Orals

Background: Blood collection agencies worldwide face the difficult task of securing a steady supply of blood. With limited resources to spend on marketing, an understanding of the factors that motivate and discourage donations is essential. Although several reviews of the donor literature have been produced, most have failed to outline their strategy for collecting primary research, their selection criteria for including each study in their synthesis, and their approach to combining individual study results to draw general conclusions. Aims: This paper compares and contrasts the results of two meta-analyses of studies of blood donor motivation: the first investigating self-reported motivators and deterrents to donating, the second investigating factors that have been linked to donation intentions and future donation behavior. The aims of the two meta-analyses were: (i) to produce an organised and consistent taxonomy of blood donation motivators and deterrents, (ii) to estimate the prevalence of donation motivators and deterrents across populations, (iii) to identify the strongest predictors of future donation behavior, (iv) to inform an agenda for future research. Methods: The same general procedure was followed for both meta-analyses: (i) we searched the literature, and attempted to obtain a near-exhaustive coverage of literature on factors influencing blood donation; (ii) we applied rigorous selection criteria to each study based on its relevance, research design, and sampling, (iii) we made a verbatim list of factors from each study, and two coders independently grouped these into categories, (iv) we synthesised the results across studies to produce estimates of the prevalence of each motivator and deterrent, and the correlation between each factor and future donation behavior. Results: From the first meta-analysis, the most commonly reported motivators included convenience of the collection location, desire to help people, obligation to donate, reputation of the collection agency, and perceived need for donation. The most prevalent deterrents were lifestyle barriers (e.g., lack of time), lack of interest in donating, inconvenience of centre locations, lack of exposure to marketing communications, and incentives being unwanted or insufficient. From the second metaanalysis, the factors most strongly associated with donation behavior were perceived control over donation barriers, confidence (self-efficacy) about donating, anticipated regret about not donating, and self-identity as a donor. Donors were less likely to redonate after being temporarily deferred, but only if the collection agency failed to contact them after the deferral period had elapsed. Vasovagal events also had a negative impact on return behavior. Measures of altruistic motivation failed to correlate with return behavior. Summary/Conclusions: The combined results of the two meta-analyses suggest that the reasons typically given for donating are at odds with the factors that actually facilitate repeat donations. In particular, while donors list convenience and altruism as principal reasons for donating, predictive correlational studies reveal these factors have only a modest effect at best on donation behavior. Collection organisations should direct their resources to initiatives designed to maximise donors' confidence and overcome lifestyle barriers to donating, promotions featuring obligation- themed messages, and re-activating temporarily deferred donors through direct contact