Elsevier

Social Science & Medicine

Volume 96, November 2013, Pages 86-94
Social Science & Medicine

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

https://doi.org/10.1016/j.socscimed.2013.07.022Get rights and content

Highlights

  • Post screen, 47 studies ordered into six research programs for empirical synthesis.

  • Positive association with intentions, self-efficacy, perceived behavioral control.

  • Negative association with temporary deferrals and adverse reactions.

  • Strong empirical support for active re-recruitment of temporary deferred donors.

Abstract

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

Section snippets

Method

Fig. 1 presents a summary of the procedure used for selecting the studies for this meta-analysis, including the literature review, application of exclusion criteria, and development and cross-validation of predictor categories.

Results

Across studies of donation behavior and intentions, the majority took place in the USA, Australia and the UK. Owing to the large number of university studies, approximately a third of the samples comprised participants whose reported age was less than 25 years. Most samples comprised repeat whole-blood donors. A detailed summary of the demographic characteristics of each sample is presented in the Supplementary materials.

Tables 1 and 2 present the associations between each antecedent and

Discussion

Incorporating studies of blood donor motivation drawn from the last four decades, the purpose of this meta-analytic review was to identify the factors that are most strongly associated with donation behavior and intentions, and to assess the impact of methodological and contextual differences between studies. These factors were drawn from six major programs of research: the TPB, prosocial motivation, affective expectations, collection site experiences, past donation behavior, and donor

Acknowledgments

We would like to acknowledge Australian governments that fully fund the Australian Red Cross Blood Service for the provision of blood products and services to the Australian community. This study was also supported by a Business and Economics Faculty research grant from the University of Melbourne. The authors would like to acknowledge Jo En Yap for her assistance in collecting research papers for this synthesis. We would also like to formally acknowledge the Australian Red Cross Blood Service

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