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Impact of disasters on blood donation rates and blood safety: A systematic review and meta-analysis
Laermans J, O D, Van den Bosch E, De Buck E, Compernolle V, Shinar E, Vandekerckhove P
Vox sanguinis. 2022
Abstract
BACKGROUND AND OBJECTIVES Timely and adequate access to safe blood forms an integral part of universal health coverage, but it may be compromised by natural or man-made disasters. This systematic review provides MATERIALS AND METHODS Five databases (The Cochrane Library, MEDLINE, Embase, Web of Science and CINAHL) were searched until 27 March 2020 for (un)controlled studies investigating the impact of disasters on blood donation rates and/or safety. Risk of bias and overall certainty of the evidence were assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. RESULTS Eighteen observational studies were identified, providing very low certainty of evidence (due to high risk of bias, inconsistency and/or imprecision) on the impact of natural (12 studies) and man-made/technological (6 studies) disasters. The available evidence did not enable us to form any generalizable conclusions on the impact on blood donation rates. Meta-analyses could not detect any statistically significant changes in transfusion-transmissible infection (TTI) rates [hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV)-1/2, human T-lymphotropic virus I and II (HTLV-I/II) and syphilis] in donated blood after a disaster, either in first-time or repeat donors, although the evidence is very uncertain. CONCLUSION The very low certainty of evidence synthetized in this systematic review indicates that it is very uncertain whether there is an association between disaster occurrence and changes in TTI rates in donated blood. The currently available evidence did not allow us to draw generalizable conclusions on the impact of disasters on blood donation rates.
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Improving the donation experience and reducing venipuncture pain by addressing fears among whole-blood and plasma donors
Gilchrist PT, Thijsen A, Masser BM, France CR, Davison TE
Transfusion. 2021
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Editor's Choice
Abstract
BACKGROUND Fear of blood donation is implicated in vasovagal reactions, donor recruitment, and retention. This study examined the extent to which fear among donors is associated with various donor outcomes in an Australian sample, and whether fear can be addressed on-site to reduce adverse reactions and improve the donation experience. STUDY DESIGN AND METHODS Six hundred and sixty-four donors (age M = 33.4, SD = 12.7; 55% female) participated in a two-center, pragmatic, parallel group, individually randomized controlled trial. Following donor registration and consent, whole-blood (n = 539) and plasma (n = 125) donors were assigned to one of four Conditions: control; fear assessment; fear assessment + brochure; fear assessment + brochure + tailored conversation focused on any self-reported fear and coping strategies. Post-donation questionnaires assessed the donors' experience including positive support, donor self-efficacy, anxiety, fear, venipuncture pain, and vasovagal reactions. RESULTS Fear among donors predicted higher venipuncture pain, post-donation anxiety, and vasovagal reactions and remained significant after controlling for other established predictors (i.e., total estimated blood volume, age, sex, and donation experience). Mediational analyses showed that exposure to brochures (with or without the tailored conversation) was associated with less pain, with this effect mediated by donor perceptions of more positive support. Venipuncture pain was also associated with vasovagal reactions, reduced likelihood of return within 6 months, and less satisfaction with the donation experience. CONCLUSION The current results underline the importance of interventions to address fear among both whole-blood and plasma donors to secure the safety and well-being of donors and the blood supply.
PICO Summary
Population
Whole-blood and plasma donors (n= 664).
Intervention
Fear assessment (n= 179); Fear assessment + brochure (n= 169); Fear assessment + brochure + tailored conversation focused on any self-reported fear and coping strategies (n= 168).
Comparison
Control (Donation as usual, n= 148).
Outcome
Fear among donors predicted higher venipuncture pain, post-donation anxiety, and vasovagal reactions and remained significant after controlling for other established predictors. Mediational analyses showed that exposure to brochures (with or without the tailored conversation) was associated with less pain, with this effect mediated by donor perceptions of more positive support. Venipuncture pain was also associated with vasovagal reactions, reduced likelihood of return within 6 months, and less satisfaction with the donation experience.
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Effects of message framing on recruiting Rh-D-negative blood donors in an emergency situation: Two randomized trials
Ou-Yang J, Huang XY, Fu YS, Dai L, Zhong HB, Jiang J, Liang HQ
British journal of health psychology. 2021
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Editor's Choice
Abstract
OBJECTIVES Prospect theory categorizes message framing according to whether it emphasizes a possible loss or a possible gain. Promotions of blood donation worldwide mainly focus on gain-framed appeal. The objective of the current study is to examine the effects of message framing on recruiting Rh-D-negative blood donors (RDNBDs) in an emergency situation. DESIGN Two randomized trials. METHODS In Study 1, 813 group O and 500 group B RDNBDs were randomly assigned to three groups receiving three different recruitment text messages: (1) gain-framed, (2) loss-framed, and (3) information messages. In addition, 613 group A and 148 group AB RDNBDs were marked as (4) no message group. In Study 2, 758 RDNBDs were randomly provided one of two versions of materials focusing on either the possible survival (gain-framed) or the death (loss-framed) of a Rh-D-negative patient needed a blood transfusion. These participants then completed a questionnaire to examine the possible mechanisms underlying the observed effects. RESULTS Compared to not receiving any message, significantly more RDNBDs re-donated within 14 days after they received a loss-framed message. Study 2 found that RDNBDs who read the loss-framed material expressed more willingness to donate immediately than those who read the gain-framed material. RDNBDs with high-risk perception expressed a greater blood donation intention in the loss-framed group. The loss-framed message made participants perceive others' needs more strongly, which generated more empathy, and thus increased blood donation intention. CONCLUSIONS The results suggested that recruiting RDNBDs using a loss-framed message is suitable under an emergency.
PICO Summary
Population
Rh-D-negative blood donors (RDNBDs) from two studies, (study 1, n= 2,074; study 2, n= 2,559).
Intervention
Gain-framed text messages and materials.
Comparison
Various comparators of text messages and materials (loss-framed, informative, and no message).
Outcome
Study 1 showed that significantly more RDNBDs re-donated within 14 days after receiving loss-framed message, compared to not receiving any message. Study 2 found that RDNBDs who read the loss-framed material expressed more willingness to donate immediately than those who read the gain-framed material. RDNBDs with high-risk perception expressed a greater blood donation intention in the loss-framed group.
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Knowledge of blood donation and associated factors in Ethiopia: a systematic review and meta-analysis
Getie A, Wondmieneh A, Bimerew M, Gedefaw G, Demis A
BMJ open. 2021;11(7):e044343
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Editor's Choice
Abstract
OBJECTIVE To assess the level of knowledge about blood donation and associated factors in Ethiopia. DESIGN Systematic review and meta-analysis. METHODS Both published and unpublished cross-sectional studies on the level of knowledge about blood donation in Ethiopia were included. Articles from different databases such as PubMed/MEDLINE, HINARI, EMBASE, Scopus, Google Scholar and African Journals Online were searched. Cochrane I(2) statistics were used to check for heterogeneity. Subgroup and sensitivity analyses of evidence of heterogeneity were carried out. Egger's test with funnel plot was conducted to investigate publication bias. RESULT Twenty cross-sectional studies with a total of 8338 study participants (4712 men and 3626 women) were included. The overall nationwide level of knowledge about blood donation was 56.57% (95% CI 50.30 to 62.84). Being in secondary school and above (adjusted OR=3.12; 95% CI 2.34 to 4.16) and being male (adjusted OR=1.81; 95% CI 1.44 to 2.28) were the factors associated with level of knowledge about blood donation. CONCLUSION More than half of the study participants were knowledgeable about blood donation. Sex and educational status were the factors significantly associated with level of knowledge about blood donation in Ethiopia. Therefore, there is a need for education and dissemination of information about blood donation among the general population to build adequate knowledge and maintain regular blood supply.
PICO Summary
Population
Men and women living in Ethiopia (20 studies, n= 8,338).
Intervention
Systematic review to assess the level of knowledge about blood donation and associated factors in Ethiopia.
Comparison
Outcome
The overall nationwide level of knowledge about blood donation was 56.57%. Being in secondary school and above and being male were the factors associated with level of knowledge about blood donation.
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Notifying donors when their deferral is ending: An effective donor retention strategy
Gemelli CN, Thijsen A, Van Dyke N, Kruse SP, Davison TE
Transfusion. 2021
Abstract
BACKGROUND The application of a temporary deferral often leads to donor lapse. Contributing factors may be donors not knowing when their deferral ends or not being contacted and asked to return. The aim of this study was to determine the effectiveness of a reminder message notifying donors that their deferral is coming to an end in increasing donors' postdeferral return rates. We evaluated the optimal time, content, and mode of delivery of the reminder message. STUDY DESIGN AND METHODS Two studies were conducted with deferred donors. Study 1: donors (n = 1676) were randomized to be sent a reminder message at one of three time points (4 weeks before, 1 week before, and 1 week after their deferral ended) or to a no contact control condition. Study 2: donors (n = 1973) were randomized to three message type conditions (emotive email, nonemotive email, nonemotive SMS). Attempted return behavior was extracted (appointments, attendances) at 1 month. RESULTS In Study 1, being sent the reminder message increased odds of donors attempting to return within 3 months compared with the control group (OR:2.01). Sending the reminder 1 week before the deferral ended was the most effective time point. In Study 2, the nonemotive message increased the odds of attempting to return compared with the emotive message (OR:1.38). No differences were found between email and SMS messages. DISCUSSION Sending a reminder message to donors when their deferral is coming to an end is a simple, effective, and cost-effective method to retain donors.
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Results from the blood donor competence, autonomy, and relatedness enhancement (blood donor CARE) randomized trial
France CR, France JL, Himawan LK, Fox KR, Livitz IE, Ankawi B, Slepian PM, Kowalsky JM, Duffy L, Kessler DA, et al
Transfusion. 2021
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Editor's Choice
Abstract
BACKGROUND This study aimed to promote competence, autonomy, and relatedness among first-time whole blood donors to enhance intrinsic motivation and increase retention. STUDY DESIGN AND METHODS Using a full factorial design, first-time donors (N = 2002) were randomly assigned to a no-treatment control condition or to one of seven intervention conditions designed to promote donation competence, autonomy, relatedness, a combination of two (e.g., competence and autonomy), or all three constructs. Participants completed donor motivation measures before the intervention and 6 weeks later, and subsequent donation attempts were assessed for 1 year. RESULTS There was no significant group difference in the frequency of donation attempts or in the number of days to return. Significant effects of group were observed for 10 of the 12 motivation measures, although follow-up analyses revealed significant differences from the control group were restricted to interventions that included an autonomy component. Path analyses confirmed direct associations between interventions involving autonomy and donor motivation, and indirect mediation of donation attempts via stronger donation intentions and lower donation anxiety. CONCLUSION Among young, first-time, whole blood donors, brief interventions that include support for donor autonomy were associated with direct effects on donor motivation and indirect, but small, effects on subsequent donation behavior.
PICO Summary
Population
First time whole blood donors (n= 2,002).
Intervention
Activities to promote donation competence (C, n= 250), autonomy (A, n= 248), relatedness (R, n= 260); or a combination of two: competence and autonomy (C + A, n= 251), competence and relatedness (C + R, n= 250), autonomy and relatedness (A + R, n= 248); or a combination of the three: (C+ A + R, n= 245).
Comparison
Standard communication (Control group, n= 250).
Outcome
There was no significant group difference in the frequency of donation attempts or in the number of days to return. Significant effects of group were observed for 10 of the 12 motivation measures, although follow-up analyses revealed significant differences from the control group were restricted to interventions that included an autonomy component. Path analyses confirmed direct associations between interventions involving autonomy and donor motivation, and indirect mediation of donation attempts via stronger donation intentions and lower donation anxiety.
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A Systematic Review of Interventions Used to Increase Blood Donor Compliance with Deferral Criteria
Cutts JC, Quinn B, Seed CR, Kotsiou G, Pearson R, Scott N, Wilson DP, Harrod ME, Maher L, Caris S, et al
Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie. 2021;48(2):118-129
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Editor's Choice
Abstract
BACKGROUND AND OBJECTIVES Pre-donation screening of potential blood donors is critical for ensuring the safety of the donor blood supply, and donor deferral as a result of risk factors is practised worldwide. This systematic review was conducted in the context of an expert review convened by the Australian Red Cross Lifeblood in 2013 to consider Lifeblood's injecting drug use (IDU)-related policies and aimed to identify studies assessing interventions to improve compliance with deferral criteria in blood donation settings. MATERIALS AND METHODS MEDLINE/PubMed, OVID Medline, OVID Embase, LILACS, and the Cochrane Library (CENTRAL and DARE) databases were searched for studies conducted within blood donation settings that examined interventions to increase blood donor compliance with deferral criteria. Observational and experimental studies from all geographical areas were considered. RESULTS Ten studies were identified that tested at least one intervention to improve blood donor compliance with deferral criteria, including computerized interviews or questionnaires, direct and indirect oral questioning, educational materials, and a combination of a tickbox questionnaire and a personal donor interview. High-quality evidence from a single study was provided for the effectiveness of a computerized interview in improving detection of HIV risk behaviour. Low-quality evidence for the effectiveness of computerized interviews was provided by 3 additional studies. Two studies reported a moderate effect of direct questioning in increasing donor deferral, but the quality of the evidence was low. CONCLUSION This review identified several interventions to improve donor compliance that have been tested in blood donation settings and provided evidence for the effectiveness of computerized interviews in improving detection of risk factors.
PICO Summary
Population
Blood donation settings undertaking pre-donation screening (10 studies).
Intervention
Systematic review to identify interventions to improve blood donor compliance with deferral criteria.
Comparison
Outcome
Ten studies were identified that tested at least one intervention to improve blood donor compliance with deferral criteria, including computerized interviews or questionnaires, direct and indirect oral questioning, educational materials, and a combination of a tick-box questionnaire and a personal donor interview. High-quality evidence from a single study was provided for the effectiveness of a computerized interview in improving detection of HIV risk behaviour. Low-quality evidence for the effectiveness of computerized interviews was provided by 3 additional studies. Two studies reported a moderate effect of direct questioning in increasing donor deferral, but the quality of the evidence was low.
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A systematic review and network meta-analysis of incentive- and non-incentive-based interventions for increasing blood donations
Irving AH, Harris A, Petrie D, Mortimer D, Ghijben P, Higgins A, McQuilten Z
Vox sanguinis. 2020
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Editor's Choice
Abstract
BACKGROUND AND OBJECTIVES Blood services are tasked with efficiently maintaining a reliable blood supply, and there has been much debate over the use of incentives to motivate prosocial activities. Thus, it is important to understand the relative effectiveness of interventions for increasing donations. MATERIALS AND METHODS This systematic review used a broad search strategy to identify randomized controlled trials comparing interventions for increasing blood donations. After full-text review, 28 trials from 25 published articles were included. Sufficient data for meta-analysis were available from 27 trials. Monetary incentives were assumed to be equivalent regardless of value, and non-monetary incentives were assumed to be equivalent regardless of type. Non-incentive-based interventions identified included existing practice, letters, telephone calls, questionnaires, and the combination of a letter & telephone call. A network meta-analysis was used to pool the results from identified trials. A subgroup analysis was performed in populations of donors and non-donors as sensitivity analyses. RESULTS The best performing interventions were letter & telephone call and telephone call-only with odds ratios of 3.08 (95% CI: 1.99, 4.75) and 1.99 (95% CI: 1.47, 2.69) compared to existing practice, respectively. With considerable uncertainty around the pooled effect, we found no evidence that monetary incentives were effective at increasing donations compared to existing practice. Non-monetary incentives were only effective in the donor subgroup. CONCLUSION When pooling across modes of interventions, letter & telephone call and telephone call-only are effective at increasing blood donations. The effectiveness of incentives remains unclear with limited, disparate evidence identified.
PICO Summary
Population
Blood donors and non-donors (25 studies).
Intervention
Monetary incentive based interventions for increasing blood donation.
Comparison
Non-monetary incentive based interventions for blood donation.
Outcome
The best performing interventions were letter & telephone call and telephone call-only with odds ratios of 3.08 and 1.99 compared to existing practice, respectively. With considerable uncertainty around the pooled effect, we found no evidence that monetary incentives were effective at increasing donations compared to existing practice. Non-monetary incentives were only effective in the donor subgroup.
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Effective methods for reactivating inactive blood donors: a stratified randomised controlled study
Ou-Yang J, Bei CH, Liang HQ, He B, Chen JY, Fu YS
BMC Public Health. 2020;20(1):475
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Editor's Choice
Abstract
BACKGROUND Recruiting of sufficient numbers of donors of blood products is vital worldwide. In this study we assessed the efficacy and cost-effectiveness of telephone calls and SMS reminders for re-recruitment of inactive blood donors. METHODS This single-centre, non-blinded, parallel randomised controlled trial in Guangzhou, China included 11,880 inactive blood donors whose last donation was between January 1 and June 30, 2014. The donors were randomly assigned to one of two intervention groups (telephone call or short message service [SMS] communications) or to a control group without intervention. SMS messages with altruistic appeal were adopted in the SMS group; in addition to altruistic appeal, reasons for deferral of blood donation were also asked in the telephone group. All participants were followed up for 1 year. The primary outcome was re-donation rate, and rates in different groups were compared by intention-to-treat (ITT) analysis and estimation of the average treatment effect on the treated (ATT). Secondary outcomes were the self-reported deterrents. Other outcomes included the re-donation interval, and the incremental cost-effectiveness ratio (ICER) of telephone calls and SMS reminders on re-recruitment. RESULTS ITT analysis revealed no significant differences in the re-donation rate among the three groups. ATT estimations indicated that among compliers, telephone calls significantly increased re-donation compared to both SMS reminders and no intervention. Donor return behaviour was positively associated with receiving reminders successfully, being male, older age, and previous donation history. The SMS reminder prompted donors to return sooner than no reminder within 6 months, and according to ICER calculations, SMS reminders were more cost-effective than telephone calls. Donors reported time constraints as the most main causes of self-deferral in the telephone group, and altruistic appeal had a positive effect on these donors. CONCLUSIONS Interventions to reactivate inactive blood donors can be effective, with telephone calls prompting more donors to return but at a greater cost than SMS messages. SMS reminder with altruistic appeal can urge donors to re-donate sooner within 6 months than no reminder. TRIAL REGISTRATION NCT03366441 (Reactivation of Inactive Blood Donors). Retrospectively registered 4 December 2017.
PICO Summary
Population
Inactive blood donors (n=11880).
Intervention
Telephone call (n=3960). Short message service [SMS] communications (n=3960).
Comparison
No intervention (n=3960).
Outcome
Intention-to-treat analysis revealed no significant differences in the re-donation rate among the three groups. Average treatment effect on the treated estimations indicated that among compliers, telephone calls significantly increased re-donation compared to both SMS reminders and no intervention. Donor return behaviour was positively associated with receiving reminders successfully, being male, older age, and previous donation history. The SMS reminder prompted donors to return sooner than no reminder within 6 months, and according to incremental cost-effectiveness ratio calculations, SMS reminders were more cost-effective than telephone calls. Donors reported time constraints as the most main causes of self-deferral in the telephone group, and altruistic appeal had a positive effect on these donors.
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10.
The effect of the video and brochure via donor recruitment on fear, anxiety and intention: Randomized controlled trial
Karacaoglu Y, Oncu E
Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis. 2020;:102698
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Editor's Choice
Abstract
Although voluntary blood donation is important in terms of sustainable blood supply, voluntary blood donation rates in the world and in our country are behind the desired target. University students are an important group in achieving the goal. The study was planned among 551 university students between 19-21 March 2018.It was planned as a single-blind randomized controlled study in order to evaluate the factors affecting students' blood donation decision and the effect of brochure and video information on fear, anxiety and intention. The data obtained by using Blood Donation Questionnaire and State Anxiety Scale and p ≤ 0.05 was accepted as significant. As a result of the study, 37.9 % of the students reported that they did not give blood due to health reasons, 26 % insecurity and 24.1 % fear. The increase in after the intervention knowledge level was mostly in the group of videos and improved brochures (p < 0.001).There was no difference between the groups in terms of the State Anxiety Scale mean scores p> 0.05). In after the intervention, those who intend to give blood have higher knowledge and their fear and anxiety scores less than those not intend to give blood (p < 0.05). There was no difference between the groups in terms of intention to give blood after the intervention (p> 0.05). As a result, it was found that the information given through the developed brochures and videos increased the level of knowledge, had no effect on the anxiety level and it can be said that the improved brochure has positive effects on intent and fear.
PICO Summary
Population
University students, (n=551).
Intervention
Video group (n=144), Enhanced brochure (n=134), Standard brochure (n=135).
Comparison
Control brochure (n=138).
Outcome
37.9 % of the students reported that they did not give blood due to health reasons, 26 % insecurity and 24.1 % fear. The increase in after the intervention knowledge level was mostly in the group receiving videos and improved brochures. There was no difference between the groups in terms of the State Anxiety Scale mean scores. After the intervention, those who intended to give blood had higher knowledge and their fear and anxiety scores less than those not intending to give blood. There was no difference between the groups in terms of intention to give blood after the intervention.