ABSTRACT
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?
ABSTRACT
In recognition of the impact of whole-blood donation on body iron stores, there has been an increased focus assessing the efficacy of strategies to minimise the risk of iron deficiency (ID). Whilst donor behaviour is an important determinant of success, this literature is yet to be fully synthesised to help guide blood collection agencies when implementing these strategies into routine practice. This rapid review identifies strategies for management of low iron, how they have been communicated to donors, donor compliance with advice, donor use of external health services and their effect on donor retention. Web of Science, Medline, CINAHL and Wiley online library databases were searched from 2012 to November 2023, with 29 studies meeting inclusion criteria. Five iron management strategies were identified: oral iron supplementation (IS), education, dietary advice, lengthening inter-donation interval and switching donation type. Most studies (n = 16) focused on IS, with only four reporting how they communicated this to donors. Donor use of IS was high in controlled research environments but has not been evaluated when implemented into routine practice. None of the four studies on dietary advice included findings on donor acceptability. The proportion of donors consulting their doctor about a low iron result or their risk of ID was found to be suboptimal. However, in general, the identified strategies and communications had a positive effect on donor retention. More evidence is needed on how to increase donor knowledge and awareness of donation-related risk of ID as well as to identify how to effectively communicate strategies to donors to ensure optimal acceptability and use.
Subject(s)
Blood Donors , Iron , Humans , Iron/blood , Adult , Iron Deficiencies , Anemia, Iron-Deficiency/blood , Anemia, Iron-Deficiency/prevention & control , MaleABSTRACT
BACKGROUND: Blood collection agencies (BCAs) hosting stool (fecal or poo) donor programs report high rates of donor deferral. However, the impact of deferral on willing donors, in terms of personal well-being and future engagement with BCAs, remains unexplored. Accordingly, we surveyed those attempting to donate intestinal microbiota about their experience of being ineligible. STUDY DESIGN AND METHODS: A total of 196 potential stool donors from Australia's BCA (>90% blood/blood product donors) completed the first stage of eligibility screening and then an online survey once notified of their ineligibility. Respondents reported motives for donating, perceptions of screening and improvements needed, experience of being told they are ineligible, and their feelings about this. RESULTS: Over 80% of participants were ineligible to donate. Of those ineligible, 58% did not know why they were ineligible resulting in potentially future eligible donors being permanently lost. Motives (>5%) included helping others, being a human substance donor, understanding benefits, curiosity/novelty, and helping science/research. Participants identified they needed clear and timely information during screening and a specific reason for their ineligibility. Participants commonly experienced disappointment, confusion, and calm in response to being ineligible. DISCUSSION: BCAs need strategies to mitigate the disappointment of ineligible donors, maintain satisfaction with BCAs, and preserve donor identity since many ineligible donors give multiple human substances. BCAs should provide more information about eligibility criteria during early screening stages to reduce disappointment and give personalized information about ineligibility to resolve the confusion. Offering alternative opportunities to give may reduce disappointment and increase ineligible donor engagement.
Subject(s)
Gastrointestinal Microbiome , Humans , Tissue Donors , Blood Donors , Feces , Emotions , MotivationABSTRACT
BACKGROUND AND OBJECTIVES: Interventions to retain existing donors are essential to increase the blood supply. Blood donor self-identity is proposed to motivate sustained donation behaviour. However, interventions to develop self-identity in the absence of donating blood are scarce. We propose that experiencing psychological ownership of a blood collection agency (BCA) may provide a potential avenue for fostering donor self-identity and subsequent sustained donation behaviour. MATERIALS AND METHODS: Two hundred and fifty-five donor participants were recruited through Prolific Academic (n = 175) and an Australian online blood donor community group (n = 80), with an additional 252 non-donors recruited through Prolific Academic. Participants completed an online survey assessing donation behaviour, perceived psychological ownership of a BCA, self-identity and intentions to donate blood, amongst other constructs. RESULTS: Consistent with our theoretical argument, psychological ownership was positively associated with self-identity, which, in turn, was positively associated with intentions to donate blood. Donation behaviour was positively associated with psychological ownership. Examination of psychological ownership by donation experience showed the expected relationship with committed donors having the strongest psychological ownership and non-donors having the weakest psychological ownership over a BCA. CONCLUSION: We provide initial support for the inclusion of psychological ownership within a model of sustained blood donation behaviour.
Subject(s)
Blood Donation , Blood Donors , Social Identification , Humans , Australia , Blood Donation/statistics & numerical data , Blood Donors/psychology , Blood Donors/statistics & numerical data , Motivation , Ownership , Surveys and Questionnaires , Behavior , Male , Female , Adult , Middle Aged , IntentionABSTRACT
BACKGROUND AND OBJECTIVES: Maintaining a panel of committed anti-D donors is crucial for the production of anti-D immunoglobulin to prevent haemolytic disease of the foetus and newborn. Given low numbers of donors in the Australian panel, there is a need to better understand motivators and barriers specific to anti-D donors. MATERIALS AND METHODS: A qualitative approach was used to gather perspectives of staff and current anti-D donors in Australia. Focus groups were held with staff involved with the anti-D programme. An asynchronous online discussion forum and interviews were conducted with donors. All data were coded using deductive and inductive thematic analysis. RESULTS: Staff stressed the importance of recruiting donors who met their own informal criteria as well as the formal selection criteria in order to maximize the chances of donors committing to making regular plasma donations. In contrast, donors were motivated by having a personal connection to anti-D, the recipient group and being eligible to join the programme. Support from staff and understanding the value of their donations also helped donors overcome concerns about the risks of joining the programme and reduced barriers to remaining in the programme. CONCLUSION: Anti-D donors in Australia are motivated by multiple factors, including knowing who the recipient is, and dedicated staff are integral to building donors' commitment through education and support. Findings suggest the current approach to recruitment could be broadened to include all donors who meet formal selection criteria, with retention enhanced by reinforcing and rewarding the motives identified by donors for donating.
Subject(s)
Blood Donors , Motivation , Australia , Humans , Infant, Newborn , Reward , Rho(D) Immune GlobulinABSTRACT
BACKGROUND: Against a background of declining blood donor numbers, recruiting new donors is critical for the effective operations of healthcare providers. Thus, interventions are needed to recruit new blood donors. PURPOSE: We provide initial evidence for Voluntary Reciprocal Altruism (VRA) to enhance nondonors' willingness to become blood donors. VRA interventions involve asking two questions: one on accepting a blood transfusion if needed and one on willingness to donate. As early trials often use self-reports of willingness to perform blood donation behavior, we derive a correction factor to better estimate actual behavior. Finally, we explore the effect of VRA interventions on two prosocial emotions: gratitude and guilt. METHODS: Across three experiments (two in the UK and one in Australia: Total N = 1,208 nondonors) we manipulate VRA messages and explore how they affect both reported willingness to make a one-off or repeat blood donation and influence click through to blood donation, organ donation and volunteering registration sites (behavioral proxies). We report data from a longitudinal cohort (N = 809) that enables us to derive a correction for self-reported behavioral willingness. RESULTS: Across the three experiments, we show that exposure to a question that asks about accepting a transfusion if needed increased willingness to donate blood with some spillover to organ donor registration. We also show that gratitude has an independent effect on donation and report a behavioral correction factor of .10. CONCLUSIONS: Asking nondonors about accepting a transfusion if needed is likely to be an effective strategy to increase new donor numbers.
Subject(s)
Altruism , Tissue and Organ Procurement , Blood Donors , Emotions , Humans , Self ReportABSTRACT
Diversification of blood collection agencies' (BCAs) core business requires donors to donate substances of human origin (SoHO) beyond whole-blood. Whole-blood donors are assumed to be willing to convert to donate other SoHO as well as whole-blood. However, no reviews consider the evidence on conversion (i.e., willingness/intention, behaviour, retention, attrition). This rapid review provides a narrative synthesis of whole-blood donors' conversion to another SoHO, characteristics contributing to conversion, motives and deterrents, and interventions encouraging conversion. Sixty-five studies were reviewed. Most were cross-sectional and examined whole-blood donor conversion to organ (willingness/pledge for deceased donation), plasma or stem cell donation. Most examined conversion rather than characteristics contributing to conversion, motives, deterrents or interventions. Whole-blood donors appear willing to donate another SoHO, yet conversion rates are unclear. Besides self-efficacy, there is little consistency in reported characteristics of donors converting, and few theories applied to understand characteristics encouraging conversion. Intrinsic (altruism, self-esteem, curiosity) and extrinsic (perceived need, service experience, direct requests) motives and barriers (lifestyle, fearing reduced health) appear important and require further research. Interventions encouraging conversion need replication and may include in-person, in-centre approaches, raising awareness of the functional benefits of other SoHO (high need, usefulness), and developing promotional materials that pique donors' curiosity, invite questions, and encourage donor-initiated conversations about conversion. Centralising BCAs as a single business or partnering with other organisations appears mutually beneficial to encourage conversion and sustainable panels/resources. Research is needed to understand the impact of encouraging conversion on donors and organisations, and identify optimal management strategies for multi-SoHO donors.
Subject(s)
Blood Donors , Motivation , Altruism , Humans , Intention , Self Concept , Surveys and QuestionnairesABSTRACT
Blood collection agencies (BCAs) are expanding core business by inviting blood donors to donate stool for fecal microbiota transplantation (FMT). However, whether blood donors also want to donate stool is unclear since, despite its benefits, stool donation is viewed by many as unpleasant. This study examined the prevalence, contributors to, and role of these mixed feelings (ambivalence) in stool donation intentions. STUDY DESIGN AND METHODS: This cross-sectional study surveyed Australian residents aged 18 years or more who believed themselves eligible to donate blood and met broad criteria for prescreening as a stool donor (eg, healthy, not taking medication). Survey questions assessed attitude, norms, self-efficacy, motives, disgust, ambivalence, and intentions to donate stool. RESULTS: A total of 382 eligible blood donors aged not more than 50 years (mean, 28.71 years; 48% female, 62% "healthy" body mass index) participated. Six percent indicated no ambivalence about donating stool. In regression, significant determinants of ambivalence were less awareness of FMT, lower self-efficacy, motivated by ensuring that stool is available for loved ones, and more disgust about stool donation. Higher ambivalence contributed to decreased donation intention. Self-efficacy and disgust differentiated participants with moderate ambivalence, a group likely responsive to intervention, from those with low or high ambivalence. CONCLUSION: Ambivalence about donating stool was common among eligible blood donors. BCAs should raise awareness about stool donation and FMT before requesting donation. BCAs may increase cost savings and donor retention by giving clear guidance about donation requirements and implementing processes that build confidence. Early screening of potential donors for ambivalence and disgust will enable BCAs to provide decision support.
Subject(s)
Attitude , Blood Donors/psychology , Fecal Microbiota Transplantation/psychology , Adult , Altruism , Australia , Body Mass Index , Cross-Sectional Studies , Disgust , Educational Status , Feces , Female , Humans , Male , Middle Aged , Motivation , Self Efficacy , Surveys and Questionnaires , Volition , Young AdultABSTRACT
BACKGROUND: Fear of blood donation is implicated in vasovagal reactions, donor recruitment, and retention. This study examined the extent to which fear among donors is associated with various donor outcomes in an Australian sample, and whether fear can be addressed on-site to reduce adverse reactions and improve the donation experience. STUDY DESIGN AND METHODS: Six hundred and sixty-four donors (age M = 33.4, SD = 12.7; 55% female) participated in a two-center, pragmatic, parallel group, individually randomized controlled trial. Following donor registration and consent, whole-blood (n = 539) and plasma (n = 125) donors were assigned to one of four Conditions: control; fear assessment; fear assessment + brochure; fear assessment + brochure + tailored conversation focused on any self-reported fear and coping strategies. Post-donation questionnaires assessed the donors' experience including positive support, donor self-efficacy, anxiety, fear, venipuncture pain, and vasovagal reactions. RESULTS: Fear among donors predicted higher venipuncture pain, post-donation anxiety, and vasovagal reactions and remained significant after controlling for other established predictors (i.e., total estimated blood volume, age, sex, and donation experience). Mediational analyses showed that exposure to brochures (with or without the tailored conversation) was associated with less pain, with this effect mediated by donor perceptions of more positive support. Venipuncture pain was also associated with vasovagal reactions, reduced likelihood of return within 6 months, and less satisfaction with the donation experience. CONCLUSION: The current results underline the importance of interventions to address fear among both whole-blood and plasma donors to secure the safety and well-being of donors and the blood supply.
Subject(s)
Blood Donors/psychology , Fear , Pain, Procedural/prevention & control , Phlebotomy/adverse effects , Adaptation, Psychological , Adult , Anxiety/etiology , Fear/psychology , Female , Health Education , Humans , Male , Pain, Procedural/etiology , Pain, Procedural/psychology , Pamphlets , Personal Satisfaction , Plasma , Self Efficacy , Self Report , Sex Factors , Social Support , Surveys and Questionnaires , Syncope, Vasovagal/etiology , Syncope, Vasovagal/prevention & controlABSTRACT
BACKGROUND: This study compared the likelihood of return to donate and donation rate ratio by age of donors at their first donation when followed up to 12 years. STUDY DESIGN AND METHODS: Donation history of two cohorts of first-time donors (those donating in 2007 and 2013) was extracted until March 2019 from Australian Red Cross Lifeblood's national database. Poisson regression analyses compared donor return and negative-binomial regression estimated the rate ratio of donations. RESULTS: A total of 120 469 and 95 381 donors were included in the 2007 and 2013 cohorts, respectively. Compared to donors aged 20-24 years, the likelihood of return in both cohorts increased consistently as age at first donation increased from 30-years and above. Average number of whole-blood and plasmapheresis donations increased as the age at first donation increased from 30-years onward. The whole-blood donation rate was highest for donors ≥60 years, while plasmapheresis donation rate was highest for donors aged 50-59 years. These patterns were largely consistent when stratified by sex. CONCLUSIONS: To continuously ensure the short- to mid-term sufficiency of blood supply in Australia, targeted recruitment of donors aged 30-years and above may be considered, however its feasibility and impact should be explored further given relatively smaller proportion of new donors are middle-aged and older under current policies. Future studies with a longer follow-up period are needed to examine whether the frequency of donation among those who start donating at a younger age increases later in their life when they are 30-years or over.
Subject(s)
Blood Donors/statistics & numerical data , Adolescent , Adult , Australia , Cohort Studies , Databases, Factual , Female , Humans , Male , Middle Aged , Plasmapheresis , Red Cross , Regression Analysis , Retrospective Studies , Time Factors , Young AdultABSTRACT
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.
Subject(s)
Blood Donors/psychology , Internet-Based Intervention/statistics & numerical data , Internet/instrumentation , Motivational Interviewing/methods , Adult , Australia/epidemiology , Blood Banks/supply & distribution , Blood Banks/trends , Blood Donors/statistics & numerical data , Female , Humans , Intention , Male , Personal Autonomy , Rh-Hr Blood-Group SystemABSTRACT
BACKGROUND: Many blood collection agencies are generating important data on donor health outcomes using large-scale blood donor cohort studies. Such studies can be very effective when donors provide access to linkage of their data to external health databases, and storage and genomic testing of their blood sample. In this study, we aimed to assess the willingness of Australian blood donors to provide additional data and blood sample for donation-related and other health research. STUDY DESIGN AND METHODS: We invited 2017 donors to complete a survey using four methods (postal letter, postal letter and email, email only, and in-center recruitment). The survey asked for information on demographics, lifestyle behaviors, health, experience and attitude to blood donation, and willingness to give blood sample and additional data for research. RESULTS: Response rates ranged from 23.8% for email only to 77.2% for in-center recruitment. Of those who responded (n = 827), 95.5% indicated they would be willing to provide a blood sample for donation and transfusion-related research. Of these, >90.0% were willing for their sample to be used in research involving genetic testing and other health-related topics. Also, >90.0% were willing to consent for linkage of their information to external health databases. CONCLUSIONS: Donors surveyed reported a high willingness to participate in health research by completing surveys, allowing linkage to external datasets, and providing a blood sample. These findings provide strong support for future longitudinal research studies with Australian blood donors.
Subject(s)
Blood Donors , Motivation , Adult , Attitude , Australia , Blood Transfusion , Female , Humans , Life Style , Male , Middle Aged , ResearchABSTRACT
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.
Subject(s)
Blood Donors/psychology , Morals , Adult , Aged , Australia , Bandages , Female , Humans , Male , Middle AgedABSTRACT
BACKGROUND AND OBJECTIVES: Blood Collection Agencies in several countries have implemented strategies to increase the number of plasmapheresis collections. Despite this, a sizable minority of plasma donors lapse from donation each year, with little research conducted on this topic. An understanding of the plasma donation experience from the perspective of lapsed donors, insights into why they stopped donating and their views on returning to donate may provide opportunities to intervene to increase the retention and reactivation of plasma donors. MATERIALS AND METHODS: A qualitative approach was used in this study, with 17 lapsed plasma donors (no plasma donation for at least 13 months) interviewed. A purposive recruitment strategy was used to obtain a sample with diversity in gender (47% men), age (M = 36·2 years, SD = 13·6) and donation experience (M = 9·2 years, SD = 9·6). Semi-structured, narrative interviews were conducted, with participants describing their plasma donation careers chronologically from first donation to most recent. RESULTS: The majority of participants described at least some aspect of the plasma donation procedure as unpleasant. However, adverse experiences were only attributed to lapsing in a minority of cases, with other participants reporting significant life events, perceived ineligibility and concerns about the safety of the procedure as the reason why they lapsed. CONCLUSION: It is common for lapsed plasma donors to intend to donate again in the future. Recommendations are given for strategies to address barriers to returning, noting the potential role of tailored education and support.
Subject(s)
Blood Donors/statistics & numerical data , Plasmapheresis , Adult , Blood Donors/psychology , Female , Humans , Male , Middle Aged , Young AdultABSTRACT
BACKGROUND: Despite recognition that blood donation is an affectively poignant process, many aspects of donors' emotional experiences and their consequences remain unexamined. PURPOSE: This study tracked the donor's experience of several positive and negative emotions live as they arose during the donation process and tracked the impact of that experience on donor return. METHODS: New whole blood donors (N = 414) reported their experience of 10 positive and 10 negative discrete emotions before, during, and after donation. Return behavior of these donors and a business-as-usual control group was tracked over the next 6 months. RESULTS: In total, 46.4% of participants and 43.2% of the control group returned to donate within 6 months. On the basis of established relevance to blood donation and statistical considerations, group-based latent trajectories of three emotions (joy, calm, and stress) were modeled over time, revealing five classes of emotion trajectories. A trajectory of low/increasing joy and calm and high/decreasing stress was associated with significantly lower probability of return (preturn = .28, 95% confidence interval [CI] = 0.20, 0.38) relative to all but one other trajectory group and the control group. A trajectory of medium-high/increasing joy, high calm, and low/decreasing stress was associated with a significantly greater probability of return (preturn = .59, 95% CI = 0.49, 0.69) relative to two other trajectory classes and the control group. CONCLUSIONS: By identifying blood donors' emotion trajectories over time and the impact of those trajectories on return behavior, this research paves the way for the development of effective emotion-focused interventions to boost retention.
Subject(s)
Blood Donors/psychology , Emotions , Adult , Blood Donors/statistics & numerical data , Female , Happiness , Humans , Latent Class Analysis , Male , Psychological Distress , Time FactorsABSTRACT
OBJECTIVES: To determine the motivators and barriers to COVID-19 convalescent plasma donation by those in the United Kingdom who have been diagnosed with or who have had symptoms of SARS-CoV-2 (COVID-19) but who have not donated. BACKGROUND: Convalescent plasma from people recovered from COVID-19 with sufficient antibody titres is a potential option for the treatment and prevention of COVID-19. However, to date, recruiting and retaining COVID-19 convalescent plasma donors has been challenging. Understanding why those eligible to donate COVID-19 convalescent plasma have not donated is critical to developing recruitment campaigns. METHODS/MATERIALS: A total of 419 UK residents who indicated that they had been infected with COVID-19 and who lived within 50 km of sites collecting COVID-19 convalescent plasma completed an online survey between 25th June and 5th July 2020. Respondents completed items assessing their awareness of convalescent plasma, motivations and barriers to donation and intention to donate COVID-19 convalescent plasma. RESULTS: Awareness of COVID-19 convalescent plasma was low. Exploratory factor analysis identified six motivations and seven barriers to donating. A stronger sense of altruism through adversity and moral and civic duty were positively related to intention to donate, whereas generic donation fears was negatively related. CONCLUSIONS: Once potential donors are aware of convalescent plasma, interventions should focus on the gratitude and reciprocity that those eligible to donate feel, along with a focus on (potentially) helping family and norms of what people ought to do. Fears associated with donation should not be neglected, and strategies that have been successfully used tor recruit whole-blood donors should be adapted and deployed to recruit COVID-19 convalescent plasma donors.
Subject(s)
Blood Donors/psychology , COVID-19/therapy , Motivation , SARS-CoV-2 , Surveys and Questionnaires , Adolescent , Adult , Aged , Altruism , Awareness , Blood Donors/statistics & numerical data , Donor Selection/methods , Fear , Female , Humans , Immunization, Passive , Male , Middle Aged , Plasma , United Kingdom , Young Adult , COVID-19 SerotherapyABSTRACT
BACKGROUND: With the coronavirus disease 2019 (COVID-19) pandemic continuing to accelerate and blood collection agencies (BCAs) warning of shortages, it is critical to identify the current determinants of donor behavior for donors and nondonors. STUDY DESIGN AND METHODS: In May and June 2020, Australian residents who believed themselves eligible to donate blood responded to measures assessing constructs from an integrated protection motivation theory, organizational trust, and theory of planned behavior framework, with donor status also assessed. RESULTS: A total of 507 residents (47% male, mean age 28.69 years; 272 had donated/attempted to donate) participated. A revised structural equation model was a good fit to these data. In this model, perceived risk, severity, anxiety, and response cost associated with donating during the COVID-19 pandemic underpinned threat appraisals, while response efficacy, self-efficacy, and attitude toward donating during COVID-19 informed coping appraisals. Trust in the BCA predicted lower threat and higher coping appraisals, and higher coping appraisals predicted stronger subjective norms. Intention to donate during the COVID-19 pandemic was positively predicted by subjective norm and self-efficacy. Donation-related behavior was positively predicted by intention, with this relationship stronger for nondonors than donors. CONCLUSION: Self-efficacy and approval from others, underpinned by coping appraisals and organizational trust, play a critical role in intentions to donate. BCAs that focus on maintaining trust with (potential) donors, providing clear messaging stating the minimal threat of contracting COVID-19 from donating and the protective measures in place, and showing how donating is achievable, may help to ensure a safe and secure blood supply throughout the COVID-19 pandemic.
Subject(s)
Blood Donors/psychology , COVID-19/epidemiology , Health Behavior , Pandemics , SARS-CoV-2 , Adaptation, Psychological , Adolescent , Adult , Aged , Anxiety/epidemiology , Anxiety/etiology , Attitude to Health , Australia/epidemiology , Female , Humans , Male , Middle Aged , Models, Psychological , Motivation , Psychological Distance , Risk , Self Efficacy , Trust , Young AdultABSTRACT
BACKGROUND: As demand for plasma-derived products grows, retention of voluntary nonremunerated plasmapheresis donors is crucial for many blood collection agencies. Currently, there is limited evidence of how to encourage first-time plasmapheresis donors to return and establish a high-frequency donation routine. This study tested the effectiveness of an intervention designed to increase retention of first-time plasmapheresis donors, increase donation frequency, and reduce time to return. STUDY DESIGN AND METHODS: A total of 6788 first-time plasmapheresis donors were randomly assigned to one of four conditions. Donors received an alternative e-mail or the business-as-usual control e-mail paired or not with a phone call. Outcomes were compared to the control e-mail in intention-to-treat analyses. RESULTS: Compared with control, donors in all intervention conditions were more likely to donate plasma as their first return donation in 6 months; however, there were no significant differences between intervention conditions. Rates of plasma donation in the alternative e-mail, control e-mail plus call, and alternative e-mail plus call conditions were 17.0, 15.0, and 18.0% higher than control. While the extra donations obtained in the alternative e-mail condition were cost neutral, the cost of one additional donation in the call conditions ranged from 20.14-20.89 AUD (13.08-13.56 USD). CONCLUSION: Communications specifically designed to encourage first-time plasmapheresis donors to view regular plasmapheresis donations as "easy"; to forward-book more than one appointment; and to provide education about plasma are effective in encouraging donors to return to plasma, to donate more frequently, and to return faster.
Subject(s)
Blood Donors , Electronic Mail , Plasmapheresis , Telephone , Adult , Female , Humans , MaleABSTRACT
BACKGROUND: This study examined the impact of age and sex of first-time donors who had not experienced an adverse event or deferral on their likelihood of and time to return. STUDY DESIGN AND METHODS: On behalf of the Biomedical Excellence for Safer Transfusion (BEST) Collaborative, international blood collection agencies (BCAs) were invited to provide data on first-time whole blood donors in 2014, including initial presentation date, collection site type, age, sex, blood type, return to donate within 24 months (yes/no), and subsequent presentation date. RESULTS: Eight BCAs contributed 706,789 records. The overall odds of returning to donate were slightly lower in female versus male donors, and the overall age trend was U-shaped with younger and older donors having higher odds for returning relative to middle-aged donors. However, variations by BCA were observed. Specifically, in three BCAs, women had higher odds of returning to donate than men. Further, while across seven BCAs the smallest cohort of older first-time donors returned at a higher rate and returned more quickly than middle-aged first-time donors, the behavior of younger donors varied substantially between BCAs. CONCLUSION: While older first-time donors are more likely to return and return more quickly than middle-aged donors they make up only a small proportion of first-time donors, whereas the larger group of younger donors exhibits less clear patterns of return compared to middle-aged donors. Further research is needed to determine whether targeting the recruitment of older donors or bolstering retention of middle-aged donors would be most effective in maintaining the blood supply.
Subject(s)
Blood Donors , Databases, Factual , Health Behavior , Adult , Age Factors , Female , Humans , Male , Middle Aged , Sex FactorsABSTRACT
BACKGROUND AND OBJECTIVES: Encouraging existing plasma donors to donate more frequently is a key objective for blood donation services committed to expanding yield through voluntary non-remunerated plasmapheresis donation. This requires an understanding of donors' perspectives on their current donation practice and how this relates to their knowledge and beliefs about the need for plasma. To explore this, Australian plasma donors were interviewed about how they arrived at the frequency at which they donate. MATERIALS AND METHODS: Semi-structured telephone interviews were conducted with 105 Australian plasmapheresis donors. RESULTS: Key themes identified were as follows: fitting donation into busy lives and how ideas about being an ongoing donor and the institutional context shaped their perspective on frequency; perceptions of the impact of donation on health; and wanting to make a greater contribution. CONCLUSION: Experienced plasma donors work to maintain a donation practice in the context of busy lives often by adopting a flexible approach to donation frequency. Their knowledge of the contribution their donations make is key to their continued donation, yet most identified constraints to donating more frequently. Health concerns were a particular concern for some, and more research is needed to understand donors' perspectives on the impact of donating on their health.