Factors that contribute to blood donation behavior among primary healthcare users: A structural approach.

This study aimed to evaluate the relative contribution of psychosocial variables to donation behavior in a sample of primary healthcare users in a Brazilian municipality. Donor recruitment and retention continue to pose significant challenges to blood collection services worldwide and is especially important among low and middle income countries (LMICs), challenged with higher rates of stigma and low public awareness about donation. A cross-sectional study with randomized stratified sampling of 1055 primary healthcare users was conducted across 12 healthcare facilities in Ribeirão Preto, state of São Paulo. Participants completed measures assessing psychosocial variables, including religiosity, knowledge regarding blood donation process, overall quality of life, blood donation of peers, sociodemographic variables, and the fear of blood, injections, and fainting. The associations between psychosocial variables and donation behaviour was examined using structural equation modelling. Blood donation was more frequent in males and among individuals with higher socioeconomic and educational levels. The structural model indicated associations between blood donation behaviour and fear, knowledge, age, sex, socioeconomic status, and educational level. Fear of blood, injections and vasovagal reactions, and a lack of knowledge of the donation process were revealed as important barriers to the decision to donate blood. In addition, there is evidence that considering the population of primary healthcare users, the women, the youngers, and those with lower socioeconomic status and lower educational level are less likely to donate blood.

Comparison of the demographic and social profile of blood donors and nondonors in Brazil.

Population-based studies on blood donation prevalence and its association with sociodemographic and behavioural factors are scarce, but remain the best approach to assess correlates of donation, including those which could be the target for donor recruitment campaigns. This study describes the population of primary healthcare users from the public system in a medium-sized Brazilian municipality to investigate the association of blood donation practice with other sociodemographic factors. A stratified, representative sample of primary healthcare users at 12 healthcare facilities in Ribeirão Preto, São Paulo, Brazil, were invited to participate. Analysis focused on demographic and psychosocial factors including, sex, age, marital status, socioeconomic status, educational level, health insurance, self-perception of health, religious beliefs, and blood donation history. Blood donors, self-defined ineligible donors, and never donors were compared. Multiple correspondence analysis (MCA) was used to assess positively and negatively associated variables in the dataset. MCA was conducted on respondents' age and monthly household income to assess dimensionality of other questionnaire responses. Of a total of 1,055 study participants, 79.7% were females and the mean age was 40.6 years. Blood donation practice was reported by 246 participants (23.3%), 669 (63.4%) had never donated, and 140 (13.3%) reported being unable to donate blood. Graphical presentation of the MCA showed that male, older age groups, those who have health insurance, and with higher socioeconomic and educational level are more likely to donate blood. Poor or average self-perception of health, lower socioeconomic status, and divorced or widowed marital status were associated with self-defined inability to donate blood. Thus, our results are useful to understand the multifactorial nature of blood donation behaviour. Our findings provide guidance for targeted recruitment campaigns focused on relevant contextual factors. The focus on reducing barriers to blood donation according to sociodemographic groups can be a relevant strategy to expand the donor base.

General Oral Health Assessment Index: A new evaluation proposal.

OBJECTIVES: To validity the General Oral Health Assessment Index (GOHAI) among adults who sought dental care and to present a new proposal for calculating scores on self-perception of oral health. BACKGROUND: There is no study that presents a GOHAI scores using weight of the items. MATERIALS AND METHODS: The one-factor model, the three-factor model (physical function, psychosocial/psychological function and pain/discomfort) and the second-order hierarchical model (SOHM) were evaluated from confirmatory factor analysis (λ, χ2 /df, CFI,GFI and RMSEA). The reliability (CR,α) was estimated. Concurrent validity was assessed using the Oral Health Impact Profile (OHIP-14). The invariance of the models was estimated in independent samples. The calculation of an overall score using the factor scores was proposed to obtain the overall weighted scores. These overall weighted scores were compared to the scores estimated as the simple arithmetic mean (overall unweighted scores) using a repeated measures analysis of variance. RESULTS: A total of 1000 individuals participated (74.1% female; age: 40.7 (SD=14.3) years). Three items of the GOHAI were excluded (λ<0.40). The one-factor model (λ=0.40-0.77; χ2 /df=6.291; CFI=0.947; GFI=0.960; RMSEA=0.073) and the three-factor model (λ=0.40-0.78; χ2 /df=8.321; CFI=0.932; GFI=0.954; RMSEA=0.086) each presented an adequate fit. Reliability was adequate (one-factor: CR=0.83/α=0.83; three-factor: CR=0.53-0.76/α=0.53-0.73), with the exception of the pain/discomfort factor. The GOHAI was invariant in independent samples, and the concurrent validity was adequate. The overall unweighted scores overestimated self-perceptions of oral health when compared with the weighted scores. CONCLUSION: Both the one-factor and three-factor models of the GOHAI were found to be valid, reliable and invariant for the sample after the exclusion of three items. The use of overall weighted scores is recommended for calculating the score of self-perception of oral health.