Further details on the write–up (& grading) of your survey .docx

Further details on the write–up (& grading) of your survey:
1) First lay out what are your research objectives and
hypotheses to be
tested by your survey. This section will discuss what the goals
of your
survey are. These can come from any source, your reading of
the
background material, the secondary data, the class discussion,
the
focus groups findings or even your own ideas. You should
include
some discussion of how you settled on what objectives and/or
hypotheses to explore and what actions your results might lead
to for
the ARCBS.
2) Next discuss what specific aspects (constructs) you are going
to need
to measure to be able to address your objectives and hypotheses
above. For example: “To explore our hypothesis concerning the
role of
acculturation in predicting blood donation, we will need to
measure the
respondent’s acculturation and sense of acceptance into
Australia
mainstream culture, respondent background (including ethnic
background, language proficiency, years in Australia), along

with their
likelihood of donating blood in Australia.” Aspect can be
broadly
defined and might include attitudes, perceptions, motivations,
barriers
to action, behavioural intentions, past behaviours, and
demographics.
The idea is to make explicit what things you need to measure
and to
make clear how they relate to your objectives.
3) Next present your actual measures and discuss how they align
with the
aspects you need to measure. You will want to discuss what
they
capture and why you designed the measures the way you did.
This is
where you demonstrate that you did not just write the first thing
that
came to you but thought about how it should be constructed to
get you
the most information. Your chance to give the rationale for
your
scaling decisions.
4) Finally discuss the limitations of your survey. You might
always want to
discuss the limitations of using surveys to meet the objectives
you set
forth. This section should discuss what you would do
differently, if you
had more resources (e.g., research experience, time, money,
people).
The goal of this section is to demonstrate that you understand
the
issues that concern the use of this research technique for

addressing
this problem.
Nuts and Bolts:
1) You need to turn in a hardcopy of your report in class (week
6) and
submit a softcopy on BB.
2) Your “actual” survey should be placed in the appendix
section of the
write-up.
3) The report should involve at least 4 pages of text (not
including the
survey itself or any appendices). You won’t be able to do a
good
job on all of the above in less space than that. The 6 page upper
limit is a soft limit; meaning you can go somewhat beyond this
limit
without grading penalty. But remember the more you write, the
more contribution and insight the grader will expect to see. If
you
are above 8 pages of text you should look to tighten your
discussion.
wuyingrui
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4) Report should be professionally presented with standard
formatting
(e.g. font 12, 1.5 spacing, 2.5cm/1 inch margin throughout etc.).
Please use Harvard referencing in your report.

5) Students are NOT required to generate a live copy of their
survey
(i.e., a web copy).
1. What is your gender?
[ ] Male [ ] Female
2. How old are you? ………………..
3. What is your highest level of education?
[ ]High school
[ ]College graduate
[ ]Post-graduate
4.What is your nationality?
[ ] Australian
[ ] Non-Australian
5. What is your relationship status?
[ ] Single
[ ] Married
[ ] Divorced
[ ] Widowed
6. Which of the following qualification suits the number of
time you have participated in blood donations?
[ ] Never
[ ] First-time donor
[ ] Repeated donor
[ ] Multigallon donor
7. To what degree does/do the following factor/factors
impact your blood donation decision rank from 0-10
[ ]fear of pin
[ ]fear of impact of health condition
[ ]fear of epidemic
[ ]never asked to donate
[ ]Apathy
other factors:
8. To what degree does/do the following factor/factors
encourage you to donate blood.

self-esteem
potential needs in the future (for one’s own and family
memebers)
physical rewards
demand from people who need blood
9. In what kinds of channels did you learn the knowledge of
blood donation?
(1) TV (2) ARCBS website (3) Radio (4) Poster (5) hearsay
(6)Nonofficial website (7) __________
10. do you think the knowledge you learn help you eliminate the
concerns for donating blood? 0-------10
11. Despite of the negative factors, are you willing to donate
blood if you knew someone can be saved by your blood? ［］
yes [ ]no [ ] not sure
12. Do you think regular presentation held in communities can
help to encourage people to donate blood? [ ] yes [ ] no [ ]
maybe
13. is there anything you want to comment regard of blood
donation, ARCBS, etc.
Term Project
Stage 1: Marketing Research Planning and Execution (20%)

This year’s term project will focus on understanding people’s
perceptions and
attitudes towards blood donation, and how to broaden the blood
donor base of
the Australian Red Cross Blood Service (ARCBS).
In Australia (like most countries), only a very small percentage
(around 2-3%)
of the eligible population donates blood. And the demographics
of those who
donate don’t tend to be very representative of the general
population. The
typical Australia blood donor tends to be a relatively wealthy,
middle aged,
white-Australian. As the demographics of Australia’s major
population centres
are shifting, the ARCBS wants to broaden its base by finding
out more about
why people don’t donate, especially those who don’t fit the
typical profile.
Toward this end, the first half of the course we will collect
some primary data by
survey to help answer this question. The second half of the
course will focus on
quantitatively analysing the data we acquire. Students will form
groups of 3-4.
The Internet is an amazing tool for learning more about issues
and best practice
for a wide array of techniques. Some preliminary research
online concerning
recommended practices for your technique will significantly
increase the quality
of your research. All students should read the background

article concerning
blood donation and familiarise themselves with slides about the
Australian Red
Cross Blood Service that are posted on Blackboard.
Stage 1:
Survey Development: A survey involves asking a set of well
designed
questions to a representative sample of people. The goal of the
survey is
to test the ideas/hypotheses that arose from the earlier steps
(e.g.
secondary data and group interviews) and to get quantitative
data so we
can more reliably answer our questions. In this project, we will
likely be
addressing issues such as reasons non-donors don’t donate and
possible
ways to increase their likelihood to donate. Again, we will
probably want
to focus on things that might differentially affect groups unlike
the typical
donor population that are well represented in our class (e.g.
young
people, new Australians, foreign residents).
Please note: The survey data will be collected using an online
survey
during week 8. Students will be sent an email with a link when
the survey
is ready to complete, they will have 72 hours to complete it. All
students

in the class will be required to complete the survey. Otherwise,
you will
lose one class participation point (10 points in total).
Each group will need to submit both a written report and a copy
of their
survey questions in week 6. The write-up will include a
discussion of what
topics the group decided to include, how they made those
decisions, the
questions they developed, the rationale for the questions and
how those
questions will get at the topics they chose to cover. You might
also want
to include what topics/issues were considered but not included
and why.
The write-up should include a discussion of what questions their
survey
should be able to answer and what actions they might be able to
recommend based on answers. You should also discuss the
weakness of
your survey and sampling plan (and survey research, in general)
and
what you could or would do it differently, if you had more
resources (e.g.
research experience, time, money, and people). Finally, include
a brief
discussion of what you learned from the experience and how
you would do
it differently now that you have tried it once.
The write-up is due Monday 10 April by 2pm (week 6). You
should submit

it electronically via BB before the due date/time. And you
should also
bring a hard copy to the class. You will be required to present
informally
in class. This will be a major driver of the class discussion that
day. This
hard copy will be turned in at the end of the class. The report
will involve
approximately 4-6 pages of text (not including the survey
questions
themselves).
Survey critique:
All students will be assigned one of the surveys developed by
the student
groups to critique. A survey critique form will be posted on
Blackboard.
Reviewers should read the group’s project report and then offer
a critical
assessment of the survey they created based on the discussion of
questionnaire design presented within the course and the
rationale they
include in their report. Your critique will need to be submitted
via
Blackboard by Thursday 13 April 4pm (week 7). Otherwise, you
will lose
one class participation point (10 points in total).
B l o o d D o n o r s a n d F a c t o r s I m p a c t i n g the B l
o o d
D o n a t i o n D e c i s i o n

Theresa W. Gillespie and Christopher D. Hillyer
The aging of the US population and the evidence that
only about 5 % of individuals in the United States donate
blood each year raise concerns about the assurance of
an adequate, safe supply of blood in the future. Blood
donation decision making has been investigated world-
wide for decades to understand the process better to
increase donation efficiency, safety, retention, collection
numbers, and diversity of the donor pool. This review
focuses on the characteristics of allogeneic blood do-
nors, the motivational sources in donor decision mak-
ing, and the research concepts and techniques used to
examine these factors. Some historic studies consid-
ered pivotal, as well as more recent surveys, may not be
pertinent to or representative of the current national
donor pool. Interpretation of data related to donor char-
acteristics should examine whether demographics mir-
ror the donor pool to assist in targeted recruitment or if
targeted recruitment actually leads to the reported de-
mographics. Few recent studies of donor motivation
have been published. Modern sources of positive and
negative motivation are worth exploring through scien-
tifically sound investigations involving representative
cohorts using multifactorial approaches. Strategies that
focus on retaining return donors and transforming first-
time donors into repeaters would be beneficial. Investi-
gations are needed also to assess research questions
and to develop well-designed interventions to test hy-
potheses and to produce generalizable findings applica-
ble to future donor decision making.
Copyright 2002, Elsevier Science (USA). All rights re-
served.

U "NIQUE AMONG the armamentarium of widespread medical
interventions, the avail-
ability of blood transfusion depends totally on a
volunteer donor base. With the aging of the US
population and the predicted doubling of the pro-
portion that is over age 65 by the year 2030, the
assurance of an adequate, safe supply of blood in
the future is an area of considerable concern. 1,2
Although close to half of the general population
has reported giving blood at some time, only about
5% of individuals in the United States donate
blood each y e a r ) Donor trends have fluctuated
over the past 30 years, 4 with a notable decline of
9.3% in the rates of blood collection from 1989 to
1994. 5 Unpublished data (M. Sullivan, oral com-
munication, August 2001) suggests that this trend
may not be continuing. Still, the number of first- /
time donors in some regions of the country has
diminished significantly, 6 with overall reductions
reported as close to 7% in the 1990s. Reduced
collection rates, in part representing the aging do-
nor pool and a decrease in the number of eligible
donors because of enhanced screening for transfu-
sion-transmitted diseases, have resulted in an esti-
mated loss of approximately one-half million do-
nors per year. v With recent data reporting fewer
collections concomitantly with greater blood use,
significant deficits in the blood supply are pro-
jected for the near future, s Furthermore, required
or voluntary restrictions on donors that relate to
potential or known emerging infectious agents (eg,
babesia, trypanosomes, or prions) will have an
additive effect on donor loss, with new restrictions
for variant Creutzfeldt-Jacob disease (as of Sep-
tember 2001) decreasing the available blood do-

nors by an estimated 7% to 11%.
Thus, although data differ as to whether a sup-
ply-utilization disequilibrium exists whether sup-
ply has driven demand, or whether a significant
increase in supply would lead to further changes in
use, allogeneic blood donation has been investi-
gated worldwide for decades. The intention of
these studies has been to understand the process
better to increase donation efficiency, safety, reten-
tion, and diversity of the donor pool, as well as the
number of new and total donations collected. It is
known that efforts at recruitment of an expanded,
consistent donor pool have not been widely suc-
cessful, and many centers have reported declines in
new donors despite significant growth in program
funding for recruiting such donors. 9 Finally, it ap-
From the Winship Cancer Institute and the Department o f
Pathology and Laboratory Medicine, Emory University, At-
lanta, GA.
Supported in part by a grant from the National Blood Foun-
dation.
Address reprint requests to Theresa W. Gillespie, PhD, Win-
ship Cancer Institute, Ernory University, 1365B Clifton Road,
NE, Atlanta, GA 30322.
Copyright 2002, Elsevier Science (USA). All rights reserved.
0887- 7963/02/1602-0004535. 00/0
doi: l O. 1053/tmrv.2002.31461
Transfusion Medicine Reviews, Vol 16, No 2 (April), 2002: pp
115-130 115

116 GILLESPIE A N D HILLYER
pears that in general the vast majority of donors are
repeat donors who represent a small but committed
group o f individuals responsible for donating most
of the blood in the United States and other coun-
tries. This review will focus on characteristics per-
tinent to allogeneic blood donors, motivational
sources in donor decision making, and research
concepts and techniques used to examine these
factors.
CHARACTERISTICS OF ALLOGENEIC BLOOD
DONORS
General Demographic and Personal
Characteristics
T h e o r e t i c a l l y , i f d o n o r s can b e p r o f i l e d in
t e r m s
o f their personal characteristics, then potentially
their behavior can be predicted and individuals
selected who are more likely to become or remain
as donors. 1~ A variety of donor characteristics re-
ported in the literature are compiled in Table 1.
A comprehensive study investigating blood do-
nors and t h e i r d e c i s i o n m a k i n g w a s c o n d u c t e
d b y
D r a k e and c o l l e a g u e s ~ as p a r t o f a 5 - y e a r ,
Na-
t i o n a l Institute o f H e a l t h - f u n d e d p r o j e c t o f
b l o o d

b a n k i n g in the U n i t e d States. l 1 T h e s e d a t a f r o
m the
1970s r e v e a l e d that the a v e r a g e d o n o r was a m i d
-
d l e - a g e d w h i t e man, the m o s t p r e f e r r e d site to
g i v e
b l o o d was a l o c a l h o s p i t a l , and the m a j o r i t y o
f
i n d i v i d u a l s s u r v e y e d o p p o s e d p a i d d o n a t
i o n s . Os-
w a l t ' s 1977 r e v i e w 12 o f the b l o o d d o n o r l i t e
r a t u r e
d e s c r i b e d the " t y p i c a l " d o n o r as a w h i t e m a
n r e p -
r e s e n t i n g an o r g a n i z e d g r o u p w h o t e n d e d
to be a
r e p e a t d o n o r and w h o g a v e at a m o b i l e u n i t
in the
c o m m u n i t y in w h i c h he r e s i d e d . M o r e r e c e n
t d a t a
p r o f i l e d o n o r s as m a r r i e d ~3 with 1 o r m o r e c
h i l d r e n
and w h o o f t e n h a v e a " r a r e r " b l o o d t y p e than
nondonors.14,15
Gender
A l t h o u g h m o s t d o n o r s w e r e r e p o r t e d as b e
i n g
m e n in the 1970s and 1980S, 12,16 i n c r e a s e s in the
n u m b e r o f w o m e n d o n o r s w e r e d e s c r i b e d
in the
Table 1. Donor Characteristics
Donor Characteristics Reference (% Cited, Specifics of

Variable)
General
Gender
Age
Race
Married
Educational level
First-time donors
Repeat donors
Multigallon donors
Elderly donors
18 (40%-50% general population at 1 point)
3 (4%-6% US population/yr, 8%-9% of eligible population)
14 (male, married, have children, higher education, rarer blood
type)
13 (80% men)
12 (majority men)
50 (47%-64% w o m e n , mean - 54%, increase trend in 1990s)
15 (increased drop out a m o n g w o m e n after 4-8
donations)
13 (28%, ages 20-29; 29%, ages 30-39; 25%, ages 40-49; 17%,

ages 50-59)
18, 17 (mean = 33-38)
26 (mean = 38)
13 (10% nonwhite)
19 (74% white, first-time donor)
13 (57%)
30 (62%)
19 (41% --- high school, 28% graduated college, 28% > college)
13 (19% total)
19 (52% men, 74% white, age: 28% -< 19 yr, 27% - 20-29 yr,
22% = 30-39 yr, 14% = 40-49 yr, 8% ->
50 yr)
50 (58% women)
6 (64% < 35 yr, 52% men, 88% US born, 32% > college
education)
24 (dropout rate: 89% w o m e n , 63% men)
15 (78%-91% of all current donors, w o m e n have major
dropout rate after 4-8 donations)
31 (81%)
19 (43% = Rh negative, 43% return rate if > 50 yr)
9 (become repeater if return within 2 y r of first time, % return
increases with age, and no. of previous
donations)
19 (highest repeat rate if return ~< 6 mos after first donation)

26 (mean age = 52 yr, mainly white, male, college grad)
50 (30% women)
23 (mean age = 68 yr, 91.4% white, 6% Hispanic, most married,
well educated with higher education)
BLOOD DONATION DECISION 117
1990s. In 1 study, women comprised 47% to 64%
of all donors, representing an average of 54%. A
recent evaluation of over 900,000 first-time donors
showed that women constituted 47.6% of this co-
hort, 6 a substantial increase in proportion of the
donor base from 2 or 3 decades earlier.
Age
Trends in donor age vary with the populations
assessed and the types of donors represented. In
1965, 47% of all donors were 20 to 39 years old; 13
in 1975, the average age was 33 to 38 years. L7,~8
This age range remained consistent through the
1990s, with 63.6% of all first-time donors for the
period of 1991 to 1996 reported as being less than
35 years old. 6
Race and Place o f Birth
Although only 10% of the donor pool was re-
ported as nonwhite in 1965,13 that number had
grown to 26% for the period of 1991 to 199579
Results of a 1991 to 1996 survey of 5 major donor
centers participating in the Retrovirus Epidemiol-

ogy Donor Study (REDS) indicated significant
changes in the race and ethnicity of first-time do-
nors, with decreases in the number of white donors
in all regions and increases in minority donors,
particularly Hispanic. 6 Wu and colleagues 6 pre-
dicted that by 2005 Hispanics will outnumber other
ethnic groups as the largest minority donor constit-
uency in the country. In their study, the percent o f
non-US-born donors overall was 12%, reflecting
an increase in this group in several regions of the
country.
Education and Socioeconomic Status
Recent data showed that approximately one
third of first-time donors had a college or graduate
degree, 6 with 45% of repeat donors having at least
a college education. 19 Higher educational status
correlated with income level of donors, which was
reported by a survey of 15 blood centers to be
about 30% higher than the average income of
nondonors. 2o
Similar characteristics have been identified for
donors in countries other than the United States. 2~
In a 1994 study of over 800 randomly selected
donors in Greece between 18 and 65 years of age,
stepwise multiple regression analysis revealed that
blood donation correlated with gender, occupation,
and knowledge level. The "standard" donor in this
setting was a man, either a student or member o f
the military, and had higher levels of knowledge
about blood donation and needs for blood. 22
Elderly Donors

In anticipating the aging of the US population,
Simon and associates 23 conducted a randomized,
controlled trial of routine blood donation in elderly
people over 63 years of age. A description of the
244 elderly donors characterized them as being
well educated, married, white, and "somewhat af-
fluent." These older individuals, although they
showed greater incidence of comorbidities and
chronic ailments than younger donors, experienced
no higher rates of negative reactions to blood do-
nation. Although the health histories of elderly
volunteers might have been a source of initial
concern, the investigators advised that "if thor-
oughly reviewed, the previous and current medical
conditions of the elderly will be found not to
disqualify them for blood donation. ''23 Donation by
the elderly in this study was concluded as being
both safe and practical and may represent an un-
tapped resource for recruitment or retention.
First-Time Donors
The need for recruitment of new donors to re-
place other donors who have become ineligible or
dropped out of the donor pool, as well as to build
the blood supply to prevent shortfalls, represents
an important focus of blood centers. About 19% o f
the donor base are those giving for the first time, ~3
with the overall dropout rate cited as 89% for
women and 63% for men. 24 Wu and others from
the national REDS group 6 described first-time do-
nors during 1991 to 1996 as mostly white, and US
born; 52% were men. In this cohort, 77% were less
than 39 years old, including 28% who were 19
years or less, reflecting targeted first-time donors

from high school and college populations. The
total number of first-time donors was reported at
the 5 REDS centers as being decreased by 6.7%
during this time period, which raised the question
of national apathy toward blood donation. How-
ever, specific regions (eg, Southern California and
Oklahoma) experienced a significant increase
(60%) in new donors. Such descriptive data do not
clarify the underlying reasons for these statistics,
although certain centers had explicitly targeted mi-
nority recruitment as part of their donor cam-
paigns.
118 GILLESPIE AND HILLYER
Return Donors
Repeat donors comprise the majority of the do-
nor pool, representing a range of 78% to 91% of all
donors.13.15 This proportion of the donor pool has
changed little over time because the blood supply
has been "heavily dependent upon a core of com-
mitted, regular donors ''15 for the past 30 years or
more. Review of the literature indicates that al-
though characteristics and motivation of first-time
donors are important for guiding recruitment strat-
egies, their high drop-out rates underscore the need
to address factors related to return donors. Recruit-
ment and retention of repeat donors lead to a safer
blood supply with lower incidence of transfusion-
transmitted viral diseases, create a donor pool that
tends to be more responsive to donation requests,
and facilitate ongoing recruitment of new and
,lapsed donors. 25,26

The importance of return donors was under-
scored in a quantitative analysis of donations in
Australia. 9 The effect on total donations caused by
a slight decrease in overall return rates from 88%
to 85% at 2 years was shown as correctable either
by maintaining the return rate at 88.5% or by
increasing the recruitment of new donors by 33%.
Clearly, retention appears to be a far more efficient
strategy in this population. Thus, defining the op-
timal method for retaining donors who later return
and give blood on multiple occasions represents a
worthwhile goal with long-term advantages and
has been the subject of intensive study. 27
Certain factors have been reported to have sig-
nificance in predicting the return behavior of do-
nors. James and Matthews 28,~9 analyzed blood do-
nor return behavior by using survival curves. The
time from the initial donation until subsequent
donation was termed the donation cycle to develop
a framework to measure and analyze return behav-
ior as interval data. Relative risks were shown to be
time dependent, with the likelihood of a second
attempt at donation diminishing over time since the
initial donation. Similar donation patterns were
reported by Whyte and colleagues 9 in Australia,
where 8.9% of the population (1.6 million people)
gave 2.4 million donations over a period of 34
months, in this study, return behavior within 2
years predicted future patterns of donation and was
highly related to age and the number of earlier
donations: for donors 45 to 69 years old, over 90%
returned within 2 years to donate again; with
smaller proportions reported for donors 30 to 44

years old (80% return) and 15 to 29 years old (70%
return rate). Return behavior correlated directly
with the number of previous donations, ranging
from a 95.7% return rate for 30 or more prior
donations to 57% return rate if the individual had
given only 1 previous donation.
Piliavin 15 classified return donors into 2 catego-
ries: (1) those who had given 1 to 3 times and those
who had donated 4 or more times. Facilitating the
transition of repeat donors to the latter classifica-
tion was found to be critical in generating long-
term repeat donors. Thus, interventions designed to
encourage donors to continue through the fourth
donation could have a significant effect on main-
taining the overall donor pool.
In studies performed by using the REDS data,
Ownby and colleagues 19 evaluated 879,816 first-
time donors from 1991 to 1995 for return behavior.
Factors predicting a higher likelihood of repeat
blood donation included (1) shorter time interval (6
months or less) between the first and second do-
nation attempt (P < .0001); (2) increased age, with
those 50 years or older showing a 43.3% return
rate, whereas those less than 20 years old associ-
ated with only a 33.3% return rate (P < .0001); (3)
higher levels of education, with college or graduate
degrees associated with a 45% return rate com-
pared with those with some college (39%) and a
high school education or less (34%) (P < .0001);
and (4) Rh-negative status, with a 43% return rate
versus Rh-positive donors who showed a 37% re-
turn rate (P < .0001). By using multiple regression
analysis, age was found to be a strong predictor of
early return and higher frequency of donation.

However, the investigators acknowledged that the
youngest age group was likely more mobile and
may actually have repeated donations at other
blood centers, but their study was unable to capture
such data. Importantly, the average time from the
initial donation to the return attempt w a s the most
significant factor in predicting later returns, with
the number of donations inversely related to the
length of time between the first and second dona-
tions. The highest number of donations was ob-
served when 6 months or less elapsed between the
initial donation and subsequent attempts.
Return Behavior of "Safe" Donors
Thomson et al3o surveyed over 50,000 randomly
selected blood donors considered "safe" after test-
ing of donated units to determine these donors'
intent to donate again during the next 12 months.
In evaluating their intentions about future dona-
tions, only 3.4% of this cohort stated they would be
unlikely to donate again in the next year. Donors
indicating a reduced intent toward repeat donations
tended to be first-time donors of minority or ethnic
background, with lower levels of education, who
had a poor assessment of their treatment by the
collection center, and/or had a negative reaction or
"bad experience" during the donation process. Al-
though intention is central to decision making,
statements of intent do not always accurately pre-
dict behavior. Although this study examined anon-

ymous survey results of intention to return, no
authentic return behavior was recorded; however, a
97% actual return rate would be highly unlikely
based on other studies in the literature. These re-
sponses also highlight the bias encountered in eval-
uating donor questionnaires because respondents
may exhibit a tendency to provide answers they
think they are expected to give or believe the
investigators wish to receive rather than supplying
a more realistic perspective.
Multigallon Donors
Among the group of return donors, most coveted
are those individuals who have given repeated do-
nations equal to 1 or more gallons. Royse and
Doochin 26 surveyed by mail 500 multigallon do-
nors who had given at least 5 gallons of blood
(median donation, 64 units) and compared their
responses to those from another 500 random do-
nors who had not donated blood as frequently
(median donation, 9.5 units). The multigallon do-
nors were characterized as white male college
graduates who had higher levels of awareness of
the need for blood donation. The mean age of these
donors was significantly older at 52 years com-
pared with the 38 years of the random donors. No
significant differences between the groups were
reported for having had close friends or family
members who were also donors or who had previ-
ously been transfusion recipients or for overall
attention to their own health habits and practices.
However, multigallon donors tended to indicate a
deeper, more long-term psychological commit-
ment toward blood donation compared with the
random donor group, with a stronger desire to give

blood until they were very old (86% vs 66%, P <
.00t). Although the multigallon donors more often
viewed their long-term donation as a proud accom-
plishment (51% vs 32%, P < .001), few donors in
either group reported feeling that they had received
support or recognition for their contributions.
About 20% of these large-volume donors had a
prior "bad experience" donating blood but per-
sisted in giving blood on a continued basis, show-
ing their ability to overcome obstacles commonly
encountered in the blood donation process. No
significant differences were noted in the stated
reasons why multigallon donors gave blood com-
pared with the random donors except that the
multigallon donors reported a greater tendency to
participate in humanitarian volunteer efforts com-
pared with other groups (35% vs 24%; P < .05).
However, in analyzing the study's findings, the
low response rate (2t%) to the mail survey by the
random donor group should be noted because it
raises the question of the representative nature of
the sample.
Despite the myriad studies and intensive efforts
over time to profile donor characteristics, the exact
usefulness of demographic data should be inter-
preted cautiously. Demographics likely are not
data causally related to donation. Most surveys of
demographic characteristics draw from limited,
nonrandom sampling often using flawed study de-
sign and/or instruments. The theoretic basis for
many donor studies remains vague or undeveloped.
Centers may target certain groups with campaigns
directed toward specific characteristics (eg, Rh-
negative blood type), or study samples may mirror

recruitment techniques and sites. The success of
cold calls to potential donors and subsequent donor
recruitment may be based o n demographic-tar-
geted calling in that "demographic differences be-
tween donors and nondonors may be perpetuated
through a self-fulfilling prophecy, m5 Donor char-
acteristics may also simply be a reflection of the
more practical aspects of blood donation. For ex-
ample, the greater return rates for individuals with
higher education may actually relate to increased
socioeconomic status and the concept that these
donors may have more time available to give
blood.
POSITIVE MOTIVATORS
Altruism
Oswalt's ~2 and Piliavin's and Callero's 15,18 re-
views of 3 decades of literature on motivation and
r e c r u i t m e n t o f d o n o r s and n o n d o n o r s r e p o r
t e d that
p r i m a r y m o t i v a t i o n to d o n a t e b l o o d c o n s i
s t e n t l y
had b e e n d e t e r m i n e d to be altruism, d e f i n e d as
" p r o s o c i a l b e h a v i o r that has no o b v i o u s b e n e
f i t for
the r e s p o n d e n t b u t is beneficial to the r e c i p i e n t .
''31
I n d i v i d u a l s t u d i e s h a v e a l s o a t t r i b u t e d d
o n o r be-

h a v i o r p r i m a r i l y to altruistic m o t i v e s . 13,32,33
T h e e x a c t r o l e o f a l t r u i s m in the b l o o d d o n a
t i o n
d e c i s i o n - m a k i n g p r o c e s s , h o w e v e r , has b e
e n ques-
tioned. ~4,34 I n s o m e cases, a l t r u i s m and s o c i a l
re-
s p o n s i b i l i t y w e r e a m o n g the l e a s t significant
m o -
t i v a t i o n s i d e n t i f i e d as r e a s o n s for b l o o d d
o n a t i o n . 35
B e h a v i o r a l c a t a l y s t s o t h e r than a l t r u i s m h
a v e b e e n
p r o p o s e d in that (1) d o n o r s m a y a c t u a l l y d e r i
v e
d i r e c t benefit f r o m g i v i n g b l o o d , i n c l u d i n g
a b o o s t
to t h e i r self-esteem14.33.36.37; (2) i n d i v i d u a l d o n o
r s
a r e l i k e l y m o t i v a t e d b y m u l t i p l e factors s i m
u l t a -
n e o u s l y ; 3~ (3) d e c i s i o n m a k i n g and b e h a v i o
r en-
c o m p a s s c o g n i t i v e , affective, and p s y c h o l o g i c
a l
c o m p o n e n t s on m a n y levels; 11 (4) a l t r u i s m i t s
e l f is
a c o m p l e x , m u l t i d i m e n s i o n a l c o n c e p t for w
h i c h the
e m p i r i c a l b a s i s for s t u d y i n g b e h a v i o r is
difficult to
e s t a b l i s h ; 3~ a n d (5) d o n o r s q u e s t i o n e d a b
o u t their
m o t i v a t i o n m a y b e u n a w a r e , unable, or u n w i l

l i n g
to e x p r e s s t h e i r u n d e r l y i n g r e a s o n s with g r
e a t ac-
c u r a c y . 3. In m a n y r e p o r t e d studies, i m p o r t a n t
dif-
f e r e n c e s l i k e l y e x i s t b e t w e e n w h a t the s u b
j e c t s
s t a t e d a n d w h a t t h e i r actual r e a s o n s were for g
i v i n g
b l o o d , r a i s i n g the q u e s t i o n o f the o v e r a l l v
a l i d i t y o f
t h e s e studies. A s for d e m o g r a p h i c data, o n e m u s
t
be careful not to a u t o m a t i c a l l y i n t e r p r e t the
stated
m o t i v a t o r s as h a v i n g a c a u s a l r e l a t i o n s h i p
w i t h the
b e h a v i o r a l o u t c o m e s . M a n y r e a s o n s c i t e d
as m o t i -
v a t i o n a l s o u r c e s m a y s i m p l y b e a m e a n s o f
r a t i o -
n a l i z a t i o n , and such c o n c e p t s are g e n e r a l l y m
u l t i -
f a c t o r i a l in nature.
Incentives
T h e r o l e o f i n c e n t i v e s has b e e n i n v e s t i g a t
e d as a
p o t e n t i a l k e y c o m p o n e n t o f d o n o r m o t i v a
t i o n . 39
E a r l i e r studies o f b l o o d donors r e v e a l e d that 50%
o f d o n o r s w e r e m o t i v a t e d b y the a s s u r a n c e
o f g u a r -
a n t e e d b l o o d r e p l a c e m e n t for f a m i l y m e m b
e r s , and

10% g a v e b l o o d to c o v e r their o w n p o t e n t i a l n
e e d s
in the future, j3 In a 1995 m a i l s u r v e y o f o v e r 7400
b l o o d d o n o r s in the R E D S cohort, 4~ s u b j e c t s w
e r e
a s k e d a b o u t t h e i r attraction to d i f f e r e n t i n c e n
t i v e s
as sources o f m o t i v a t i o n to c o n t i n u e g i v i n g b l
o o d .
O f this g r o u p , 58% i n d i c a t e d they w o u l d return i
f
o f f e r e d b l o o d c r e d i t s , w h e r e a s 4 6 % s t a t e
d t h e y
w o u l d b e m o t i v a t e d to r e p e a t d o n a t i o n i f
m e d i c a l
t e s t i n g was a benefit. T h e e l i m i n a t i o n o f a s s u
r a n c e
a n d c r e d i t p r o g r a m s at m o s t centers has m o d i f i
e d
this r e a s o n as a s o u r c e o f g e n e r a l m o t i v a t i o
n , js
R e c e i p t o f i t e m s o f s m a l l o r l i m i t e d v a l u
e for
b l o o d d o n a t i o n was i d e n t i f i e d as a p o s i t i v e
m o t i -
v a t o r to 20% o f t h o s e s u r v e y e d b y S a n c h e z
and
c o l l e a g u e s , z~ I n c e n t i v e s h a d a g r e a t e r e f

f e c t on
first-time d o n o r s and those in y o u n g e r a g e groups.
A l t h o u g h i n c e n t i v e s o f l i m i t e d v a l u e w e r
e v i e w e d
as b o t h safe and p o t e n t i a l l y e f f e c t i v e , the o f f
e r i n g
o f c a s h was f o u n d to e n t i c e d o n o r s w h o w e r
e 60%
m o r e l i k e l y to b e at r i s k for d o n a t i o n o f
transfu-
s i o n - t r a n s m i t t e d i n f e c t i o u s d i s e a s e s ( P
= .03). 4o
D o n o r s w h o w e r e m o t i v a t e d b y free t i c k e t s
to
e v e n t s as a r e s u l t o f t h e i r d o n a t i o n w e r e a l
s o m o r e
l i k e l y to r e p r e s e n t an i n c r e a s e d r i s k ( o d d s
ratio,
[OR], 1.5) o f t r a n s f u s i o n - r e l a t e d i n f e c t i o n ,
as w e r e
r e s p o n d e n t s w h o f a v o r e d e x t r a t i m e o f f w
o r k as an
i n c e n t i v e (OR, 1.2). In an e a r l i e r s t u d y c o m p a r
i n g

the m o t i v a t i o n s o f d o n o r s with n o n d o n o r s ,
80% o f
d o n o r s i n d i c a t e d m o n e y w o u l d n o t s e r v e
as an
i n c e n t i v e to them. 41
C o u n t r i e s o u t s i d e the U n i t e d S t a t e s h a v e
m o d i -
fied their v o l u n t a r y d o n o r s y s t e m and i m p l e m e
n t e d
m e t h o d s w h e r e b y d o n o r s are paid. Z e i l e r and
K r e t s c h m e r 42 q u e s t i o n e d o v e r 1100 G e r m a
n b l o o d
d o n o r s a b o u t t h e i r v i e w s t o w a r d r e i m b u r
s e m e n t for
d o n a t i o n : 77% r e s p o n d e d t h e y w o u l d no l o n
g e r
w a n t to d o n a t e b l o o d i f r e i m b u r s e m e n t c e a
s e d en-
tirely, a l t h o u g h 78% w e r e w i l l i n g to a c c e p t a b
a n k
t r a n s f e r r a t h e r than i m m e d i a t e c a s h p a y m e
n t as
r e m u n e r a t i o n . A l t e r n a t i v e p a y m e n t s to
cash, such

as i n - k i n d tickets or c o u p o n s , m e t w i t h the ap-
p r o v a l o f o n l y 27% o f this cohort, b u t 37% i n d i -
c a t e d t h e y w o u l d still b e w i l l i n g to d o n a t e b
l o o d i f
the i n - k i n d p a y m e n t s w e r e the o n l y r e i m b u r
s e m e n t
r e c e i v e d . G r e e k s u b j e c t s s p e c i f i e d 3 t y p e
s o f in-
c e n t i v e s that m o s t i n f l u e n c e d their d e c i s i o n
to g i v e
b l o o d : (1) h e a l t h i n c e n t i v e s for the d o n o r ;
(2)
structural and o r g a n i z a t i o n a l factors, i n c l u d i n g
do-
n o r e d u c a t i o n and m a n a g e m e n t o f b l o o d
center
f a c i l i t i e s ; and (3) s o c i a l or e c o n o m i c i n c e n t
i v e s . 22
I n c e n t i v e s m a y a c t u a l l y s e r v e to i m p e d e
the b l o o d
d o n o r d e c i s i o n . In 1 study, h i g h i n c e n t i v e s w
e r e
a s s o c i a t e d w i t h d e c r e a s e d n u m b e r o f d o n
a t i o n s ,

w h e r e a s h i g h l e v e l s o f p o s i t i v e i n t r i n s i c
m o t i v a t i o n
c o u p l e d with l o w r e w a r d s w e r e f o u n d to r e s
u l t in
the h i g h e s t n u m b e r o f d o n a t i o n s o v e r a l l .
43
P?'essbtre
S o u r c e s o f e x t e r n a l p r e s s u r e u s e d to m o t i
v a t e
i n d i v i d u a l s to g i v e b l o o d m a y t a k e n u m e r o
u s
f o r m s i n c l u d i n g r o l e m o d e l s ; p e r s o n a l r e
q u e s t s ;
and c o n t a c t s with others w h o m a y e x e r t p r e s s u r
e in
the f o r m o f p h o n e calls, letters, or f a c e - t o - f a c e
c o m m u n i c a t i o n . 44 O n e t h e o r y c o n t e n d s
that b l o o d
d o n o r s a c t u a l l y h a v e a l o w e r s e n s e o f s e l f
- e s t e e m
and g i v e b l o o d in an a t t e m p t to r a i s e t h e i r
self-
c o n c e p t . I f correct, this c o u l d m e a n that d o n o r s

are
n a t u r a l l y m o r e v u l n e r a b l e to p r e s s u r e to c
o m p l y
w i t h o t h e r s ' stated requests. ~ 5 0 b o r n e and B r a d -
l e y 33 r e p o r t e d that o v e r h a l f (56%) o f all d o n o
r s
g a v e b l o o d o n l y b e c a u s e o f p e r s o n a l p r e s
s u r e f r o m
others. I n D r a k e et a l ' s s t u d y 11 c o n d u c t e d in
the
1970s, o n l y 19% o f e l i g i b l e n o n d o n o r s r e p o r t
e d
h a v i n g b e e n d i r e c t l y a s k e d to d o n a t e c o m p
a r e d
w i t h 38% o f first-time d o n o r s a n d 54% o f t h o s e
r e p e a t i n g b l o o d d o n a t i o n . T h e p r i m a r y r e
a s o n
i d e n t i f i e d as to w h y n o n d o n o r s d i d not g i v e
w a s
" n o one a s k e d m e p e r s o n a l l y . "
P e r s o n a l c o n t a c t b y r e c r u i t e r s a n d o t h e r
d o n o r s
can b e v e r y p o w e r f u l m o t i v a t o r s , w i t h f a c
e - t o - f a c e
c o n t a c t r e p o r t e d as 4 t i m e s m o r e e f f e c t i v e
t h a n a

p h o n e call, e s p e c i a l l y for t h o s e c o n s i d e r i n g
d o n a t -
ing for the first time. 15,45,46 F r i e n d s and r e l a t i v e s
w h o are a l r e a d y d o n o r s w e r e c i t e d b y 75% o f
n e w
d o n o r s as p o s i t i v e m o t i v a t i o n a l factors in L o
n d o n
and H e m p h i l l ' s r e v i e w J 3 w h e r e a s c o n t a c t
w i t h or
m o d e l i n g b y other d o n o r s was i d e n t i f i e d as the
p r i m a r y r e a s o n for g i v i n g b l o o d b y 45% o f A
u s -
t r a l i a n first-time donors. In a h i g h s o c i a l p r e s s u r
e
s i t u a t i o n d e s i g n a t e d as " i n t e n s e c o l l e c t i
o n e n v i r o n -
m e n t " , in w h i c h p o t e n t i a l d o n o r s are h e a v i l
y re-
cruited, d o n o r y i e l d can b e i m p r e s s i v e . 11 T h e
s e
r e c r u i t m e n t efforts f o r c e d i n d i v i d u a l s to state
t h e i r
d e c i s i o n as to w h e t h e r t h e y w i l l d o n a t e b l o
o d o r
not, w i t h the m a j o r i t y s u b m i t t i n g to the p r e s s
u r e
and a g r e e i n g to give. T h o s e w h o r e s i s t the r e c r
u i t -

m e n t p r e s s u r e m u s t do so p r o a c t i v e l y : in an i
n t e n s e
c o l l e c t i o n e n v i r o n m e n t , 7 4 % o f n o n d o n o
r s c o n -
s c i o u s l y m a k e the d e c i s i o n not to g i v e b l o o d
,
w h e r e a s in the g e n e r a l p o p u l a t i o n o n l y 20%
o f
t h o s e w h o d o not d o n a t e e v e r m a k e s u c h a d
e l i b -
erate d e c i s i o n .
E v e n c o l d contacts can be useful in r e c r u i t m e n t .
W h e n H a y e s et a147 c o n t a c t e d i n d i v i d u a l s
to a s k
t h e m for p e r m i s s i o n to b e p u t on a list o f p o t e n
t i a l
d o n o r s to c a l l for future b l o o d drives, 85% o f
current donors, 71% o f l a p s e d donors, and 40% o f
n o n d o n o r s agreed. C o l d c a l l s t a r g e t e d to n o n
d o n o r
h o u s e h o l d s that fit a p r e c i s e d e m o g r a p h i c
profile o f
p o t e n t i a l d o n o r s y i e l d e d a 20% a g r e e m e n t
rate
a m o n g i n d i v i d u a l s c o n t a c t e d , b u t o n l y
14% o f
those w h o a g r e e d a c t u a l l y s h o w e d up to donate.
B e c a u s e m a n y o f t h e s e n o n d o n o r s a l s o b r

o u g h t in
1 or m o r e i n d i v i d u a l s to g i v e at the s a m e time,
the
true r e s p o n s e rate to the c o n t a c t s was c l o s e r to
30%. 48 A r e v i e w o f p o s i t i v e m o t i v a t o r s is i n
c l u d e d
in T a b l e 2.
NEGATIVE MOTIVATORS
Fear and Anxiety
V a r i o u s fears h a v e b e e n d e s c r i b e d b y b o t h
non-
donors and d o n o r s as h a v i n g a n e g a t i v e influence
on the d e c i s i o n to d o n a t e b l o o d , i n c l u d i n g
fear o f
n e e d l e s , sight o f b l o o d , p a i n o r d i s c o m f o r t
, and
b e i n g t o l d t h e y are not e l i g i b l e to g i v e b l o o d
.
D o n o r s m a y e x p e r i e n c e t h e s e fears b u t m a k
e the
d e c i s i o n to g i v e b l o o d d e s p i t e t h e i r
concerns. 49
W h e t h e r such fears are l e g i t i m a t e or serve m a i n l
y
as r a t i o n a l i z a t i o n to a v o i d g i v i n g b l o o d r e
m a i n s
unclear. 12 G e n e r a l fears a b o u t the d o n a t i o n p r o
c e s s
h a v e b e e n a l l u d e d to as a p r i m a r y s o u r c e o f
n e g a -
tive m o t i v a t i o n for at l e a s t one q u a r t e r to one
third

o f n o n d o n o r s , 13,41,44 w i t h specific f e a r o f n e e
d l e s
i d e n t i f i e d b y 15% to 27% o f t h o s e d e c i d i n g
not to
g i v e b l o o d . ~3,41 F i r s t - t i m e d o n o r s f e a r p a
i n m o r e
often than t h o s e w h o h a v e p r e v i o u s l y g i v e
b l o o d 24,32 a l o n g w i t h a g r e a t e r f e a r o f the "
u n -
k n o w n . " L i k e w i s e , a n x i e t y m a y b e g e n e r a
l l y ex-
a g g e r a t e d i n i t i a l l y , w i t h a r a n g e o f 19% to
37% o f
donors r e p o r t i n g b e i n g n e r v o u s b e f o r e the d o
n a t i o n
p r o c e s s . H o w e v e r , a n x i e t y was o b s e r v e d to
de-
c r e a s e as the n u m b e r o f d o n a t i o n s i n c r e a s e
d and
the d o n o r b e c a m e m o r e a c c u s t o m e d to the e x p
e r i -
ence.50
Short-Term Donor Deferral
V o l u n t e e r b l o o d d o n o r s m a y not return for sub-
sequent d o n a t i o n s b e c a u s e o f t e m p o r a r y
deferral,
i n c l u d i n g l o w h e m a t o c r i t , s o r e throat, fever,
or use
o f d i s a l l o w e d m e d i c a t i o n w i t h i n e s t a b l i s
h e d t i m e
p e r i o d s b e f o r e the d o n a t i o n point. A n t i c i p a t
i o n o f
t e m p o r a r y o r p e r m a n e n t d e f e r r a l has b e e n

fre-
q u e n t l y cited as a r e a s o n to a v o i d d o n a t i o n .
51 P i l i -
a v i n 52 s u r v e y e d o v e r 1200 d o n o r s to d e t e r m
i n e the
r o l e o f t e m p o r a r y d e f e r r a l on l a t e r d o n a t i
o n s . F i r s t -
Table 2, Sources of Positive Motivation for Blood Donation
Positive Motivator Reference (% Cited, Specific Concept)
Altruism
Community
Incentives
Personal benefit
General pressure to donate
Personal request
Personal contact
Request from other donors
Awareness
Self-Esteem
Don't know w h y they give

13, 14, 31, 33, 34, 44 (also duty)
26 (35%), 75, 76
39, 41 (87% not motivated by money)
40 {20% want items of limited value; 46%-58% want medical
testing)
44 (28% health)
33 (personal fulfillment)
44, 26 (11% multigallon donors);
11 (higher yield in "intense collection environments")
15 (if lower self-esteem especially vulnerable to pressure as
motivator)
33 (56% donate only because of peer pressure)
11 (19% nondonors asked to give vs 38% first-time donors vs
54% repeat donors)
17 (38% first-time donors give with a friend)
45, 46 (for 1st time donor, face-to-face by recruiter more
effective than phone contact)
15 (face-to-face most effective for recruitment)
13 (75% donors had family/friends already as donors)
2 (45% donors cited contact with other donors as main reason w
h y give blood)
11 (#1 reason cited w h y gave blood)
58 (27% current/lapsed donors-primary motivator)
36, 37, 33, 14 (decreased self-esteem in donor's vs nondonors)
13 (donors experience increased self-esteem after donation)
38, 32 (2nd most c o m m o n reason cited)
time donors who had received a short-term tempo-
rary deferral (STTD) and those who had no donor
deferral (NDD) were compared for later donor
behavior. In a 6-month follow-up period, only
2.8% of the STTD first-time donors returned for a
second donation versus 27.3% of those donors who
were not deferred. The investigator proposed that
first-time donors interpreted temporary deferral as
a psychological reason justifying why they should

not repeat blood donation.
Halperin et al 5~ found similar results in a longi-
tudinal study of donor behavior in which donors
with STTD were matched with donors with NDD
by sex, age, and date of donation and followed for
over 4 years. Return rate and total number o f
donations were compared between the 2 groups.
Those individuals with NDD were 29% more
likely than the STTD donors to return for further
donation (80% vs 62%, P < .001). In terms of total
units of blood donated, donors with NDD gave
81% more blood (13798 units vs 7615 units) and
averaged 1.45 units/year/donor versus 1.03 units/
year/donor for those with STTD. The reason for
deferral also played a role, with return rate by
deferral code ranging from 11% to 34% and dif-
ferences measured in units of blood donated by
deferral code ranging from 43% to 202%.
Short-term temporary deferrals can have acutely
negative effects on first-time donors in particular.
In Noonan et al's 54 study of 187 donors with
STTD, only 11% returned despite phone calls and
letters in follow-up; however, none of the first-time
donors (0/64) with STTD returned. In a study 55
designed to promote retention of deferred donors,
considerable effort to contact donors with STTD
within 3 to 4 weeks after their deferral resulted in
a doubling of the return rate of STTD donors from
24% to 47% within the first 6 months after deferral.
All of these studies underscore the importance of
the potential effects of short-term deferral on sub-
sequent donor behavior and emphasize the central
goal of blood centers to keep donors in the pool.

Permanent Deferral and Medical Reaction
Close to 60% of potential donors claim concerns
about possible chances of being medically disqual-
ified as a donor or physical reactions to blood
donation as sufficient reasons not to give blood. 24,4~
But, as for other fears, the apprehension regarding
deferral or reactions may simply serve as justifica-
tion to avoid giving blood. 12 Approximately 10%
of individuals who attempt donation experience
some form of adverse reaction (eg, syncope, 2%-
9%) ~s often resulting in a negative attitude that
may limit or delay return donations. ~8 Ranasinghe
and Harrison 56 investigated 1 specific type of "bad
experience" as viewed by blood donors, evaluating
the effects of significant bruising on subsequent
donation behavior in the United Kingdom. No sig-
nificant difference was noted in repeat donations
between those donors who experienced bruising
during blood collection versus those donors who
did not sustain bruising. Adverse reactions were
shown to have no effect on the return behavior of
multigallon donors? ~ Again, as for fear and anxi-
ety, first-time donors were more susceptible to
worries about and the negative effects of medical
deferral and donor reactions.
Lack of Awareness
Ignorance or being unaware of the need for

blood or other aspects of the donation process has
been consistently identified as a negative factor in
potential donor decision making. 44,57 The lack of
being specifically asked to give blood is the chief
reason provided why nondonors failed to give 11
and may also explain poor return rates among the
majority of donors. Analysis of 9000 current,
lapsed, and nondonors in the United Kingdom de-
termined that 27% of the current or lapsed donors
were primarily motivated by awareness of the need
for blood coupled with an understanding that indi-
vidual donors may personally need blood in the
future. ~8
Apathy
Defined often as "a state of indifference, lack of
feeling," apathy has been cited as a major reason
for about 16% to 20% of nondonors as to why they
do not choose to give blood. 24,41 Oswalt 12, how-
ever, hypothesized that this concept is misleading
in that nondonors are rarely indifferent. Rather, the
majority of individuals questioned about their will-
ingness to give blood appear to recognize the im-
portance of blood donation and state they would
agree to give if the "correct conditions" were in
place. 2 The "correct conditions" may encompass
motivators, physical status, and aspects of the do-
nation process, which presumably do not meet the
standards of nondonors or do not continue to meet
the standards of lapsed donors. Only about 20% of
eligible nondonors in the general population ac-
tively decide not to give blood in the future; 11 yet,
less than 10% of the eligible population actually
donates blood. 3 A more accurate reason why so

many potential donors decide not to pursue dona-
tion is likely inertia rather than apathy. 2
A listing of common sources o f negative moti-
vation is provided in Table 3.
PROCESS MEASURES
General Donation Experience
First-time donors may posses greater concerns
about discomfort and fear of the donation experi-
ence, whereas repeat donors tend to be more fo-
cused on the donation process and the blood center.
Repeat donors often perform a cost-benefit analy-
Table 3. Sources of Negative Motivation for Blood Donation
Negative Motivator Reference (% Cited, Specific Concept)
Fear (general) 12, 13, 44, 41
49 (both nondonors & donors have fears, emphasis on fears
exaggerated).
41 (36%)
24 (23%)
11 (61%)
Fear of needle 41 (27%)
13 (15%)
Fear of pain 2, 32, 24, 13 (new donors more than repeats)
Fear of deferral 9, 52
Fear of medical disqualification 41 (60%)
24 (57%)

51 (frequently cited)
27 (may represent rationalization)
Anxiety-nervousness 44, 41 (37%)
13 (19%)
50 (decreases as number of donations increase)
Unaware/ignorant of need 44, 57, 60 (primary reason cited by
minority students)
Never asked to give 11 (#1 reason by nondonors w h y don't
give)
Apathy 41 (16%), 24 (16%), 12 (likely not real reason)
2 (more likely inertia vs apathy)
sis based on their prior experiences and recalculate
whether it is "worthwhile" to donate again. 15 Neg-
ative donation experiences account for about 6% to
19% attrition for all donors and 20% to 41% of the
dropout rate for first-time donors? 0
Convenience
General convenience of the process is rated as
very important by most donors, with "inconve-
nience" identified as a primary barrier to donation
by 13% to 19% of lapsed or nondonors. 13,24,41,5v
Overall, convenience or lack thereof has been
shown to be a major factor separating the high-
volume donor from those who give less often and
was cited as the second most important reason why
nondonors do not give blood. ~j Perception of con-

venience of the donation process varies with do-
nation frequency: 54% of nondonors thought the
~ process was convenient compared with
60% of those giving blood for the first through
third times and 72% of donors who had previously
given blood 4 or more times.lJ These data do not
clarify whether the more frequent donors simply
accepted any inconvenience because they were
more accustomed, or more committed, to the pro-
cess or if the findings reflect heightened concerns
about inconvenience by individuals who rarely or
ever gave blood based on inexperience, misinfor-
mation, or rationalization. The site where donation
takes place is considered an important deterrent to
donation if it is specifically perceived as inconve-
nient. 11,15 Thus, mobile units, worksite- or school-
based drives, and opportunities for donation close
to population centers are essential to donor recruit-
ment and retention. 59
Center Staff"
Treatment of donors by the staff who provide
the technical and administrative oversight of blood
donation is a key factor in the donation decision. In
Thomson et al's 3~ study of "safe" donors, most
donors rated their overall donation experience as
good to excellent (96%), with high levels of satis-
faction with their treatment (98%) and the skill
level of the technical staff (96.3%). For donors
who reported a very positive donation experience,
the attrition rate was quite low (2.3%-3.0%). How-
ever, donors who gave a fair to poor rating of the
waiting period (13.8%) or physical well-being dur-
ing and/or after the donation process (6.3%) were
less likely to return for subsequent donations

(6.2%-19% attrition). These findings were espe-
cially relevant to first-time donors, for whom attri-
tion rates among those who reported negative do-
nation experiences ranged from 19.7% to 40.9%.
In comparison, first-time donors who provided
positive ratings about the donation process showed
significantly lower attrition rates (10.7 %- 14.1%, P
-< .0001). In this study, the donor's view of treat-
ment by the center staff (OR, 3.0) and the level of
physical well-being during and after the donation
process (OR, 6.0) were the 2 factors with the
strongest predictive value for future donation (P --<
.001). Waiting time was also an important predic-
tor: donation time of 2 hours or less was associated
with increased donor retention (OR --> 1.5, P --<
0.039). However, in this study, analysis of return
behavior was based on stated intent to return rather
than actual documented return rates.
A review of aspects of the blood donation pro-
cess that may affect decision making and behavior
is included in Table 4.
Because blood donation by minorities tends to
be significantly reduced compared with whites,
Oswalt and Gordon ~~ investigated the motivation
of minority students to determine the relation to
donation behavior. Of 120 minority college stu-
dents surveyed, 33% had donated blood, for whom
the primary motivational factor was cited as altru-
ism. Similar negative motivators, including fear,
decreased awareness of the need to give, and per-
ceived lack of time, were identified for minority
subjects as those reported for whites. The investi-
gators concluded that educational and socioeco-

nomic factors, rather than motivational, were the
prime reasons for lower rates of blood donation
among minorities as compared with whites.
THEORETIC MODELS AND METHODOLOGIES
IN BLOOD DONATION STUDIES
Social Capital and Public Goods
Interpretation and application of some of the
findings published in the literature may be facili-
tated through attention to theoretic models and an
understanding of the methodologic limitations in
specific cases. A widespread theory used to explain
donor behavior draws from the concepts of social
capital and public goods. In keeping with the pref-
erence toward a voluntary, public, nonprofit, low-
cost blood system, yon Schubert 61 applied the the-
ory of public goods to blood donation to explain
Table 4. Process Measures t h a t Influence Blood Donation
Donation Process Measure Reference (% Cited, Specific
Concept)
General donation process
General convenience of process
Convenience of site
Treatment by center staff

Waiting time
Total time for process
Short-term t e m p o r a r y deferral (STTD)
Questions for health history
Reaction during donation
30 (6%-19% attrition for all donors, 20%-41% attrition for
firstAime donors
due to negative donation experience)
30 (first-timers more concerned about discomfort, repeat donors
more
focused on donation process)
57, 41 (19% inconvenient), 24 (13% inconvenient)
13 (13% perceived process as inconvenient);
11 (54% nondonors vs 60% 1st through 3rd-time donors vs 72%
> 4th time
donors perceive process as convenient)
11 (#2 reason after "never been asked" cited by nondonors as
w h y don't give, major factor to separate frequent vs less
frequent donors
59 (61%-91% w a n t weekday schedule not weekend)
11, 15 (major deterrent if inconvenient)
59 (mobile units, e m p l o y m e n t sites important)

9, 30 (OR = 3.0 perception of staff treatment, strongest
predictor of return
donor behavior, 2%-3% attrition if good-excellent treatment by
staff)
15 (10% donors complain of long wait)
56 (perceived wait, not actual waiting time, especially during
first donation,
most predictive of later repeat donation)
59 (75% w a n t < 90 min for entire donation process, including
travel time)
30 (7% projected attrition if previous donation t o o k > 2 hr)
15 (perception of wait more important than actual time waited)
9, 52 (2.8% return after STTD vs 27% if not deferred)
53 (62% return after STTD vs 80% if no deferral, nondeferred
give 81%
more units blood over 4-yr period)
54 (11% return after intensive follow-up efforts but 0% of first-
time donors
after STTD)
30 (8% d r o p o u t rate if perceived as too personal)
15 (2%-9% experience syncope)
18 (10%-12% have bad experience, reduced return rates)
10 ("bad" experience has negative effect on first-time donors
not on
multigallon donors)

56 (no effect on repeat donations after bruising)
Abbreviation: OR, odds ratio.
the altruistic motivations of donors. Donors show a
lesser tendency to desire a "free ride ''5~ related to
public goods in general and a greater commitment
to responsible stewardship of social capital.
Personal Norm and Attribution of Responsibility
Other sociopsychological theories and approaches
to interpreting motivation and decision making in
blood donation have been cited. Personal norm
proposes that donors possess the feeling that they
"ought" to give blood, whereas attribution of re-
sponsibility to oneself suggests that individuals
cannot simply make excuses for lack of action. 62
Changes in motivation across the donor cycle m a y
be explained by the attribution of responsibility to
oneself theory. The influence exerted by external
motivators, such as social pressure, decreases as
the level of intrinsic motivation (eg, sense o f duty
or responsibility) increases.
Health Belief Model and Intended Behavior
The aim of most studies o f donor characteristics
and motivations is to develop a profile that might
be used to predict donor behavior, thus promoting
further blood donations. However, surveys have
generally focused on respondent attitudes, beliefs,
and intents, without necessarily reflecting actual
behavior. The Health Belief Model 6~ incorporates
intent into its concept o f knowledge, attitude, and
practice in that intent most frequently precedes

behavior. Promotion of intent m a y be important as
a first step in decision making toward sustained
return behavior. Oswalt and colleagues 64 contacted
inactive donors in 3 ways to attempt to facilitate
repeat donations: group A, notified o f dates when a
blood mobile would be nearby; group B, notified of
blood mobile dates and requested to choose a time
when they intended to donate blood; and group C,
126
informed o f upcoming drive through general pub-
licity only. Those individuals who were asked to
specify their intent (group B) showed higher rates
of donation than those informed by other means.
Reports o f intention to return have varied
widely, from Piliavin and Callero's ~8 finding of
39% to 57% of donors who indicated they were
certain to return to Thomson and associates whose
survey found almost 97% of their cohort intended
to donate again within the next 12 months? ~ Ac-
tual dropout rates among first-time donors are
much higher (89% for women and 63% for men24);
thus, intention m a y represent an unreliable surro-
gate as a predictor of subsequent donor behavior.
Opponent-Affective Process
To aid in predicting donor behavior, Zillmer et
al 3~ tested 245 college students before blood dona-
tion and at 3 different time points after donation
was completed. Mood was measured by using the
mood adjective checklist, and anxiety was identi-

fied as present at the highest levels before dona-
tion, with positive feelings of elation elevated after
the donation experience. The investigators inter-
preted these findings as indicative of an opponent-
affective process, which is similar to an addiction
in which negative feelings are replaced by a sense
of exhilaration because of the specific action o f
blood donation, in line with this theory, first-time
donors, in particular, would need to be encouraged
to overcome the initial anxiety and negative feel-
ings to reach the point of elation postdonation.
Evaluation of Motivational Factors
Reports from studies of motivational factors
need to be examined for how accurately they rep-
resent the complexity of reasons most donors show
in deciding to give blood. Attitudes, motivation,
and behavior have frequently been organized and
measured along a 1-dimensional continuum rang-
ing from absent/very low to very high. Such mea-
surements fail to take into account the competing
elements, both positive and negative, that are in-
volved in decision making. Cacioppo and Gard-
ner 65 suggest the use of a 2-dimensional grid to
evaluate attitudes that affect the blood donor deci-
sion. Although positive motivators such as altruism
m a y account for some aspects of the decision-
making process, negative deterrents including per-
sonal fears, time constraints, and lack of knowl-
edge also impact behavior. Understanding both
GILLESPIE AND HILLYER
positive and negative forces and their interactive
roles is essential in designing successful and cost-

effective interventions.
Measurement Techniques
Because attitudes are closely linked to affect,
cognition, and behavior, Breckler and Wiggins 66
warned against simply using a bipolar scale to
measure attitude. Instead, they recommended all
dimensions be measured simultaneously. In their
study of both donors and nondonors, implementa-
tion of 3 new scales, in addition to an attitude scale
measured on a continuum, showed affect to be
more strongly correlated with the number o f prior
donations than cognition. Thus, how the donor felt
about donating blood was identified as the key
factor in the blood donation decision and subse-
quent behavior, showing greater impact than what
the donor knew about the collection process and
need for blood donation.
Issues of interviewer bias and question threat
were raised by Lightman 6v in a study of altruism in
Canadian blood donors, which compared responses
with identical questions asked b y both personal
interview and mail survey. Incongruities in re-
sponses were shown to be caused by methodologic
problems rather than representing actual differ-
ences in the motivation, attitudes, and behavior
reported by subjects.
The approaches used to predict and present
trends in blood donation have also been questioned
in terms of techniques used in data collection and
interpretation. The delay between collecting dona-
tion rates and reporting these data can vary f r o m 1
to 4 years or more, meaning projections of future

trends may be based on outdated information 5,68,69
and seldom on real-time data. Other aspects o f the
blood donation system m a y also have significant
impact on trends, as shown by Whyte 9 who devel-
oped a logical predictive model of return behavior
of blood donors in Australia. What appeared ini-
tially to be large shifts in the blood collection
trends and projections, on further analysis were
explained as small (2%-4%) decreases in donor
retention rates at 2 years. Had these donors actually
returned to collection centers at that point to repeat
donation, the overall trends would have been un-
changed.
APPLICATION OF FINDINGS TO DESIGN
OF INTERVENTIONS
Routinely, the study of donor characteristics and
motivation has been undertaken as a means to
identify significant variables that affect the blood
donation decision and other key components of the
collection process. Frequently, studies report long
lists of attributes that describe their sample. By
using discriminate analysis technique, Burner04
evaluated the results of 577 questionnaires com-
pleted by donors and nondonors in 1 city to attempt
identification of the most relevant variables and the
integration of characteristics into a meaningful
model for both donors and nondonors. The com-
posite profile of donors in 1982 revealed some new
variables not previously reported. A typical donor
was a family man, often possessing rarer blood

types, with higher education but lower sense of
self-esteem, who was concerned about his health
and family and unwilling to take significant risks.
Nondonors were described as having opposite
traits. The results of this study advise against de-
veloping interventions that are generically de-
signed to target both donors and nondonors. As an
example, an appeal using fear or guilt as a theme
may serve as strong motivation for a group of
donors but may be ineffective in recruiting nondo-
n o r s .
Much of the earlier literature tended to describe
donors compared with nondonors rather than ex-
plore the differences within the donor group by
using multivariate analyses. Because such a small
subgroup (3% to 8%) of the overall population
represents regular donors, Ibrahim and Mobley 7~
pursued forging a strategic linkage between re-
cruitment and retention as a means to build and
maintain a repeat donor pool. Phone interviews
were conducted with 521 blood donors to deter-
mine differences between "high" and "low" do-
nors. The profile of multiple-giving donors re-
vealed a married man educated at the high school
or trade school level with many friends or relatives
as recipients of blood transfusions and who had
experienced the blood donation process as highly
satisfactory and convenient. With personal gratifi-
cation noted as the primary motivator for high
donors, a blood drive campaign focused on promo-
tion of self-esteem and humanitarianism would be
more likely to appeal to this targeted group.
Frequency of donation might be enhanced

through simple, practical approaches as well. As a
mechanism to address the hypothesis that donors
easily forget when they are eligible to give blood
again, written reminders were sent to French do-
nors. 71 However, the frequency of mobile collec-
tion units to particular sites was also increased as a
second intervention to determine the effect of this
variable on donor return behavior. An increase in
the frequency of blood donation was shown to be
secondary to the greater number of mobile unit
visits but was not related to reminders of upcoming
donation due dates.
Building on data drawn from the literature,
Gimble and colleagues v2 identified the issues of
donor knowledge, donor defeixal, waiting time,
and convenience as being important for recruit-
ment and retention of blood donors. Twenty-four
collection sites were paired with an equal number
of other sites and randomly assigned as either
experimental or control. Recruitment brochures ex-
plaining eligibility to donate and criteria for tem-
porary deferral, as well as other aspects of the
collection process, were distributed to the 24 ex-
perimental sites 2 weeks in advance of the blood
drive. Three drives were held at each site. No
significant differences were reported between the
sites or various blood drives over time. The bro-
chures were not shown to expand recruitment or to
facilitate the return of donors who had received a
temporary deferral. Although this educational ap-
proach focused on 1 factor of the blood donation
decision and resulting behavior, recruitment and
retention are multifactorial in nature. The lack of
efficacy shown by this intervention may under-
score the need to design approaches that integrate

multiple variables o f equal or potentially greater
importance to blood donor behavior.
CONCLUSIONS
Based on the review of the literature for the past
3 decades or more, studies have reported (1) de-
mographic profiles of the populations evaluated,
(2) what donors and nondonors claim are their
major reasons to give or refrain from giving blood,
and 3) general effectiveness of some forms of
social pressure and incentives and potential use for
long-term retention of donors.
Some studies considered pivotal in the literature
date from a time period that reflects an earlier
donor pool, many o f whom are aging or no longer
serving as donors. 5I More recent surveys, even of
128 GILLESPIE A N D HILLYER
large numbers of subjects, often draw the sample
from a limited number and type o f blood center,
representing about 5% to 8% of total donors. 6
Thus, findings do not necessarily reflect the donor
pool nationwide. The investigation of the charac-
teristics of more contemporary donors has revealed
donor profiles largely similar to previous studies,
except for increased proportions of women and
minority first-time donors in some cases. Interpre-
tation of these data should be performed in view of
the question of whether demographics mirror the
donor pool to assist in targeted recruitment or if
targeted recruitment actually leads to the reported

demographics. 15 In uncommon cases in which an
individual center focused on recruitment o f donors
with atypical demographics (eg, minority donors),
an expansion of the number of atypical donors was
reported. 6
Continued targeted recruitment of the histori-
cally desirable blood donor tends to result in the
same type of blood donor overall. Successful mar-
keting-to 35-year-old white men who are Rh neg-
ative m a y be a major goal o f blood centers, but this
approach is unlikely to diversify the donor pool.
Theoretically, the "best" donor is a "safe" donor
who is intrinsically motivated to continue donating
on a repeated basis, with gender, age, educational
level, or other personal characteristics considered
as lesser issues.
Few recent studies o f donor motivation have
been published. Piliavin's 15 review of the literature
through the 1980s cited issues related to time re-
quired for the donation process, length of history
taking, inconvenient hours or location, other
sources of delay, and fear of temporary or perma-
nent deferral as major deterrents to initial and
repeat donation. T w o decades later, these issues
appear to persist. In fact, issues of time and donor
convenience m a y be considered even more signif-
icant obstacles to blood donation now than in pre-
vious decades. 3~ The vast majority of nondonors,
rather than being directly opposed to blood dona-
tion, actually indicate they would give if "correct"
conditions were present. 2 Apparently, the "correct"
conditions are difficult to achieve as evidenced by
the extremely high rates of nondonors and individ-
uals who drop out after their first donation. 24 The

practical challenges encountered by potential do-
nors who often deal with long commutes, 2-job
households, care o f children and aging parents, and
chronic overscheduling may be distinct f r o m the
major impediments identified by earlier genera-
tions of donors, v3 Modern sources o f positive and
negative motivation axe worth exploring through
scientifically sound investigations involving repre-
sentative cohorts. Future studies might also pursue
the role of incentives that have been proposed
historically but never used, such as a tax incentive
similar to that given to other charitable dona-
tions. 34
Motivation and behavioral outcomes are not
static elements in blood donation, arguing that
well-designed and executed interventions could
potentially alter motivations, attitudes, and result-
ing behaviors. Application of findings from pub-
lished studies toward design and implementation
o f interventions to promote donor recruitment and
retention merit a multifactorial approach. Address-
ing a single aspect o f the decision-making process,
or ignoring the interplay o f knowledge, attitudes,
motivation, and behavior when assessing potential
donors or designing interventions, is less likely to
achieve desired goals.
Strategies that focus on retaining return donors
and transforming first-time donors into repeaters
would be beneficial. The reasons underlying the
decision to give blood the first time tend to differ
from the rationale to give repeat donations and
likely alter over time. Changes in motivation m a y
reflect the life cycle of the donor, moving f r o m the

first-time donor experience to early repeat (1 to 3
times) donor to repeat donor (4 or more times) to
multigallon donor. It In addition to positive forces
influencing the decision to donate blood, barriers to
donation are also constantly present and m a y in-
terfere with the translation o f attitudes, motivation,
and intention into actual behavior. Motivational
factors might be modified in their importance as an
individual moves through the donor life cycle,
chooses not to give beyond the initial donation, or
stops (lapsed donor). Use o f surrogate end points,
such as stated intent rather than actual donation
behavior, should be used and interpreted with cau-
tion. Investigations of what respondents, particu-
larly nondonors, do not say or are not asked could
greatly contribute to the understanding o f motiva-
tional factors impacting the blood donation deci-
sion.
Decision making and behavior related to blood
donation are complex concepts and likely need to
be evaluated on m a n y levels simultaneously. The
c o m p l i c a t e d n a t u r e o f d e c i s i o n m a k i n g r e
q u i r e s
c l o s e a t t e n t i o n t o t h e t h e o r e t i c b a s i s , m e
t h o d o l o g i c
a p p r o a c h e s , a n d a n a l y t i c t e c h n i q u e s u s e
d i n its

s t u d y . I n v e s t i g a t i o n s a r e n e e d e d t h a t u s e
o p t i m a l
m e t h o d o l o g i e s to a s s e s s r e s e a r c h q u e s t i o
n s a n d
w e l l - d e s i g n e d s t r a t e g i e s t o t e s t h y p o t h e
s e s a n d
p r o d u c e g e n e r a l i z a b l e f i n d i n g s . A s n e w d
e f e r r a l s
a n d t h e a g i n g p o p u l a t i o n p o t e n t i a l l y i m p
a c t t h e
c u r r e n t d o n o r b a s e , c o s t - e f f e c t i v e a p p r o
a c h e s l e a d -
i n g to l o n g - t e r m s u c c e s s i n d o n o r r e c r u i t
m e n t a n d
r e t e n t i o n a r e e s s e n t i a l in a s s u r i n g a s a f e ,
s u f f i c i e n t ,
n a t i o n a l b l o o d s u p p l y i n t h e f u t u r e .
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ARCBS background information
1
Who we are
The Australian Red Cross Blood Service (ARCBS) is
responsible for providing quality blood products, tissues and
related services to the Australian community
We are an operating division of the Red Cross Society from who
we receive < 1% funding
A not for profit organisation, we are government funded through
the National Blood Authority (NBA)
Established in 1929 the Blood Service was funded solely by Red
Cross donations until after WWII
Moved from being a state based services to one national
organisation in 1996
2,300 staff, 1,000 volunteers and over 500,000 volunteer blood
donors.
2
Why we’re here
To ensure a sufficient, suitable and sustainable donor panel to
supply reliable and safe blood and blood products to meet the
needs of the Australian Community
3

Blood 101
Red blood cells
Used for anaemia and bleeding from trauma or surgery
Lasts 42 days in storage
Plasma
Plasma transports nutrients & carries away waste
Products derived from plasma (through a process called
fractionation) are used for: treatment for prevention of tetanus,
hepatitis B and chicken pox treatments for liver failure; auto-
immune diseases; and Haemophilia
Platelets
Platelets help the blood to clot
Used to control bleeding, especially with leukaemia patients
Platelets last for just 5 days in storage (on rocking trays so they
don’t stick together)
4
Eight blood types
% of the Australian population
5
Three donation types
Whole blood
Given at fixed and mobile sites. Can donate every 12 weeks.

Plasmapheresis
You must have given at least one whole blood donation. Some
fixed sites only. Can donate every 2 weeks.
Plateletpheresis
You must have given at least one whole blood donation. Some
fixed sites only. Can donate every 2-4 weeks.
8%
90%
6
Meeting the collection plan
The collection plan details the number of each type of donation
required:
Whole blood
Plasmapheresis
Plateletpheresis
Fluctuates throughout the year based on expected demand
Broken down by donor centre – each centre has a daily, weekly,
monthly and annual “collection target” to achieve.
7

Significant growth required
Whole Blood
1.5% growth in collections required, in line with population
Plasmapheresis
19% growth, year on year for next 10 years
Plateletpheresis
16.5% growth, year on year for next 10 years
While collections increases in whole blood are relatively small,
a large whole blood panel growth is required to account for
donors converting to plasma and platelet panels.
8
Donor centre locations
Plus over 1,000 mobile sites each year including shopping
centres, community halls, schools and businesses
9
Who does donated blood help?
10

The donation experience
Having made an appointment, register at the front desk
Complete a donor questionnaire form (60 questions)
Have an interview during which your haemoglobin (iron) levels
will be tested
Give blood (10 – 15 minutes)
Relax and enjoy some refreshments
Entire process takes approximately 1 hour
11
Potential donors - motivations for giving blood
Have been affected personally by use of blood.
Normalised behavior – mum/dad donate so I do.
Do your bit for the community.
Feel good about yourself.
Gain esteem of others – family, peers, employers.
Realisation ‘it could happen to me’ or ‘people I love.’
Sources: Non Donor Attitudinal Research, Woolcott, Dec 2004
Social Capital and Blood Donation: The Australian
Case.
12
Potential donors - barriers to giving blood
View that there is enough blood – and it keeps indefinitely.
There is a lack of ownership to giving blood: “It’s something
someone else does”
Simply not a top-of-mind issue
Concern it will hurt, be unpleasant: “it’s a needle in the vein
thing with me”

Fear of contracting something or discovering something they
didn’t know about
Effort: “Its easier to give money than blood – you’re less
involved”
Convenience: too hard, I’m too busy
Sources: Non Donor Attitudinal Research, Woolcott, Dec 2004
Social Capital and Blood Donation: The Australian
Case.
13
Donor objective
The ARCBS aims to create long-term social change.
Encourage community take personal responsibility for ensuring
we’re able to meet the needs of blood donations for the future.
Shift the responsibility from a few of us to all Australians.
This social change platform is designed to recruit the next
generation of Australians to become lifelong donors.
14
Donor communications objective
Our task is threefold;
1. To educate and inform them with the
information they need to become regular donors.
2. Touch their hearts and inspire them to want
to become long term donors.

3. To influence them to donate as often as they
can for as long as they can.
15
Donor Profile
16
Marketing to an ethnic segment
Challenge:
ARCBS does not actively target ethnic population
85% of donors English first language*
Australian population changing
Need on-going support
Lack of systems at ARCBS to manage large increase (if non-
english speaking/reading)
Ad-hoc management with interpreters
Issues with translation due to privacy policy
Based on research undertaken and demographic question asked
on first language.
We do not take this info down at any other time for data
collection.
But international research has shown that donors from different
ethnic background have lower frequency.
17

Marketing to an ethnic segment
What are we currently doing:
Ad hoc local marketing to ethnic groups
Provide limited translator services at big expense to ARCBS
18
40%
9%
31%
7%
8%
2%2%
1%
O+O-A+A-B+B-AB+AB-
Chart1 (2)O+O-A+A-B+B-AB+AB-
0.4
0.09
0.31
0.07
0.08
0.02
0.02
0.01
Chart1O+O-A+A-B+B-AB+AB-
0.4
0.09
0.31
0.07
0.08
0.02
0.02

0.01
Sheet1O+O-A+A-B+B-AB+AB-40%9%31%7%8%2%2%1%
Sheet2
Sheet3
Donation Type
85%
13%
2%
Whole blood
Plasmapheresis
Plateletpheresis

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