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.

How to increase first-time donors' returns? The postdonation letter's content can make a difference.

BACKGROUND: Retention of first-time donors is pivotal for blood collection centers. The present study built on research showing the importance of donor identity among regular donors and sought to compare the effectiveness of various communication strategies on return rate. STUDY DESIGN AND METHODS: Postal letters were sent to a large sample of first-time whole blood donors (N = 1219) a few weeks following their first donation. Four versions of this letter were differently constructed in a way to boost the acquisition of donor identity (i.e., by including information about their ABO and Rh(D) blood group, emphasizing the salience of donor identity, offering a keyring with personalized information, or specifying the percentage of those sharing the same ABO and Rh(D) blood group). One version with no identity-related information served as a control condition. Participants' subsequent blood donations were tracked for 5-22 months after receiving the letter. RESULTS: Survival analysis showed that the return rate was significantly higher among those who had received information about the percentage of the country's population with the same ABO and Rh(D) blood group (in comparison with the four other versions). There was no significant effect on the blood type rarity. CONCLUSION: Blood collection centers could orient the strategy employed to communicate with first-time donors to improve donors' retention. Arousing a sense of social identification with others with the same blood type may reveal a promising avenue.

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.

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.

Determinants of intention to return to donate blood among first-time blood donors in Ghana.

OBJECTIVE: This study seeks to identify factors that are predictive of intention to return to donate blood among first-time blood donors. METHODS: A cross-sectional survey of 505 first-time blood donors, selected from blood donation sessions across three regions in Ghana. Data were obtained on their intention to donate blood in the next four months, factors that would influence this decision. Logistic regression models were used to test factors that were predictive of intention to return. RESULTS: First-time donors were young with 87·4% below 35 years of age, male (72·5%), single (73·3%), Christian (93·7%), employed (58·8%), with at least a basic education (98%). Factors that positively predicted intention to return included: motivational incentives (OR = 1·67, 95%CI: 1·01-2·78; P = 0·045); ease of access to the donation site (OR = 2·65, 95%CI: 1·48-4·73; P = 0·001); SMS and email reminders (OR = 2·84, 95%CI: 1·60-5·06; P < 0·001); and television, radio or newspaper advertisements (OR = 2·97, 95%CI: 1·66-5·31; P < 0·001). Factors that negatively predicted intention included preferential access to transfusions (i.e. 'blood credits') (OR = 0·43, 95%CI: 0·23-0·83; P = 0·012); getting to know test results (OR = 0·40, 95%CI: 0·20-0·80; P = 0·010); and not knowing and/or trusting what happens to the blood after donating (OR = 0·50, 95%CI: 0·28-0·88; P = 0·016). CONCLUSION: Motivational incentives, convenient access to donation sessions, reminders and mass media advertisements appear to positively influence intention to return to donate. Conversely not knowing what happens to the blood after donation negatively influenced intention to return. Interventions to promote repeat blood donation should consider the identified factors.

In the Mood for a Blood Donation? Pilot Study about Momentary Mood, Satisfaction, and Return Behavior in Deferred First-Time Donors.

INTRODUCTION: To maintain a sufficient donor pool, deferred first-time donors (FTD) should be motivated to return for blood donation. This pilot study investigates how deferral affects momentary mood, satisfaction with the donation process, and subsequent return behavior to examine their potential for motivating (deferred) FTD. METHODS: All of the subjects (n = 96) completed a first questionnaire (A1) before pre-donation assessment. Deferred FTD (n = 22) were asked to complete a second questionnaire (A2) immediately after deferral, while non-deferred FTD (n = 74) filled in the second questionnaire (A3) after blood donation. The impact of deferral, momentary mood, and satisfaction with the donation process on return behavior within 12 months was tested by calculating two path analyses, controlling for sex and age. RESULTS: Mood (p < 0.001) and satisfaction with social aspects of the donation process (p = 0.01) were decreased after deferral. Deferred FTD were less likely than non-deferred FTD to return to the blood donation center within 12 months (60.8 vs. 36.4%; p = 0.043). However, path analyses revealed that deferral effects on mood and satisfaction were not connected to return behavior. Instead, age had a significant influence on return behavior (p < 0.05) such that, overall, non-returning FTD were older than returning FTD, regardless of their deferral status. CONCLUSION: Our findings suggest that mood and satisfaction with the donation process are directly affected by deferral but not clearly responsible for low return rates. It seems promising to embed these variables in established health behavior models in further studies to increase the return rates of deferred FTD.

Well-being and return rate of first-time whole blood donors.

BACKGROUND AND OBJECTIVES: Previous studies observed a transient increase in well-being in about one-third of regular donors after blood donation. In addition, personal contact with donors after donation seems to increase return rates. We were interested whether changes in well-being and/or personal contact after the first donation impact return rates of first-time donors (FTDs). MATERIALS AND METHODS: First-time donors were randomized to a questionnaire group (QG), in which questionnaires assessing the well-being had to be filled in, or a control group (CG), which was not contacted with a questionnaire. The QG had to complete the same questionnaire three times at the day of the first donation and then four times over an 8-week period with reminding calls by the study coordinator. Return rates of participants were followed for 12 months. RESULTS: A total of 102 FTDs participated in the QG and 115 in the CG. Changes in well-being after the first donation had minimal impact on the return rates. In contrast, contacting FTDs after their first donation had a significant impact on the return rate of male donors (89·2% in the QG vs. 58·3% in the CG; P = 0·001). Females showed no significant difference in return rates between both groups (P = 0·32). CONCLUSION: The well-being of FTDs had no influence on their return rate. The intervention of regular contacts during a research project follow-up resulted in an increased return rate of male but not of female FTDs. The pronounced difference of the impact of this intervention between male and female donors requires further studies.

Human T-cell lymphotropic virus: A simulation model to estimate residual risk with universal leucoreduction and testing strategies in Canada.

BACKGROUND AND OBJECTIVES: In Canada, transfusion transmission risk of Human T-cell lymphotropic virus -I/II (HTLV) is addressed by universal leucoreduction and universal antibody testing. We aimed to estimate the risk with the current policy, if testing only first-time donors and if testing were stopped. MATERIALS AND METHODS: Monte Carlo simulation was employed to estimate the proportion of red cell concentrate, random donor platelet and apheresis platelet units that would be released into inventory in each scenario (10 billion donors each). The model estimated the number of HTLV-positive donations not intercepted by testing, randomly assigned the number of HTLV particles/100 leucocytes using proportions from published data and randomly selected a postleucoreduction leucocyte count from quality control data. Units were considered infectious if ≥9 × 104 copies of HTLV provirus. RESULTS: With universal leucoreduction in place, the residual risk of releasing an HTLV potentially infectious unit with universal testing was 1 in 1·2 billion units (0, 1 in 55·9 million), with testing only first-time donors 1 in 7·1 million (0, 1 in 1·05 million) and with no testing 1 in 1·0 million (0, 1 in 178 600). The efficacy of leucoreduction was >99·5% (lower bound 95·7%) for all scenarios. CONCLUSION: With universal leucoreduction in place, switching from universal testing to testing first-time donors would incur very low risk.

Dissecting the decline of hepatitis C in first-time donors in England and Wales.

BACKGROUND AND OBJECTIVES: The rate of confirmed hepatitis C virus (HCV) cases, in first-time donors, is much lower in 2015 than 20 years ago. We investigate reasons for the decline. MATERIALS AND METHODS: HCV rates were analysed by gender and birth cohort for 1996 to 2015 and ethnic group for 2006 to 2015. Variables for confirmed positive cases were compared for two ten-year periods (1996 to 2005 and 2006 to 2015) including genotyping data for 2006 to 2015. RESULTS: There were 2007 confirmed HCV cases identified between 1996 and 2015. The rate per 100 000 donations fell from 78·6 in 1996 to 26·9 by 2015. By birth cohort, HCV rates were highest in donors born in the 1950s and 1960s who contributed a decreasing proportion of first-time donors. Between 2006 and 2015, there was no significant decline in HCV rate. The HCV-positive donor profile has changed in the last 10 years with increased proportions of younger donors, donors born abroad and decreased reported injecting drug use. Genotype 1a remains predominate, but genotype 1b has increased associated with this change in birth cohort and ethnicity. CONCLUSION: The decline in number and rate of confirmed HCV-positive first-time donors is mainly due to a decrease in first-time donors born before 1970, with the highest rate of HCV. However, the decline has slowed and the profile of HCV-positive first-time donors is changing. A better understanding of behaviour and sources of HCV in younger and ethnic minority donors are needed.

Changes in the Whole Blood Donor Population in South-West Germany: 2010 versus 2016.

BACKGROUND: In the recent past, the discrepancy between blood supply and future demand may have been overestimated. As medical progress develops rapidly, it will be essential to monitor ongoing demographic changes in the donor population regularly and to re-evaluate retention and recruiting strategies. The aim of the current study was to compare first-time donor (FTD) characteristics and their return rates. We therefore compared whole blood (WB) donations in total and the annual donation frequencies in 2010 and in 2015/2016. Furthermore, we evaluated whether over the same observation period, medical reasons for deferral underwent a change (2010 vs. 2015). METHODS: The return probability of FTD within 12 months was analysed in 2010 and 2015 with respect to successful donation versus deferral and with regard to age. The total number of WB donations was investigated, and age distribution was compared between 2010, 2013 and 2016. WB donation frequencies were calculated with respect to age and gender in 2010 and 2016. In a second analysis, medical reasons for deferral were differentiated into 14 categories and a possible impact of time (2010 vs. 2015) on the respective percentage was studied. RESULTS: We observed a significant decline of the FTD return rate from 42.5% to 38.8% in donors that successfully donated WB while the rate remained unchanged in deferred FTD. At the same time the mean FTD age decreased from 29.1 ± 11.6 to 28.5 ± 11.7 years in 2016. Analysis of total WB donations revealed an increase of all donations from donors ≥60 years, a constant percentage from donors <30 years but a declining proportion of donors aged 30-59 years from 2010 to 2013 to 2016. In parallel, annual mean WB donation frequencies decreased over time. Deferrals due to travel history increased significantly from 2010 to 2015 both in FTD and repeat donors. CONCLUSION: There is ongoing demographic change in our WB donor population. Our data prove a need for a re-evaluation of retention and recruitment strategies since previous marketing campaigns seem to have neglected the age group 30-59 years. This must be addressed in further studies as this age group will be highly relevant for assuring future blood supplies since donor recruitment from adolescents will be limited due to declining birth rates. Furthermore, deferral due to travel history is increasing significantly. Thus we will require further studies on the possible impact on donor retention.

Stratified analysis of risk factors affecting vasovagal reactions in first-time whole blood donors: A regional multi-center donor hemovigilance data study.

BACKGROUND AND OBJECTIVES: Vasovagal reactions (VVR) are the most common adverse reactions in blood donation. This study aimed to provide and analyze the data of the regional hemovigilance system in Chongqing, China from 2020 to 2022, report the prevalence and explore the risk factors of VVR. MATERIALS AND METHODS: R software (version 4.2.3) was used for all statistical analyses. Frequency and composition rates were used to describe the data of total donation, as well as data on the different types of ADR. The Chi-square test was used to analyze risk factors for VVR and inter-group comparisons of VVR stratified by gender (female/male), age (18-22; 23-29; 30-39; 40-49; 50-60) and season(Spring (Mar.-May.); Summer (Jun.-Aug.); Autumn (sep.-Nov.); Winter (Dec.-Feb.)). RESULTS: The reported incidence rate of VVR was 8.69‰ during whole blood donations and 1.02‰ during platelet-apheresis donations.The stratified analysis revealed that female donors aged 18-22 years old and 30-39 years old were reported to have lower VVR rates than male donors, oppositely, higher in females in 50-60 years old. Statistically significant differences in the incidence rate of VVR were observed between winter and summer, and between winter and spring in 18-49 years old. No seasonal variation was found in 50-60 years old. CONCLUSIONS: The reported incidence rate of VVR related to blood donation was very low and varied from those calculated by other haemovigilance systems. The higher prevalence of VVR in young, first-time donors, college students, donating in mobile vehicles, males and in spring. Among first-time donors, the prevalence of VVR was higher in males than in females; and stratified analysis revealed there were seasonal variation and gender differences within a same age group.

Beliefs underlying the intention to donate again among first-time blood donors who experience a mild adverse event.

Using the belief basis of the theory of planned behavior (TPB), the current study explored the rate of mild reactions reported by donors in relation to their first donation and the intention and beliefs of those donors with regard to returning to donate again. A high proportion of first-time donors indicated that they had experienced a reaction to blood donation. Further, donors who reacted were less likely to intend to return to donate. Regression analyses suggested that targeting different beliefs for those donors who had and had not reacted would yield most benefit in bolstering donors' intentions to remain donating. The findings provide insight into those messages that could be communicated via the mass media or in targeted communications to retain first-time donors who have experienced a mild vasovagal reaction.

Effects of Performing Applied Muscle Tension during Recovery after Phlebotomy in Young, First-Time Donors: A Pilot Study.

Vasovagal reaction (VVR) compromises donor safety and reduces the subsequent return rates. Performing applied muscle tension (AMT) during phlebotomy may reduce the incidence of VVR. However, the effectiveness of performing AMT after phlebotomy to reduce delayed VVR remains unclear. With ethics approval, 12 young, first-time donors (YFTD) were recruited to study the effects on stroke volume (SV), cardiac output (CO) and systemic vascular resistance (SVR) while performing AMT from needle insertion to end of recovery. Measurements from 12 matched control YFTD were used for comparison. Pre-donation anxiety and VVR severity were assessed. Compared to controls, donors who performed AMT had higher SV (Control: 57 mL vs. AMT: 69 mL, p = 0.045), higher CO (Control: 3.7 L·min-1 vs. AMT: 5.2 L·min-1, p = 0.006) and lower SVR (Control: 1962 dyn·s·cm-5 vs. AMT: 1569 dyn·s·cm-5, p = 0.032) during mid-phlebotomy. During recovery, the AMT group retained higher SV, higher CO and lower SVR than the control, but not reaching statistical significance. Practicing AMT during recovery resulted in sustained haemodynamic improvements beyond the donation period, despite the reduction in delayed VVR was insignificant compared to the control group. A larger sample size is needed to validate the effectiveness of performing AMT after donation to mitigate delayed VVR.

Motivational factors for blood donation, potential barriers, and knowledge about blood donation in first-time and repeat blood donors.

BACKGROUND: Blood transfusion is an essential component of the health care system of every country and patients who require blood transfusion service as part of the clinical management of their condition have the right to expect that sufficient and safe blood will be available to meet their needs. However, this is not always the case, especially in developing countries. To recruit and retain adequate regular voluntary non-remunerated blood donors the motivators and barriers of donors must be understood. Equally important to this goal is the knowledge of blood donors. METHODOLOGY: A cross-sectional study was conducted at the donor clinic of Tamale Teaching Hospital in the Northern Region of Ghana from 06 January to 02 February 2018. Purposive sampling technique was used to sample 355 eligible first-time and repeat whole blood donors. Data were collected face-to-face with a 27-item self-administered questionnaire. Chi-square test was used to determine the association between donor status and the motivators of blood donation, barriers to blood donation and the socio-demographic characteristics of donors. RESULTS: Out of the 350 donors, 192(54.9%) were first-time blood donors while 158 (45.1%) were repeat donors. Nearly all the donors, 316(90.3%), indicated they were motivated to donate when someone they know is in need of blood. Over four-fifths of the donors endorsed good attitude of staff (n = 291, 83.4%) and the desire to help other people in need of blood (n = 298, 85.1%) as motivators. Approximately two-thirds, 223(63.7%), of the donors endorsed poor attitude of staff as a deterrent to blood donation. More than half of the donors considered the level of privacy provided during pre-donation screening (n = 191, 54.6%) and the concern that donated blood may be sold 178(50.9%) as deterrents. Only a little over one-third of the donors knew the minimum age for blood donation (n = 126, 36.0%) and the maximum number of donations per year (n = 132, 37.7%). CONCLUSION: Our findings suggest that public education on blood donation, regular prompts of donors to donate when there is a shortage, and friendly attitude of staff have the potential to motivate donors and eliminate barriers to blood donation.

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

BACKGROUND: Donating blood in Estonia is non-remunerated and voluntary. Estonian Blood Service system has four independent regional blood centres that are responsible for blood collection, processing, screening and distribution of blood components to hospitals for clinical use. STUDY DESIGN: This research was carried out as a questionnaire survey. A questionnaire was developed to study lapsing first time donors' (FTD) blood donation experience, intention and willingness to donate again. METHODS: A thousand five hundred and forty-six questionnaires were posted to donors who had one successful donation in 2010 and who had not returned to second donation till the year 2012. For data analysis routine statistical methods were used. To evaluate the most appropriate number of classes, based on previous experience and future expectations, latent class analysis was used. RESULTS: There were 453 respondents (29.3%). For the majority of aspects of blood donation experience the emotions were positive. Results of the study suggested that blood collection agencies should intervene to bolster donors' attitudes, perceived control, and identity as a donor during this crucial post-first donation period. CONCLUSION: First blood donation seems to have been a positive experience. Reasons leading to stopping blood donation should be studied further. Establishing a donor registry for Estonia would be essential to keep track of donors.

A single-centre study of vasovagal reaction in blood donors: Influence of age, sex, donation status, weight, total blood volume and volume of blood collected.

CONTEXT: Vasovagal reactions (VVRs) in blood donors. AIM: To find an association of age, sex, donation status, weight, total blood volume and volume of blood collected with occurrence of immediate VVR. SETTINGS AND DESIGN: Retrospective single-centre study. MATERIALS AND METHODS: The study was conducted from March 2000 to November 2010 at a tertiary care blood transfusion centre. All VVRs with or without syncope occurring during or at the end of donation were noted. STATISTICAL ANALYSIS USED: For qualitative association, c (2)-test was used. Unpaired 't' test was used for assessing difference between two groups with respect to VVR status. Simultaneous impact of all risk factors was assessed using multivariate logistic regression analysis. The data entry software SPSS (version 17.0) was used for statistical analysis. A P-value <0.05 was considered statistically significant. RESULTS: Overall 1085 VVRs were reported in relation to 88,201 donations, resulting in an overall VVR rate of 1.23%, that is, an incidence of 1 in every 81 donations. Donors with low blood volume, first-time donors, with low weight and female donors had higher absolute donation VVR rates than other donors. CONCLUSIONS: Donation-related vasovagal syncopal reactions are a multifactorial process determined largely by weight, age, first-time donor status and total blood volume. Our study reinforces the fact that blood donation is a very safe procedure, which could be made even more event-free by following certain friendly, reassuring practices and by ensuring strict pre-donation screening procedures.