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.

'Yeah, this is my donation': An application of psychological ownership in blood donation.

To meet the priority healthcare needs of any population there must be a consistently available blood supply donated by willing donors. Due to this universal need for blood, retaining blood donors remains an ongoing challenge for blood services internationally. Encouraging psychological ownership, or the feeling of ownership one experiences over a possession, provides a potential novel solution to donor retention. This study, based on semi-structured interviews with blood donors, investigates how donors perceive and develop psychological ownership in the context of blood donation. Interviews were conducted in Australia with 20 current blood donors (10 men, 10 women; Mage = 41.95). Through thematic analysis, six themes were identified based primarily on the theoretical framework of psychological ownership. This research offers a novel perspective on donor retention, suggesting that donors' ownership over their individual donation practices, and not the blood service, may contribute to maintaining a stable blood supply.

"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.

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.

Understanding Mothers' Experiences of Being Ineligible to Donate Their Milk to a Not-for-Profit Milk Bank.

Background: Donor milk banks have strict donor screening criteria to ensure that donor milk is safe for premature or hospitalized babies. Yet little evidence is available to understand how potential donors, who are often breastfeeding their own infants, experience being ineligible ("deferred") to donate their milk to a milk bank. Materials and Methods: Interviews were conducted with 10 mothers who were permanently or temporarily deferred from donating to a large, not-for-profit milk bank in Australia. Interviews focused on becoming a donor and being deferred, meanings of deferral, impact of deferral on feeding own infant, and improving the deferral process. Results: Thematic analysis of interviews identified nine themes: (1) donation as a solution to wasting milk; (2) eligibility questions were acceptable and understandable; (3) more information early on allows self-deferral; (4) deferral is not always clear; (5) deferral is disappointing but does not prevent future donation; (6) deferral did not prevent feeding own infant; (7) early information enables preparation for donation; (8) slow communication disrupts perfect timing to donate; and (9) alternatives to wasting milk. Conclusions: Milk banks have a duty of care to both milk recipients and donors. While mothers who want to donate milk are disappointed by deferrals, clear communication protects their breastfeeding relationships with their own infants. Milk banks can improve their screening processes by providing information up-front and ensuring timely contact with mothers. Mothers can then make informed decisions about donating and not feel as if their milk and resources are "wasted."

Rage donations and mobilization: Understanding the effects of advocacy on collective giving responses.

Advocacy is intended to change people's attitudes and behavior. Yet the psychological and behavioral consequences of advocacy have rarely been considered. Across 3 experiments (combined N = 934) in the contexts of debates around racial discrimination and abortion, we investigated if and how exposure to advocacy can influence collective giving responses: self-reported willingness to make donations congruent with one's beliefs on the issue and actual giving behavior. Reading tweets from one's own side of a contentious debate sometimes indirectly mobilized collective giving responses by enhancing perceptions of efficacy and ensuring people empathized and identified with highlighted victim groups. Simultaneously, however, supporting advocacy sometimes inadvertently suppressed action by reducing anger and perceived injustice. Results therefore show that advocacy can simultaneously mobilize and demobilize support. However, effects were not found consistently across contexts and donation measures. Overall, mobilization pathways were stronger, especially on donation behavior and in the context of the abortion debate. Results suggest advocacy can work broadly as intended: by influencing the attitudes and behaviors of audience members. Online advocacy exposure in social media echo chambers may therefore be contributing to political polarization. Finally, results also demonstrate that charitable giving can be a form of collective action.

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.

A review of whole-blood donors' willingness, motives, barriers and interventions related to donating another substance of human origin.

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.

Simple Reciprocal Fairness Message to Enhance Non-Donor's Willingness to Donate Blood.

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.

Identifying Nonphysical Intimate Partner Violence in Relationships: The Role of Beliefs and Schemas.

While substantial research has been conducted on intimate partner violence (IPV), comparatively little research has examined peoples' perceptions of which behaviors comprise this form of abuse. Early identification of IPV is critical to ending abuse, however, forms of IPV that typically occur earlier in a relationship (e.g., nonphysical abuse) may not be core components of peoples' mental frameworks (schemas) of IPV and may therefore be less commonly identified as abusive. To explore this, in Study 1 participants from an Australian University (N = 86) separately described the relationships with IPV and nonphysical IPV. Analyses identified control, power imbalance, stereotypical gender dynamics (male perpetrator, female victim), physical abuse, and having a low socioeconomic status abuser as common components of participants' IPV schema when not prompted with type of abuse. However, participants largely failed to describe nonphysical IPV behaviors, suggesting limited awareness of the specific behaviors that constitute abuse. To explore this in Study 2, participants from an Australian University (N = 305) were asked to categorize a range of specific behaviors (including physically abusive, nonphysically abusive, and nonabusive behaviors) as definitely, maybe, or never abusive. Drawing on the known positive association between gender and romantic beliefs with the experience of abuse, we also assessed the relationship of identification of IPV behaviors to these beliefs. Moderated multilevel modeling showed that nonphysical IPV behaviors were generally perceived as less abusive than physical IPV behaviors. In addition, stronger endorsement of romantic jealousy was associated with evaluating nonphysical IPV as less abusive. However, romantic jealousy beliefs were not significantly associated with the perceived abusiveness of physical IPV behaviors. Findings support the conclusion that individuals' IPV schemas contribute to a failure to identify nonphysical IPV behaviors as abusive, and this is particularly true for people who more strongly endorse romantic jealousy.

Australian Perspectives on Opt-In and Opt-Out Consent Systems for Deceased Organ Donation.

Introduction: As many countries change to opt-out systems to address organ shortages, calls for similar reform in Australia persist. Community perspectives on consent systems for donation remain under-researched, therefore Australian perspectives on consent systems and their effectiveness in increasing donation rates were explored. Design: In this descriptive cross-sectional study, participants completed a survey presenting opt-in, soft opt-out, and hard opt-out systems, with corresponding descriptions. Participants chose the system they perceived as most effective and described their reasoning. Results: Participants (N = 509) designated soft opt-out as the most effective system (52.3%; hard opt-out 33.7%; opt-in 13.7%). Those who identified with an ethnic/cultural group or were not registered had greater odds of choosing opt-out. Six themes identified in thematic analysis reflected their reasoning: (1) who decides (individual, shared decision with family); (2) right to choose; (3) acceptability (ethics, fairness); and utility in overcoming barriers for (4) individuals (apathy, awareness, ease of donating, fear/avoidance of death); (5) family (easier family experience, family veto); (6) society (normalizing donation, donation as default, expanding donor pool). Choice and overcoming individual barriers were more frequently endorsed themes for opt-in and opt-out, respectively. Discussion: Results suggested the following insights regarding system effectiveness: uphold/prioritize individual's recorded donation decision above family wishes; involve family in decision making if no donation preference is recorded; retain a register enabling opt-in and opt-out for unequivocal decisions and promoting individual control; and maximize ease of registering. Future research should establish whether systems considered effective are also acceptable to the community to address organ shortages.

Willingness of blood donors in Australia to provide additional data and blood sample for health research.

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.

Improving the donation experience and reducing venipuncture pain by addressing fears among whole-blood and plasma donors.

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.

The Impact of Temporal Trajectories of Emotional Experience on Blood Donor Return.

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.

Intoxicated But Not Incapacitated: Are There Effective Methods to Assist Juries in Interpreting Evidence of Voluntary Complainant Intoxication in Cases of Rape?

Jurors often negatively evaluate complainants making allegations of rape when those complainants were intoxicated at the time of the assault. It is, therefore, essential that legal practitioners have effective methods of ensuring that jurors use evidence of intoxication for the legally permissible purpose, which is to determine the complainant's cognitive capacity to consent. This study examines whether providing judicial instructions about how jurors should make use of complainant intoxication evidence assists jurors to use this evidence appropriately. University students (N = 212) read a case synopsis of an Australian criminal trial in which the complainant described experiencing mild or moderate levels of cognitive impairment due to alcohol consumption. Participants were then given a standard instruction about using the evidence of the complainant's intoxication or one that provided an upper decision limit for determining complainant cognitive capacity (providing inference support). As expected, presenting evidence about the complainant's alcohol-impaired cognitive state attenuated participants' negative perceptions of the complainant. The judicial instructions also assisted participants as they evaluated a moderately intoxicated complainant as less capable of consenting when participants received an instruction that supported the correct inference to draw from the evidence compared to a standard instruction. However, parallel mediation analysis showed that rape schemas mediated the relationship between perceived complainant capacity to consent and perceptions of defendant guilt. Judicial instructions that support perceivers' inferences may assist participants to more appropriately evaluate information about complainants' intoxication, however problematically, rape schemas still influenced decisions about defendant guilt.

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

BACKGROUND AND OBJECTIVE: Recruiting and retaining male donors remain an ongoing challenge for blood collection agencies. Research suggests that interventions based on costly signalling theory that allows donors to unobtrusively but publicly signal their donor status may be effective. However, what functions as such a signal and how it is interpreted has not been determined. MATERIALS AND METHODS: A total of 242 Australian residents (127 female; 115 male) recruited through an online research platform rated their perceptions of a male target wearing (a) no bandage, (b) a regular unmarked bandage or (c) a blood donor branded bandage. RESULTS: The target wearing a blood donor branded bandage was rated as significantly more generous by female participants and moral compared to both the target who wore no bandage and the target wearing a regular unmarked bandage. The target wearing the unmarked bandage was perceived as significantly less healthy and competent compared to the target not wearing a bandage. CONCLUSION: A public signal of public donor status conveys the generosity and morality of the wearer. The bandage applied to donors after they have donated can act as such an effective signal, but only when these bandages are clearly branded as resulting from donating blood.

Gone, but haven't forgotten: insights on plasmapheresis donation from lapsed donors.

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.

Motivators of and barriers to becoming a COVID-19 convalescent plasma donor: A survey study.

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.