Negative experiences and donor return: an examination of the role of asking for something different.

BACKGROUND: Negative donation experiences, including vasovagal reactions, deter donor retention. However, whether this deterrence effect varies as a function of whole blood (WB) donation history and requests to donate the same or a different product remains unclear. STUDY DESIGN AND METHODS: The responses of 894 eligible WB donors who had been approached to convert to plasmapheresis and 954 eligible first-time plasmapheresis donors who had been surveyed on their last donation experience and their intention to donate plasma were considered. This information was matched with individual vasovagal reaction records, deferral category, WB donation history, and subsequent donation behavioral data obtained from the blood collection agency. RESULTS: Path analysis indicated that the application of a deferral and an officially recorded vasovagal reaction decreased donors' intentions to continue plasmapheresis donation, but had no effect on WB donors' intentions to convert to plasmapheresis. Consistent with past findings, vasovagal reactions occurred more frequently with female and inexperienced donors. CONCLUSION: Experiencing vasovagal reactions and deferrals may not universally deter donors from continuing to donate. Rather, the offer to convert to another form of donation-in this instance, plasmapheresis-after experiencing a negative donation event while donating WB may be sufficient to eliminate the deterrence effect on retention.

Asking for something different from our donors: factors influencing persuasion success.

BACKGROUND: Demand for plasma-derived products, and consequently plasmapheresis donors, continues to increase. This study aims to identify the factors that facilitate the persuasion success of conversations with whole blood (WB) donors to convert to plasmapheresis donation within a voluntary nonremunerated context. STUDY DESIGN AND METHODS: Surveys were sent to WB donors after a plasmapheresis conversion conversation with a blood collection agency (BCA) staff member: in center (Sample 1) or via a call center (Sample 2). Participants reported the number of donor-initiated and BCA-initiated conversations about plasma, experienced in the prior 12 months. Perceptions of the most recent conversation, donor oriented and conversion oriented, were also reported. The BCA provided WB donation history for the prior 5 years. Participants' intentions to make a first plasmapheresis donation were captured and any subsequent plasmapheresis donation was objectively recorded. RESULTS: Conversion rates were higher for in-center than call center-based conversations. For both samples, path analyses revealed that intentions are associated with conversion. Prior WB donations are negatively associated, while donor-initiated and donor-orientated conversations are positively associated with conversion intentions. Results for agent-initiated conversations and conversion-orientated conversations were mixed across samples. CONCLUSION: Converting suitable WB donors to plasmapheresis is best achieved early in the donor's career using face-to-face conversations with collection center staff. BCAs should facilitate donor-initiated conversations through promotional campaigns that encourage donors to approach staff. Conversations that focus on donors' needs and welfare more effectively encourage conversion intentions than those perceived as pushing the requirements of the BCA.

A systematic review and meta-analysis of antecedents of blood donation behavior and intentions.

This meta-analysis sought to identify the strongest antecedents of blood donation behavior and intentions. It synthesized the results of 24 predictive correlational studies of donation behavior and 37 studies of donation intentions. The antecedents were grouped into six research programs: (1) the Theory of Planned Behavior (TPB) and its extensions, (2) prosocial motivation, (3) affective expectations, (4) donor site experience, (5) past donation behavior, and (6) donor demographics. Antecedent categories were cross-validated by multiple coders, and combined effect sizes were analyzed using a random-effects model. For donation behavior, medium positive associations were found with five of the constructs from the extended TPB: intentions to donate, perceived behavioral control, attitude toward donation, self-efficacy and donor role identity. Other antecedents displaying a positive association with donation behavior included anticipated regret for not donating, number of past donations and donor age. Donor experiences at the collection site in the form of temporary deferral or adverse reactions had a medium negative association with behavior. For donation intentions, strong positive associations were observed for perceived behavioral control, attitude, self-efficacy, role identity and anticipated regret. Medium positive associations were observed for personal moral norm, subjective norm, satisfaction, and service quality. All other potential antecedents had weak or non-significant associations with behavior and intentions. Several of these associations were moderated by between-study differences, including donor experience, the period of data collection in which donation behavior was observed, and the use of a nominal (yes/no return) versus a ratio measure of donation behavior. Collectively, the results underscore the importance of enhancing donors' attitudes towards donation and building their perceived behavioral control and self-efficacy to donate. Further, minimizing the risk of adverse reactions and enacting re-recruitment policies for temporarily deferred donors will help protect future donation behavior. Implications of these findings for blood collection agencies and researchers are discussed.

Perceived deterrents to being a plasmapheresis donor in a voluntary, nonremunerated environment.

BACKGROUND: As demand for plasma-derived products increases internationally, maintaining a committed plasmapheresis panel membership is critical for blood collection agencies. This study addresses the current lack of knowledge regarding deterrents to the recruitment and retention of plasmapheresis donors in a voluntary nonremunerated environment. STUDY DESIGN AND METHODS: Nine focus groups (n = 84) and six individual interviews were conducted using semistructured schedules. Three focus groups were conducted with each category of eligible whole blood (WB) donors: those who had 1) declined to convert to plasmapheresis (DTC), 2) converted but lapsed to WB (LWB), and 3) converted and lapsed from the panel completely (LFP). Transcript analysis revealed distinct deterrent categories. RESULTS: The time required for plasmapheresis was a universally identified deterrent, with concerns of donation frequency expectations shared between DTC and LWB. LWB and LFP both reported excessive questioning and paperwork, and eligibility requirements as deterrents. Unique deterrents for DTC were a lack of accurate knowledge about safety and process. LWB reported concerns about plasmapheresis donation outcomes; however, they were more committed to continuing donation than LFP, who reported donation not being salient, being too busy, and poorer donation experiences. CONCLUSION: Providing information to address safety and health concerns should be the focus for successful conversion to plasmapheresis. Setting donation frequency expectations at levels to which donors are accustomed may improve evaluations of the cost/benefit ratio of conversion and retention. Involvement levels (i.e., importance, personal meaning of donation) may be the key differentiator between those donors who return to WB and those that lapse altogether.

A new perspective on the incentive-blood donation relationship: partnership, congruency, and affirmation of competence.

BACKGROUND: The Motivation Crowding-out Theory suggests that incentives undermine intrinsic motivation and thus blood donation behavior. While there is strong evidence showing the negative relationship between monetary incentives and blood donation, findings on the effect of nonmonetary incentives are mixed. Set in a voluntary, nonremunerated environment, this study explores aspects of the nonmonetary incentive-blood donation relationship not captured by the crowding-out hypothesis. STUDY DESIGN AND METHODS: In-depth interviews were conducted to explore donors' attitudes toward nonmonetary incentives currently used or considered by the Australian Red Cross Blood Service (Blood Service). Transcripts were analyzed using an inductive, thematic approach. RESULTS: Of the nonmonetary incentives examined (i.e., health screening tests, branded tokens, paid time off work, recognition of key milestones, and postdonation refreshments), none were found to crowd out intrinsic motivation, although not all were viewed favorably. Donors who viewed branded tokens negatively considered the cost implications for the Blood Service, while donors who responded positively considered the public benefit of tokens in raising the profile of the Blood Service. Other nonmonetary incentives-paid time off work, postdonation refreshments, and health screening tests-were viewed positively because donors perceived them to be congruent to the effort expended in donating blood. Finally, donors expressed a preference for private over public recognition when acknowledging significant contributions. CONCLUSION: When operating in a voluntary, nonremunerated environment, blood services should view donors as supply partners rather than customers, only consider nonmonetary incentives that are congruent with the act of donation, and provide private rather than public recognition of key milestones.

Donating blood: a meta-analytic review of self-reported motivators and deterrents.

Although research on blood donor motivation abounds, most studies have typically focused on small sets of variables, used different terminology to label equivalent constructs, and have not attempted to generalize findings beyond their individual settings. The current study sought to synthesize past findings into a unified taxonomy of blood donation drivers and deterrents and to estimate the prevalence of each factor across the worldwide population of donors and eligible nondonors. Primary studies were collected, and cross-validated categories of donation motivators and deterrents were developed. Proportions of first-time, repeat, lapsed, apheresis, and eligible nondonors endorsing each category were calculated. In terms of motivators, first-time and repeat donors most frequently cited convenience, prosocial motivation, and personal values; apheresis donors similarly cited the latter 2 motivators and money. Conversely, lapsed donors more often cited collection agency reputation, perceived need for donation, and marketing communication as motivators. In terms of deterrents, both donors and nondonors most frequently referred to low self-efficacy to donate, low involvement, inconvenience, absence of marketing communication, ineffective incentives, lack of knowledge about donating, negative service experiences, and fear. The integration of past findings has yielded a comprehensive taxonomy of factors influencing blood donation and has provided insight into the prevalence of each factor across multiple stages of donors' careers. Implications for collection agencies are discussed.

Understanding the plasmapheresis donor in a voluntary, nonremunerated environment.

BACKGROUND: Increasing demand for plasma-derived products presents a major recruitment and retention challenge for blood collection agencies; however, little is known about what motivates individuals to become committed plasmapheresis donors. This study explored triggers for individuals' first plasma donation and factors associated with continuing donations. STUDY DESIGN AND METHODS: A total of 103 plasma donors were recruited into 11 focus groups. Reasons for donating were discussed using a semistructured questioning approach. Transcripts were analyzed using a grounded theory approach. Categories of perceptions, beliefs, and attitudes were developed from the data, cross-validated, and when relevant, assigned to higher-order themes. RESULTS: Awareness of plasmapheresis was most often gained when donors were unable to donate whole blood. Accordingly, the main trigger for conversion to plasma donation was a personal request by collection staff. A key benefit of plasma donation was its increased frequency, which facilitated the establishment of a routine and relationship development with staff and donors, whereas the key reported sacrifice was the greater donation time. Disappointment was the main response to an inability to donate. Functional tokens and refreshments were valued by donors, although it was felt that money spent on tokens would be better invested in making operations more efficient. CONCLUSION: Suitable whole blood donors should be made aware of plasmapheresis and its associated benefits through collection staff. Sustained donation can be encouraged by the establishment of a regular schedule and positive interactions with collection staff and other donors to enhance the donors' subjective well-being.