and intentions (F[1, 3692] = 10.137, p = 0.001) but did not significantly affect anxiety. CONCLUSION: Donation-related fear is associated with inflated expectancies of adverse events, especially regarding oneself. Such fear may be particularly important to address, as it has both a direct and indirect negative effect on donor retention.

Online responses to motivational interview questions enhance blood donation intention.

BACKGROUND: A motivational interview may promote blood donor retention, but live interviews can be costly. To address this challenge, we conducted two studies to examine the impact of online delivery of motivational interview content on donation intention. STUDY DESIGN AND METHODS: In Study 1, a total of 3883 respondents (52.2% female; mean ± SD age, 35.69 ± 11.3 years) completed a donation commitment measure and were randomly assigned to one of seven motivational interview-based questions or a no-question control group. In Study 2, a total of 2246 respondents (58.4% female; mean ± SD age, 35.5 ± 11.4 years) with a moderate level of donation commitment were randomly assigned to receive zero to four motivational interview-based questions. In both studies, future donation intention was measured immediately after the intervention. RESULTS: The first study revealed a significant effect of interview question on donation intention among participants with moderate blood donation commitment (F(7,1299) = 3.699, p = 0.001), but not among those with low or high commitment (F(7,1233) = 1.411, p = 0.20; and F(7,1327) = 0.964, p = 0.46, respectively). Study 2 replicated the significant effect of interview questions on donation intention (F(1,2230) = 2.168, p = 0.006). Relative to the no-question control condition, follow-up analyses revealed significantly higher donation intentions with 14 of the 15 question combinations (p ≤ 0.05). CONCLUSION: These findings provide initial support that online survey questions modeled on motivational interview content may elicit personal reflections that enhance donation intention, particularly among individuals with a moderate level of donation commitment.

Fear of blood draw is associated with inflated expectations of faint and prefaint reactions to blood donation.

BACKGROUND: Although the risk of fainting and prefaint reactions (e.g., dizziness, lightheadedness) is low during blood donation, there is evidence that this risk remains a concern for many donors. This study sought to measure perceived risk for such reactions within the general population and to relate perceived risk to individual reports of fear of having blood drawn. STUDY DESIGN AND METHODS: A sample of 1019 men and women (52.2% male; mean ± SD age, 37.2 ± 12.3 years; range, 18-80 years) completed an anonymous online survey that included questions that asked about their 1) estimation of the frequency of faint and prefaint symptoms experienced by blood donors and 2) fear of having blood drawn. RESULTS: Survey respondents overestimated the risk of both faint and prefaint reactions to blood donation, with estimates of fainting risk being more than 20 times the actual risk. Further, the perceived risk of both faint reactions (F(4,1008) = 25.88, p < 0.001) and prefaint reactions (F(4,1008) = 17.37, p < 0.001) was higher among those who reported greater fear of having blood drawn. CONCLUSION: The general public has inflated expectations of the risk for faint and prefaint reactions to blood donation, suggesting that efforts to educate prospective donors with accurate information may help to reduce this relatively common concern.

The Development of a Social Networking-Based Relatedness Intervention Among Young, First-Time Blood Donors: Pilot Study.

BACKGROUND: Increasing repeat blood donation behavior is a critical public health goal. According to self-determination theory, the process of developing internal motivation to give blood and an associated self-identity as a blood donor may be promoted by feelings of "relatedness" or a connection to other donors, which may be enhanced through social relations and interactions. OBJECTIVE: The purpose of this report it to describe the development and pilot testing of a social networking-based (Facebook) intervention condition designed to increase feelings of relatedness via virtual social interaction and support. METHODS: To develop the intervention condition content, images, text, polls, and video content were assembled. Ohio University college students (N=127) rated the content (82 images/text) presented by computer in random order using a scale of one to five on various dimensions of relatedness. Mean ratings were calculated and analyses of variance were conducted to assess associations among the dimensions. Based on these results, the relatedness intervention was adapted and evaluated for feasibility, acceptability, and preliminary efficacy among 24 first-time donors, aged 18 to 24 years, in a 30-day pilot trial. Paired t-tests were conducted to examine change over time in relatedness and connectedness. RESULTS: The intervention condition that was developed was acceptable and feasible. Results of the uncontrolled, preintervention, and postintervention evaluation revealed that feelings of individual-level relatedness increased significantly after the intervention. CONCLUSIONS: By promoting first-time blood donor relatedness, our goal is to enhance internal motivation for donating and the integration of the blood donor identity, thus increasing the likelihood of future repeat donation. TRIAL REGISTRATION: ClinicalTrials.gov NCT02717338; https://clinicaltrials.gov/ct2/show/NCT02717338 (Archived by WebCite at http://www.webcitation.org/6ymHRBCwu)

Fear of donation-related stimuli is reported across different levels of donation experience.

BACKGROUND: This study aimed to characterize the extent of donation-related fears among donors with different levels of donation experience. STUDY DESIGN AND METHODS: A sample of 1054 recent donors (48.3% female; mean ± SD age 33.1 ± 9.8 years) completed an anonymous, online survey of their fear of donation-related stimuli, including blood, needles, pain, and fainting. Respondents also provided information regarding demographics, pain, and vasovagal symptoms associated with their recent donation and confidence and intention with respect to a future donation. RESULTS: The sample was divided into four donation history subgroups, including one, two or three, four or five, or six or more prior donations. A significant negative relationship was observed between donation history and each of the assessed fears, indicating less fear with more experience. However, at least one-third of even the most experienced donors reported some fear for each of the stimuli. Further, greater fear was associated with more pain (r = 0.35-0.56, all p < 0.001) and more intense vasovagal symptom reports (r = 0.41-0.61, all p < 0.001). Finally, greater fear was associated with less donor confidence (r = -0.24 to -0.33, all p < 0.001) and lower intentions of donating again (r = -0.14 to -0.20, all p < 0.001). CONCLUSION: These data provide novel evidence that fear persists for many donors, despite increasing experience, and suggest that a greater appreciation of individual differences in fear is needed to address these concerns and promote long-term donor motivation.