A virtual reality paradigm simulating blood donation serves as a platform to test interventions to promote donation.

Effective interventions that support blood donor retention are needed. Yet, integrating an intervention into the time-pressed and operationally sensitive context of a blood donation center requires justification for disruptions to an optimized process. This research provides evidence that virtual reality (VR) paradigms can serve as a research environment in which interventions can be tested prior to being delivered in blood donation centers. Study 1 (N = 48) demonstrated that 360°-video VR blood donation environments elicit a similar profile of emotional experience to a live donor center. Presence and immersion were high, and cybersickness symptoms low. Study 2 (N = 134) was an experiment deploying the 360°-video VR environments to test the impact of an intervention on emotional experience and intentions to donate. Participants in the intervention condition who engaged in a suite of tasks drawn from the process model of emotion regulation (including attentional deployment, positive reappraisal, and response modulation) reported more positive emotion than participants in a control condition, which in turn increased intentions to donate blood. By showing the promise for benefitting donor experience via a relatively low-cost and low-resource methodology, this research supports the use of VR paradigms to trial interventions prior to deployment in operationally-context field settings.

Psychological therapies for depression in older adults residing in long-term care settings.

BACKGROUND: Depression is common amongst older people residing in long-term care (LTC) facilities. Currently, most residents treated for depression are prescribed antidepressant medications, despite the potential availability of psychological therapies that are suitable for older people and a preference amongst many older people for non-pharmacological treatment approaches. OBJECTIVES: To assess the effect of psychological therapies for depression in older people living in LTC settings, in comparison with treatment as usual, waiting list control, and non-specific attentional control; and to compare the effectiveness of different types of psychological therapies in this setting. SEARCH METHODS: We searched the Cochrane Common Mental Disorders Group Controlled Trials Register, CENTRAL, MEDLINE, Embase, five other databases, five grey literature sources, and two trial registers. We performed reference checking and citation searching, and contacted study authors to identify additional studies. The latest search was 31 October 2021. SELECTION CRITERIA: We included randomized controlled trials (RCTs) and cluster-RCTs of any type of psychological therapy for the treatment of depression in adults aged 65 years and over residing in a LTC facility. DATA COLLECTION AND ANALYSIS: Two review authors independently screened titles/abstracts and full-text manuscripts for inclusion. Two review authors independently performed data extraction and risk of bias assessments using the Cochrane RoB 1 tool. We contacted study authors for additional information where required. Primary outcomes were level of depressive symptomatology and treatment non-acceptability; secondary outcomes included depression remission, quality of life or psychological well-being, and level of anxious symptomatology. We used Review Manager 5 to conduct meta-analyses, using pairwise random-effects models. For continuous data, we calculated standardized mean differences and 95% confidence intervals (CIs), using endpoint data, and for dichotomous data, we used odds ratios and 95% CIs. We used GRADE to assess the certainty of the evidence. MAIN RESULTS: We included 19 RCTs with 873 participants; 16 parallel group RCTs and three cluster-RCTs. Most studies compared psychological therapy (typically including elements of cognitive behavioural therapy, behavioural therapy, reminiscence therapy, or a combination of these) to treatment as usual or to a condition controlling for the effects of attention. We found very low-certainty evidence that psychological therapies were more effective than non-therapy control conditions in reducing symptoms of depression, with a large effect size at end-of-intervention (SMD -1.04, 95% CI -1.49 to -0.58; 18 RCTs, 644 participants) and at short-term (up to three months) follow-up (SMD -1.03, 95% CI -1.49 to -0.56; 16 RCTs, 512 participants). In addition, very low-certainty evidence from a single study with 82 participants indicated that psychological therapy was associated with a greater reduction in the number of participants presenting with major depressive disorder compared to treatment as usual control, at end-of-intervention and short-term follow-up. However, given the limited data on the effect of psychological therapies on remission of major depressive disorder, caution is advised in interpreting this result. Participants receiving psychological therapy were more likely to drop out of the trial than participants receiving a non-therapy control (odds ratio 3.44, 95% CI 1.19 to 9.93), which may indicate higher treatment non-acceptability. However, analyses were restricted due to limited dropout case data and imprecise reporting, and the finding should be interpreted with caution. There was very low-certainty evidence that psychological therapy was more effective than non-therapy control conditions in improving quality of life and psychological well-being at short-term follow-up, with a medium effect size (SMD 0.51, 95% CI 0.19 to 0.82; 5 RCTs, 170 participants), but the effect size was small at postintervention (SMD 0.40, 95% CI -0.02 to 0.82; 6 RCTs, 195 participants). There was very low-certainty evidence of no effect of psychological therapy on anxiety symptoms postintervention (SMD -0.68, 95% CI -2.50 to 1.14; 2 RCTs, 115 participants), although results lacked precision, and there was insufficient data to determine short-term outcomes. AUTHORS' CONCLUSIONS: This systematic review suggests that cognitive behavioural therapy, behavioural therapy, and reminiscence therapy may reduce depressive symptoms compared with usual care for LTC residents, but the evidence is very uncertain. Psychological therapies may also improve quality of life and psychological well-being amongst depressed LTC residents in the short term, but may have no effect on symptoms of anxiety in depressed LTC residents, compared to control conditions. However, the evidence for these effects is very uncertain, limiting our confidence in the findings. The evidence could be strengthened by better reporting and higher-quality RCTs of psychological therapies in LTC, including trials with larger samples, reporting results separately for those with and without cognitive impairment and dementia, and longer-term outcomes to determine when effects wane.

The health impacts of blood donation: a systematic review of donor and non-donor perceptions.

BACKGROUND: The health and well-being of volunteer donors is of critical concern for blood collection agencies responsible for ensuring a stable supply of blood products. However, lay understandings of the impact of donating blood on health remain poorly understood. As lay perceptions are likely to influence critical decisions about donation, understanding these perceptions is key for informing evidence-based approaches to donor retention and recruitment. As such, we conducted a systematic review of the blood donation literature to identify donors' and non-donors' perceptions of the short and longer-term physiological health effects of whole-blood and/or blood product donation. MATERIALS AND METHODS: This review was conducted in line with PRISMA guidelines. Studies published from January 1995 to February 2021 were included. Perceptions were defined as both experiences and beliefs. Psychological effects were considered outside the scope of the review. RESULTS: A total of 247 studies were included. Most studies (89.5%) had donation-related health perceptions as a background rather than a central (10.5%) focus, and they were only assessed in relation to whole blood donation. More results focused on health-related beliefs than experiences (82 vs 18%), specific rather than general beliefs and experiences (80 vs 20%) and more frequently examined negative than positive beliefs and experiences (83 vs 17%). The most commonly studied and reported specific negative beliefs related to increased risk of infectious disease, reduced vitality, vasovagal reactions and low iron. Most studies examining specific negative beliefs were conducted in Asian countries. DISCUSSION: Findings reinforce that lay perspectives on how donation impacts health are under-researched, and it is difficult to know how important these are in informing critical decisions about donation for donors and non-donors. We suggest that further research with donation-related health beliefs and experiences as the central focus is needed to provide insights to inform communications with donors and the public.

Warming up cool cooperators.

Explaining why someone repeats high-cost cooperation towards non-reciprocating strangers is difficult. Warm glow offers an explanation. We argue that warm glow, as a mechanism to sustain long-term cooperation, cools off over time but can be warmed up with a simple intervention message. We tested our predictions in the context of repeat voluntary blood donation (high-cost helping of a non-reciprocating stranger) across 6 studies: a field-based experiment (n = 5,821) comparing warm-glow and impure-altruism messages; an implementation study comparing a 3-yr pre-implementation period among all first-time donors in Australia (N = 270,353) with a 2-yr post-implementation period (N = 170, 317); and 4 studies (n = 716, 1,124, 932, 1,592) exploring mechanisms. We show that there are relatively warm and cool cooperators, not cooling cooperators. Cooperation among cool cooperators is enhanced by a warm-glow-plus-identity message. Furthermore, the behavioural facilitation of future cooperation, by booking an appointment, is associated with being a warm cooperator. Societal implications are discussed.

Study protocol for ELders AT Ease (ELATE): a cluster randomised controlled trial of cognitive behaviour therapy to reduce depressive symptoms in aged care residents.

BACKGROUND: This protocol describes a study of the effectiveness of cognitive behaviour therapy (CBT) for reducing depressive symptoms in older adults living in residential aged care (RAC) facilities in Australia. Depressive symptoms are highly prevalent in this population, yet the benefits of CBT for reducing such symptoms in RAC facilities have not been widely investigated. Elders at Ease (ELATE) is a 16-session CBT intervention designed for implementation in RAC facilities. The intervention includes cognitive, behavioural and reminiscence strategies and is delivered by mental health trainees (MHTs) in collaboration with RAC facility staff and residents' family. METHODS AND ANALYSIS: ELATE will be evaluated using a cluster randomised trial comparing outcomes for residents who participate in the intervention with those living in usual care control facilities. The participants are RAC residents aged 65 years or above, with depressive symptoms (Patient Health Questionnaire-2 ≥ 3) and normal cognition or mild cognitive impairment (Standardised Mini Mental Status Examination ≥ 21). They are assessed at four time points: baseline prior to randomisation (T1), mid-treatment (T2; 2.5 months post randomisation), post-treatment (T3; 5 months post-randomisation) and 3-month follow-up (T4; 8 months post randomisation). The primary outcome is change in depressive symptoms between T1 and T3. Secondary outcomes are depressive symptoms at T4, anxiety, suicide ideation, sleep problems, quality of life, staff and family knowledge of late-life depression, stress levels and efficacy in caring for residents, and MHT levels of geropsychology competencies. Residents receiving the intervention are hypothesised to report a greater decrease in depressive symptoms between T1 and T3 compared to residents receiving usual care. The primary analysis is a regression, clustered over site to account for correlated readings, and independent variables are condition and depressive symptoms at T1. A cost-utility analysis is also undertaken. DISCUSSION: ELATE is a comprehensive CBT intervention for reducing depressive symptoms in RAC residents. It is designed to be implemented in collaboration with facility staff and residents' families, individually tailored to residents with normal cognition to mild cognitive impairment and delivered by trainee therapists. ELATE offers a model that may be widely applicable across the RAC sector. TRIAL REGISTRATION: Trial registered with the Australian and New Zealand Clinical Trial Registry (ANZCTR) Number ACTRN12619001037190, prospectively registered on 22 July 2019.

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.

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.

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.

"Please help us with important research": A retrospective analysis examining the impact of research invitation and participation on subsequent blood donor behavior.

BACKGROUND: As over-communication can negatively impact consumer behavior, it is important to understand the impact of research communication on donors' future donation behavior. The aim of this study was to determine the effect of (i) being invited to participate in research, and (ii) participating in that research, on future donation behavior. STUDY DESIGN AND METHODS: A retrospective cohort analysis was conducted with 36,418 donors who were invited to participate in one of 17 research projects, and a matched control group of 36,252 non-invited donors. Poisson regression models were used to examine the associations between invitation or participation in the studies and the likelihood of creating an appointment to donate and attending an appointment at 1, 3, and 6 months. RESULTS: Donors were significantly more likely to create an appointment within 14 days of receiving an invitation compared to controls (RR: 1.91, 95% CI 1.81-2.02), and to return to donate at 1 (RR:1.18, 95% CI 1.13-1.24), 3 (RR:1.10, 95% CI 1.07-1.13) and 6 (RR:1.11, 95% CI 1.09-1.13) months compared to non-invited controls. Donors who participated in the research were more likely to return than control donors at all time points, while donors who were invited but did not participate were also likely to return more at 1 month (RR:1.06, 95% CI 1.00-1.11) and 6 months (RR:1.03, 95% CI 1.00-1.5) than non-invited controls. DISCUSSION: Our findings suggest that research participation is positively associated with future donor behavior and provides reassurance that contacting donors for research does not negatively impact blood collections.

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.

Program to Enhance Adjustment to Residential Living (PEARL): Effect on Adjustment, Anxiety, Quality of Life, and Stress.

OBJECTIVES: The Program to Enhance Adjustment to Residential Living (PEARL) is a five session intervention primarily designed to address high rates of depression in newly admitted residents. This study reports the efficacy of PEARL on secondary outcomes of resident adjustment, symptoms of anxiety, quality of life, and stress. METHODS: A cluster randomized controlled trial was conducted with 219 newly admitted nursing home residents (M age = 85.5 years) from 42 nursing homes. Outcomes were assessed at baseline, post-intervention, and at two and six month post-intervention follow-up, compared to a standard care condition. RESULTS: There was a significant overall condition by time interaction for adjustment (p = .027) and quality of life (p = .015), but not for stress (p = .309). While the overall condition by time interaction was not significant for anxiety (p = .221), there was a significant interaction contrast six-month post-intervention, indicating a greater decrease in anxiety scores in the intervention group relative to control (p = .039). CONCLUSIONS: This study demonstrates the broad effects of PEARL on the wellbeing of newly admitted residents. CLINICAL IMPLICATIONS: PEARL is a brief intervention that may be feasible for routine use in nursing homes to facilitate adjustment and improve residents' quality of life.

Improving donor retention following a temporary deferral: A cluster randomized controlled trial of deferral educational materials.

BACKGROUND: Providing educational materials to deferred donors has been shown to increase their understanding about their deferral and knowledge about their return. The aim of this study was to determine the effectiveness of educational materials in increasing the retention of deferred donors. STUDY DESIGN AND METHODS: A three-arm cluster randomized controlled trial was conducted, with the following conditions: (a) Incenter Brochure plus Email; (b) Email Only; (c) Control. The Incenter Brochure plus Email condition also included a guided conversation led by staff at the point of deferral. Donors were followed up for 3 months after their deferral had ended to determine if they had attempted to donate. RESULTS: Compared with the Control condition, donors in the Incenter Brochure plus Email condition had increased odds of return at 3 months after their deferral ended (OR: 1.16; 95% CI 1.00-1.33). Subgroup analysis highlighted that novice (OR: 1.38; 95% CI 1.04-1.83) and established donors (OR: 1.36; 95% CI 1.13-1.64) had increased odds of return if they received the incenter materials. Donors who were deferred to maintain their well-being (OR: 1.28; 95% CI 1.03-1.60) and donors with a prior deferral history (OR: 1.55; 95% CI 1.15-1.55) had increased odds of return if they received the incenter materials. No significant differences were found between the Email Only and Control conditions. DISCUSSION: This trial demonstrates the benefits of providing onsite educational materials to donors at the point of deferral. This is a simple, effective strategy to increase the return behavior of donors within 3 months of their deferral ending.

Designing and testing an ethnic-ancestry question for Australian blood donors: Acceptability, feasibility, and understanding.

OBJECTIVES: We aimed to evaluate the acceptability, feasibility, and understanding of a donor ethnic-ancestry question with Australian blood donors. BACKGROUND: Ethnic-ancestry assists blood collection agencies to meet the demand for rare blood-types. However, there is no standard ethnicity question used by health/blood services around the world and we do not know how blood donors in Australia will respond to being asked for this information. METHODS/MATERIALS: A survey and ethnic-ancestry question was administered to a sample of donors (n = 506) to evaluate their views on being asked for their ethnic-ancestry, test a comprehensive ethnic-ancestry list, and determine the level of information required by donors. RESULTS: Donors reported being very comfortable providing their ethnic-ancestry and the majority of donors found an ethnic-ancestry option they were happy with (91.3%). Overall donors reported a high level of understanding of why ethnic-ancestry was important to blood donation. However, when provided more information on why ethnic-ancestry is required, donors reported increased understanding. CONCLUSION: The findings from this study demonstrated that it is acceptable and feasible to introduce a comprehensive ethnic-ancestry question for Australian blood donors. We also found that a greater understanding is achieved when a more comprehensive explanation for inclusion of the question is provided.

Trajectory and Predictors of Mental Health Symptoms and Wellbeing in Newly Admitted Nursing Home Residents.

OBJECTIVES: This study determined changes in multiple aspects of mental health and wellbeing in newly admitted nursing home residents, and identified risk and protective factors. METHODS: Participants were 204 residents recently admitted to one of 42 nursing homes in Melbourne, Australia. A subgroup of 82 participants were followed up eight months post-admission. Depression, anxiety, stress, adjustment, and quality of life were assessed at baseline and follow-up. Predictive factors (demographics, health, transition factors, nursing home characteristics) were examined in multiple regression analyses. RESULTS: Rates of depression and anxiety were high at both baseline and follow-up. Low self-rated health and medical comorbidity predicted poor wellbeing at baseline. Higher perceived control in the relocation to the nursing home and engagement in meaningful activities were associated with better post-admission outcomes. Baseline psychotropic medication use predicted lower anxiety at follow-up but did not impact depressive symptoms. CONCLUSIONS: There were no significant changes in mental health and wellbeing from one to eight months post-admission. The negative effect of residing in a for-profit nursing home requires further investigation. CLINICAL IMPLICATIONS: Individual activity scheduling and an opportunity to participate in relocation decision-making and planning may support resident wellbeing post-admission.

Facilitating Staff Adoption of New Policies and Procedures in Aged Care Through Training for Readiness for Change.

This study examined whether training staff in preparation for organizational changes, such as the implementation of new practices, can increase levels of change readiness in residential aged care. Four aspects of organizational readiness were compared across time and between training and control conditions. Participants (n = 129) were employed in eight residential aged care facilities in Australia. Survey data were collected at four time-points: preintervention and three postintervention time-points. The two conditions (training and control) differed significantly from one another on the subscales of appropriateness, personal valence, and efficacy postintervention but not at preintervention. The finding of support diminishing at 6 month and 12 months following the intervention for the training group was unexpected. The findings suggest that within aged care facilities, training in change processes may enhance an organization's readiness for change, and booster training may be needed to help to sustain all aspects of change readiness over time.

Assessing Residents' Perceptions of Their Relocation to Long-Term Care: Psychometric Validation of the View of Relocation Scale.

OBJECTIVES: Relocation to long-term care is a major challenge for older people. The View of Relocation Scale (VRS) was developed to address the need for a brief instrument to assess residents' perceptions of the relocation. DESIGN: Secondary analysis of data collected in a cluster randomized trial. The psychometric properties of the VRS examined in this study included factorial structure (using exploratory factor analysis), unidimensionality (Rasch modeling), internal consistency reliability (Kuder-Richardson Formula 20, squared multiple correlations, and item-total correlations), and known groups validity (analysis of variance). The results were used to identify the psychometrically most robust items for inclusion into the final version of the instrument. SETTING AND PARTICIPANTS: Participants were 202 long-term care residents in Melbourne, Australia (mean age = 85.52 years, standard deviation = 7.33), who had relocated to the facility a mean of 4.4 weeks previously. Residents with moderately severe and severe dementia were excluded. MEASURES: The VRS was developed following a review of the literature describing residents' views of relocation and was designed for administration shortly after their relocation. RESULTS: There was support for a 2-factor, 10-item solution, with separate subscales assessing Perceived Control (degree of control in the decision making and planning for the relocation) and Perceived Need (perceived need for the relocation to long-term care). Participants who were admitted directly from hospital reported higher perceived need but lower perceived control than those admitted to the facility from home. CONCLUSION AND IMPLICATIONS: The VRS can be used to understand the impact of older people's perceptions of relocation to long-term care on their subsequent adjustment and well-being, and to identify those who may benefit from tailored support.

Views of Greenery and Psychological Well-Being in Residential Aged Care Facilities: Longitudinal Associations.

OBJECTIVES: This study examined associations of objectively measured views of greenery in residential aged care facilities (RACFs) with changes in multiple psychological well-being measures among residents who were newly admitted to RACFs. METHODS: Data were collected from 52 residents (mean age: 84, 73% women) of 13 RACFs, located in Melbourne, Australia. The outcomes were changes in depression, stress, anxiety, and quality of life (QoL) between baseline and 8-week follow-up. The exposure measures were the amount and presence of greenery visible from participant's bedroom and common areas (lounge, dining). Greenery was categorized as being either within or beyond the RACF perimeter. RESULTS: Regression analyses found that greenery visible from participant's bedroom was not associated with any outcomes. The amount of greenery visible from common areas within the RACF perimeter was adversely related to stress, unexpectedly: Each additional 1 m2 of greenery was associated with a greater increase in stress (b = 0.05; 95% CI [0.07, 0.94]). However, greenery visible from common areas beyond the perimeter contributed favorably to stress and QoL. The presence of such greenery was associated with a lower increase in stress (b = -3.99; 95% CI [-7.75, -0.23]; reference: no greenery), and a 1 m2 increment was associated with a greater increase in QoL (b = 0.07; 95% CI [0.02, 0.11]). CONCLUSION: Views of greenery outside of the RACF from lounge and dining areas may be protective against residents' stress increase and improve their QoL. Locating residents in areas with such outdoor views may prevent their psychological condition from worsening.

Visits to general practitioners after iron-related deferrals from blood donation in middle-aged and older Australian blood donors.

BACKGROUND: Australian Red Cross Lifeblood (Lifeblood) advises donors to visit their general practitioner (GP) for medical follow-up if they are deferred from donating due to having a lower than acceptable level of hemoglobin (Hb) and/or serum ferritin (iron-related deferrals). METHODS: We used the Sax Institute's 45 and Up Study data linked to Lifeblood's donor datasets and other health administrative datasets. We examined the rate of visits to a GP after iron-related deferral from donation, and investigated whether an early visit to a GP (within 30 days following the deferral) had an impact on return to make successful donation within 12, 18, and 24 months compared to a delayed or no GP visit. RESULTS: A total of 1928 donors underwent iron-related deferral. The rate of visits to a GP in the first month after deferral was double the rate observed a month prior. However, only 52.4% of those deferred visited a GP early with slightly more than half of those receiving an iron-monitoring test. Return to donate over the 24 months was lower in donors visiting their GP early (adjusted Hazard Ratio [aHR] 0.86, 95% CI 0.77-0.97). Early GP visitors were likely to have a relatively poorer health than the delayed or no GP visit group. CONCLUSIONS: Only half of the donors with an iron-related deferral followed advice from Lifeblood and visited their GP within 30 days of deferral, and these donors have a significantly reduced likelihood of future successful blood donation which may be due to their relatively poorer health status.

Notifying donors when their deferral is ending: An effective donor retention strategy.

BACKGROUND: The application of a temporary deferral often leads to donor lapse. Contributing factors may be donors not knowing when their deferral ends or not being contacted and asked to return. The aim of this study was to determine the effectiveness of a reminder message notifying donors that their deferral is coming to an end in increasing donors' postdeferral return rates. We evaluated the optimal time, content, and mode of delivery of the reminder message. STUDY DESIGN AND METHODS: Two studies were conducted with deferred donors. Study 1: donors (n = 1676) were randomized to be sent a reminder message at one of three time points (4 weeks before, 1 week before, and 1 week after their deferral ended) or to a no contact control condition. Study 2: donors (n = 1973) were randomized to three message type conditions (emotive email, nonemotive email, nonemotive SMS). Attempted return behavior was extracted (appointments, attendances) at 1 month. RESULTS: In Study 1, being sent the reminder message increased odds of donors attempting to return within 3 months compared with the control group (OR:2.01). Sending the reminder 1 week before the deferral ended was the most effective time point. In Study 2, the nonemotive message increased the odds of attempting to return compared with the emotive message (OR:1.38). No differences were found between email and SMS messages. DISCUSSION: Sending a reminder message to donors when their deferral is coming to an end is a simple, effective, and cost-effective method to retain donors.