"Okay, I respect this publicity stunt." A snapshot of public perceptions of an online game-based blood donation campaign.

BACKGROUND: With a decrease in young and first-time donors, applying gaming elements to blood donation may provide a novel means of encouraging young donors. In August 2023, the online game DiabloIV launched the Blood Harvest in which players were encouraged to donate blood products in the United States to receive virtual in-game rewards. Given the novelty of this independent initiative, our aim was to capture Diablov IV players opinions of the Blood Harvest through thematically analyzing their online discourse related to this blood donation campaign. STUDY DESIGN AND METHODS: We captured publicly available Twitter/X posts (n = 78) and engagement (n = 390) relevant to the Blood Harvest posted during and immediately after the campaign (October 13, 2023-November 27, 2023). RESULTS: Using thematic analysis, we identified 5 themes relating to the Blood Harvest campaign: (1) Positive perceptions and community motivations to donate, (2) Negative perceptions of the initiative and online game, (3) Players' inability to donate and participate in the initiative, (4) Incentives and incentive comparisons, and (5) Benefiting from positive associations focusing on the reputational gain that may be accessed through promoting blood donation. DISCUSSION: Situating a donation campaign in an established video game provides a novel opportunity to engage young donors. Through capturing public data, we provide a unique snapshot of how an online gaming community perceives and reacts to an independently initiated game-integrated blood donation campaign. This highlights key strengths of the approach as well as identifying potential risks for blood collection agencies.

Blood, sweat, and fears: Athletes' perceptions of blood donation and engagement in physical activity.

BACKGROUND: Athletes are a key group from which likely eligible donors could be sourced. While blood donation has been popularized as detrimental to athletic performance, little is known about how athletes perceive blood donation. The aim of this study was to investigate athletes' perceptions of the impacts of donating blood on their athletic performance and whether these influence their engagement with blood donation. STUDY DESIGN AND METHODS: A total of 175 athletes (78 donors; 97 non-donors) prescreened as eligible to donate blood in Australia completed an online survey assessing the perceived impact of (i) donating blood on engagement and performance in physical activity (type of impact, direction, and duration) and (ii) engaging in physical activity on blood donation (magnitude of impact and modification of behavior). RESULTS: We found that 37%-39% of our sample indicated that they had considered the impact of donating blood on their engagement or performance in physical activity, with the impact seen as negative but short term. Fatigue was the most commonly identified impact of donation on performance in physical activity. While the impact of donating did not account for athletes' non-donor status, many donors noted changing their engagement in physical activity pre- and post-donation to allow recovery, and aligning blood donation with their training schedule. DISCUSSION: Athletes are a key community from which likely eligible donors could be sourced, however a significant proportion of athletes perceive that donating will negatively impact their athletic performance. Strategies to engage athletes with donation should acknowledge and facilitate athletes need to align their training with donating.

Acceptability of sexual history questions in a gender-neutral risk assessment for blood donation.

BACKGROUND: Currently in Australia, men are deferred from donating blood if they have had sex with another man within the past 3 months. However, a proposed gender-neutral assessment (GNA) process will ask all donors questions about sex with new or multiple recent partners, with deferral based on responses to a question about anal sex. Understanding the acceptability of such questions among existing and potential blood donors is paramount for successful implementation of GNA. STUDY DESIGN AND METHODS: We used data from a nationally representative survey to estimate the levels of comfort with the proposed GNA questions among the Australian population and subgroups, defined by self-reported ethnicity and religion. Respondents were aged over 18 and living in Australia. Results were weighted to represent the population. RESULTS: Most of the 5178 respondents described themselves as comfortable with answering questions about new partners (73.1%) or anal sex (64.0%) to donate blood. However, 2.2% and 4.5% indicated that questions about new sex partners and anal sex, respectively, would stop them from donating, and 4.4% and 7.7% respectively, said they were "completely uncomfortable." By religion, the least comfortable were Muslim or Eastern Orthodox respondents, and by country of birth, the least comfortable were those born in the Middle East, followed by those born in Southern Europe and Asia. DISCUSSION: GNA appears to be broadly acceptable in the Australian context, but our findings suggest that key GNA questions are less acceptable in some population subgroups, indicating a need for targeted campaigns that consider cultural sensitivities.

The impact of blood donation deferral strategies on the eligibility of men who have sex with men and other sexual risk behavior in Australia.

BACKGROUND: In Australia, a man cannot donate blood if he has had sex with another man within the past 3 months. However, this policy has been criticized as being discriminatory as it does not consider lower risk subgroups, and led to calls for modifications to the policy that more accurately distinguish risk among gay, bisexual, and other men who have sex with men (GBM). STUDY DESIGN AND METHODS: We used data from a nationally representative survey to estimate the proportion of GBM aged 18-74 years old who would be eligible to donate under current criteria and other scenarios. RESULTS: Among the 5178 survey participants, 155 (3.0%) were classified as GBM based on survey responses, Among the GBM, 40.2% (95% CI 28.0%-53.7%) were eligible to donate based on current criteria, and 21.0% (95% CI 14.5%-29.5%) were ineligible due to the 3 months deferral alone. Eligibility among GBM, all men, and the population increased as criteria were removed. Under the new Australian plasma donation criteria, 73.6% (95% CI 64.4%-81.1%) of GBM, 68.4% (95% CI 65.5%-71.2%) of all men, and 60.8% (95% CI 58.8%-62.8%) of the full population were estimated to be eligible. Only 16.1% (95% CI 8.6%-28.1%) of GBM knew that the male-to-male sex deferral period is 3 months. DISCUSSION: Changing the deferral criteria and sexual risk evaluation would lead to a higher proportion of GBM being eligible to donate blood. Knowledge of the current GBM deferral period is very low. Improved education about the current criteria and any future changes are required to improve blood donation rates.

The power of arts-based film interventions to encourage Black blood donors.

BACKGROUND: Blood services must consider innovative ways to encourage more Black people to donate to enhance the efficacy of treatments. We evaluate how two innovative arts-based approaches (co-designed and locally produced films and a large-scale Marvel Studios'/NHSBT collaboration) can achieve this by generalizing to a wider audience from their target audiences. STUDY DESIGN AND METHODS: Four co-designed short community films were produced in the United Kingdom: Comedy, Reciprocity, Donor-Recipient, and Sliding Doors. In Study 1 (N = 44: Black people), these films were evaluated in the target community in which they were produced. In Study 2 (N = 1237: Black = 638, White = 599), the community and Marvel Black Panther/NHSBT films were evaluated in a nontarget general population sample. Evaluations were in terms of campaign behavioral efficacy (e.g., willingness to donate, encourage others to donate) and affect. These analyses were segmented by donor status, age, and gender. RESULTS: Study 1 shows that the community groups rated the films very positively, with over 90% stating that they would be convinced to donate blood. Study 2 shows the results from the community films generalized to the general population, with the Black Panther film also rated positively in the general population. Three community films and the Black Panther film were rated equally positively. There were notable differences across generations and by donor status. DISCUSSION: The results highlight the power of arts-based approaches (both locally co-produced community films and franchise collaborations) in encouraging donors within their target audiences and, importantly, on the broader population.

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

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

A rapid review of strategies to manage low iron levels in adults donating whole-blood: A focus on donor behaviour.

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.

Word-of-mouth among blood service employees who also donate blood: a qualitative investigation of advantages and challenges for dual-role donors.

BACKGROUND: Despite word-of-mouth (WOM) and electronic WOM (eWOM) influencing people's willingness to donate blood, no research has explored this behavior among blood service employees who are also donors. This underexplored segment is highly important, as they are generally committed to both the organization and the cause and are likely more informed on the topic of blood donation than the average donor. METHODS: This study comprised six online focus groups with 26 Australian Red Cross Lifeblood employees who are also donors. Questions covered a range of blood donation and WOM topics, including when they became blood donors, if they had engaged in WOM about blood donation, what they had talked about and with whom, and what were audience reactions. Thematic analysis was then used to explore how responses related to the employees' motivations, opportunities, and abilities to engage in WOM and eWOM about blood donation. RESULTS: While most employee-donors saw alignment in their employee and donor roles, advocating for blood donation was not considered a necessary part of either role. Educating others about blood donation was a common goal of employee-donor WOM and eWOM, and almost all employees engaged in reactive WOM, triggered by events (e.g., recent donations) or questions about their work. Employee-donors in donor-facing roles (e.g., communications and collections staff) felt more aware of the importance of encouraging others to donate blood and were also more likely to be proactive in their WOM activity. Along with these perceived advantages of having a dual role, employee-donors also identified some disadvantages, such as unrealistic expertise expectations and negative audience responses that can be difficult to navigate. CONCLUSIONS: Being an employee-donor is a double-edged sword. For example, increased opportunities to talk about blood donation and access to more information can be offset by having to respond to more challenging questions/comments and expectations, while appropriately representing their employer. More research is needed among those in employee-donor roles within the healthcare and/or non-profit sectors, to determine whether these are issues faced more broadly, and how those in dual roles can be most effectively supported to engage in positive WOM and eWOM.

Evaluating an online module for sexual violence prevention in a tertiary educational setting: An exploratory study.

ISSUE ADDRESSED: Sexual violence is an important public health issue affecting significant numbers of university students across Australia and internationally. In response, online modules have been widely implemented and there is an urgent need to better understand their effectiveness. The aim of this study was to evaluate an online sexual violence prevention and response education module designed for and implemented in one Australian university. METHODS: We used a mixed-methods approach that included pre/post module completion surveys of key measures relating to sexual consent, being a bystander, and response to disclosures as well as knowledge of resources and support services. We conducted post module completion semi-structured interviews. RESULTS: Results indicated potential effectiveness of the module on beliefs about sexual consent, confidence intervening when witnessing potentially harmful situations, willingness to report incidents, confidence supporting a peer who discloses an incident, and knowledge of support services. Qualitative results indicated support for the online module as an accessible, private and self-paced tool for sexual violence education. Interactive, relevant and engaging content that can be applied in real-life contexts was noted as key for effectiveness. CONCLUSIONS: This exploratory study suggests there may be potential for online modules to be effective, as one aspect of universities' sexual violence prevention and response strategies-particularly modules aimed at addressing primary, secondary and tertiary prevention. Further rigorous research is required to strengthen best practice in the development and implementation of online modules as part of whole-of-campus strategies. SO WHAT?: Universities across Australia and internationally are grappling with sexual violence response and prevention in light of high prevalence rates among students. Online modules may be one effective tool when implemented as part of a wider strategy.

"Why don't you want my poop?" Willing stool donor's experiences of being ineligible to donate intestinal microbiota.

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.

Experiences of knowledge translation among researchers in transfusion medicine: Findings from an international survey study.

BACKGROUND: Translation of research knowledge is critical to ensure transfusion medicine policies and practices reflect current evidence and so effectively support the health of blood donors and recipients, as well as ensuring ongoing blood supply. The aim of this study was to investigate the barriers and facilitators of knowledge translation (KT) among transfusion medicine researchers and determine what KT supports are needed. STUDY DESIGN AND METHODS: An anonymous, cross-sectional survey was distributed by emailing corresponding authors of papers in four major blood journals, emailing grant recipients in the area of transfusion medicine, posting on social media, and through an international blood operator network. RESULTS: The final sample included 105 researchers. Participants had a positive orientation toward KT, with few perceiving KT as not relevant to their research or beneficial for their careers. However, many reported facing difficulties practicing KT due to time constraints, competing priorities, or lack of funds or resources. Fostering relationships with stakeholders was seen as a key facilitator of KT but a number of researchers expressed difficulties engaging and communicating with them. Collaboration opportunities, protected time for KT, and access to KT resources were some of the supports researchers felt were required to help their KT efforts. CONCLUSION: To minimize the knowledge to practice gap in transfusion medicine and ensure findings from research lead to improved outcomes, organizations need to support researchers in their KT efforts and facilitate interactions between researchers and research end-users.

A randomized controlled trial of post-donation communication materials to increase donor return following a vasovagal reaction.

BACKGROUND: Vasovagal reactions (VVRs) are one of the primary reasons for people to stop donating blood. The aim of this study was to evaluate the impact of newly developed online communications on the rate of return of whole-blood (WB) and plasma donors who experienced a VVR. STUDY DESIGN AND METHODS: First-time and experienced WB and plasma donors who had a VVR without a loss of consciousness in the previous 3 days were randomly allocated to receive (a) an SMS sent 1-4 days post-VVR (n = 2303), (b) an email sent 6-10 days post-VVR (n = 2360), (c) both the SMS and the email (n = 2248), or (d) business-as-usual donor retention communications (control; n = 2557). Donation data were extracted to determine subsequent donation attempts. RESULTS: For return within 3 months, WB donors in the Email Only condition had significantly increased odds of returning (OR: 1.26, 95%CI: 1.01-1.56). Subgroup analysis within WB donors showed increased odds of return for women sent the SMS and Email (OR: 1.50, 95%CI: 1.14-1.96) or the Email Only (OR: 1.44, 95%CI: 1.10-1.89), and for first-time donors sent the Email Only (OR: 1.48, 95%CI: 1.07-2.05). At 6 months, only first-time WB donors in the Email Only condition had significantly increased odds of returning (OR: 1.30, 95%CI: 1.01-1.69). No significant effects of the intervention were found for immediate or intermediate return for plasma donors. DISCUSSION: Sending an email addressing common donor concerns regarding VVRs increases WB donor retention, but additional strategies are needed for the effects to last and to retain plasma donors.

Beyond fear: A longitudinal investigation of emotions and risk of a vasovagal reaction in first-time whole-blood donors.

BACKGROUND: Fear is a recognized predictor of vasovagal reactions (VVRs) in blood donors. However, less is known about the role of other emotions, including positive emotions, that donors might experience. The aim of this study was to identify the emotions experienced in center that predict onsite VVRs, and to determine at what point during the donation appointment, the experience of these emotions is most influential. STUDY DESIGN AND METHODS: A sample of 442 first-time whole-blood donors (57.7% female; mean ± SD age 30.7 ± 11.7 years) completed a survey in the waiting area and before venepuncture in the donation chair to assess their current emotional experience. The survey data were matched with routinely-collected demographic, donation, and donor adverse event information. A generalized estimating equations model was used to identify emotions associated with the occurrence of a VVR. RESULTS: A total of 56 (12.7%) participants experienced a VVR. The occurrence of a VVR was significantly associated with lower love/closeness/trust (OR: 0.53, 95%CI: 0.34-0.82) and higher scared/fearful/afraid (OR: 1.96, 95%CI: 1.18-3.25) states. Significant interaction effects suggested that the effect of scared/fearful/afraid decreased while stressed/nervous/overwhelmed increased from the waiting area to before venepuncture on the likelihood of a VVR. DISCUSSION: To effectively reduce donor VVR risk, blood collection agencies need to address a broader range of emotions at different points during the donation process.

Donor and non-donor perspectives on receiving information from routine genomic testing of donor blood.

BACKGROUND: Genomic testing is already used by blood collection agencies (BCAs) to identify rare blood types and ensure the best possible matching of blood. With ongoing technological developments, broader applications, such as the identification of genetic markers relevant to blood donor health, will become feasible. However, the perspectives of blood donors (and potential blood donors) on routine genomic testing of donor blood are under-researched. STUDY DESIGN AND METHODS: Eight online Focus Groups were conducted: four with donors and four with non-donors. Participants were presented with three hypothetical scenarios about the current and possible future applications of genomic testing: Performing rare blood type testing; identifying donors with genetic markers associated with iron metabolism; and identifying donors with genetic markers associated with bowel cancer. RESULTS: Testing to identify rare blood types was perceived to be an appropriate application for the BCA to undertake, while identifying markers associated with iron metabolism and cancer genetic markers were only partially supported. Participants raised concerns about the boundaries of acceptable testing and the implications of testing for privacy, data security, and health insurance. Perspectives of donors and non-donors on all scenarios were similar. DISCUSSION: The principles of who benefits from genomic testing and the perceived role of BCAs were key in shaping participants' perspectives. Participants generally agreed that testing should be directly related to blood donation or be of benefit to the recipient or donor. Findings indicate that consent and communication are key to the acceptability of current and expanded genomic testing.

Prevalence of blood donation eligibility in Australia: A population survey.

BACKGROUND: Reliable estimates of the population proportion eligible to donate blood are needed by blood collection agencies to model the likely impact of changes in eligibility criteria and inform targeted population-level education, recruitment, and retention strategies. In Australia, the sole estimate was calculated 10+ years ago. With several subsequent changes to the eligibility criteria, an updated estimate is required. STUDY DESIGN AND METHODS: We conducted a cross-sectional national population survey to estimate eligibility for blood donation. Respondents were aged 18+ and resident in Australia. Results were weighted to obtain a representative sample of the population. RESULTS: Estimated population prevalence of blood donation eligibility for those aged 18-74 was 57.3% (95% CI 55.3-59.3). The remaining 42.7% (95% CI 40.7-44.7) were either temporarily (25.3%, 95% CI 23.5-27.2) or permanently ineligible (17.4%, 95% CI 16.1-18.9). Of those eligible at the time of the survey, that is, with the UK geographic deferral for variant Creutzfeldt-Jakob disease included, (52.9%, 95% CI 50.8-54.9), 14.2% (95% CI 12.3-16.3) reported donating blood within the previous 2 years. Eligibility was higher among men (62.6%, 95% CI 59.6-65.6) than women (52.8%, 95% CI 50.1-55.6). The most common exclusion factor was iron deficiency/anemia within the last 6 months; 3.8% (95% CI 3.2-4.6) of the sample were ineligible due to this factor alone. DISCUSSION: We estimate that approximately 10.5 million people (57.3% of 18-74-year-olds) are eligible to donate blood in Australia. Only 14.2% of those eligible at the time of survey reported donating blood within the previous 2 years, indicating a large untapped pool of potentially eligible blood donors.

Psychological ownership and identity motives in blood donation.

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.

'Stay at home and limit contact': The impact of stay-at-home advice on the behavior of Australian donors aged 70 and over in the first year of the pandemic.

BACKGROUND: Early in the COVID-19 pandemic, Australian donors aged 70 and over were advised to temporarily stop donating. The aim of this research was to understand the factors associated with some of these donors continuing to donate despite the advice, and whether adherence to the advice had negative implications for donor retention. STUDY DESIGN AND METHODS: Survey data from 2078 donors were analyzed to understand the factors associated with donating blood during the first 6 months of the pandemic, and the impact of following stay-at-home advice during the first 6 months of the pandemic on donor return 6-12 months into the pandemic. Panel data were used to gain an overview of donation behavior before, during, and after the initial phase of the pandemic. RESULTS: Donations by donors aged 70 and over decreased disproportionately to other age groups during the early stages of the pandemic. Sex, total donation count, awareness of stay-at-home advice from the Blood Collection Agency, the mode of receiving stay-at-home advice, donor risk perceptions and attitudes toward stay-at-home advice were associated with donation behavior in the first 6 months of the pandemic. Donors who did not donate in the first 6 months of the pandemic had lower odds of returning 6-12 months into the pandemic. CONCLUSION: Stay-at-home advice was partially successful in preventing older donors from donating; however, more tailored communication approaches may have prevented more donors from donating. Implementation of stay-at-home advice should be accompanied by strategies to prevent ongoing donor lapse in the medium- to long-term.

Using the Health Action Process Approach to predict blood donation intentions and return behavior following a vasovagal reaction for whole blood and plasma donors.

BACKGROUND: To inform the development of interventions to retain donors following a vasovagal reaction (VVR), the aim of this study is to use the Health Action Process Approach (HAPA) to identify predictors of intentions to re-donate and actual return behavior among whole blood (WB) and plasma donors who experienced a VVR. STUDY DESIGN AND METHODS: A total of 1136 WB donors (Mage  = 32.4 ± 12.5 years; 73.4% female) and 1141 plasma donors (Mage  = 36.5 ± 14.4 years; 73.3% female) completed an online survey after experiencing a VVR. Two hierarchical regression analyses were conducted for each donation type. In the first analysis, donation intentions were regressed onto the motivational HAPA constructs and social support. In the second analysis, donor return within 6 months was regressed onto social support, intentions, and the volitional HAPA constructs. RESULTS: The motivational and social support variables accounted for 47.2% of the variance in intentions to return in WB donors and 15.7% in plasma donors. For both groups, task self-efficacy, positive and negative outcome expectancies, and social support were significant predictors of intentions to return. Intentions and action planning were significant predictors of donor return in both groups, and recovery self-efficacy was significant for plasma only. CONCLUSION: The HAPA model can provide guidance to blood collection agencies to design phase-specific and individually-focused interventions to retain WB and plasma donors following a VVR.

A typology of strategies that recognize, reward, and incentivize blood donation.

BACKGROUND: Blood collection agencies (BCAs) worldwide are continuously looking to improve recognition, reward, and incentive (RRI) policies to optimize the recruitment and retention of blood donors. However, given the inconsistent categorization and variety of strategies available, there is a need for a theoretically informed and empirically supported framework to guide RRI research and policy development. STUDY DESIGN AND METHODS: Survey data from 1028 voluntary nonremunerated whole blood and plasma donors in Australia was used to validate a theorized RRI typology based on distinctions between the level of congruency with the act of donating blood (congruent vs. incongruent), visibility of acknowledgment (public vs. private), benefits provided (self vs. other), and likely reinforcement schedule (fixed vs. variable). RESULTS: A six-factor solution met all statistical criteria and was most consistent with a priori theoretical underpinnings. The factors were labeled (i) deal promotion, (ii) loyalty program, (iii) BCA token, (iv) health check, (v) charity donation, and (vi) travel compensation. DISCUSSION: This typology provides researchers with a standardized theoretical and conceptual framework to organize and synthesize findings from the existing literature and help BCAs develop RRI policies that are likely to be successful. We present a future research agenda across and within the RRI strategies.

It is about who you know (and how you help them): Insights from staff and donors about how to recruit and retain a panel of committed anti-D donors.

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.