Motives and barriers for Blood Donation in the Swiss Population. Bild 28.4 cm x 8 cm

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Volken ZHAW Centre for Health Sciences Swisstransfusion

1 Health Motives and barriers for Blood Donation in the Swiss Population Peter Rüesch, Nicole Maeder, Thomas Volken ZHAW Centre for Health Sciences Swisstransfusion Annual Conference 2011, , Fribourg Bild 28.4 cm x 8 cm

2 Blood donation: Current state of knowledge from previous studies are inconclusive and partially contradictory Research gap with non-donors: while donors were examined regularly, there are only few studies with non-donors Until now no comprehensive national study of blood donation for Switzerland 2

while donors were examined regularly, there are only few studies with

3 Objectives Research Project General (Knowledge-)Objectives of the Blood Transfusion Service SRC Meet the medium to long term needs in the supply with blood and blood stem cells in Switzerland Identification of factors influencing the behavior in the donation of blood or blood stem cells. 3

with blood and blood stem cells in Switzerland Identification of factors

4 Objectives Research Project General questions research project Which knowledge exists in the population concerning the donation of blood and blood stem cells? How is the current situation concerning the behavior of blood donation and blood stem cells donation in Switzerland? What are motives for a blood donation or a registration for a blood stem cell donation? Which barriers can be identified for a donation of blood or blood stem cells? Which specific socio-demographic characteristics have an influence on the donation behavior? 4

How is the current situation concerning the behavior of blood donation and blood stem cells donation in Switzerland?

5 Specific questions for this contribution Are there clear-cut groups with specific blood donation motives («Motivations») which can be identified in the Swiss Population? How are this motivations distributed according to sociodemographic characteristics? In which context are the motivations for behavior and intention of blood donation? 5

6 Study design Pre-study Qualitative Sub-study Quantitative Sub-study Processing State of research (Literature review) Construction & Pre-test Interview guideline Semi-structured guidelineinterviews Non-donors New-registered First-time donors (N=88) Standardized CATI Representative Population Survey (N=900) Disproportionate Stratification (D, F, I) / /2011 6

guidelineinterviews Non-donors New-registered First-time donors (N=88) Standardized CATI

7 Quantitative sub-study: spot check Spot check Representative population spot check of Switzerland Soll Ist Quoten % n % n Geschlecht Frauen Männer Altersgruppe Jahre Jahre Region Deutsche Schweiz Französische Schweiz Tessin Present analysis: Persons who are physically able to donate blood; N=726 (Women=307; Men=419) 7

9 451 33-45 Jahre 50 450 50.1 452 Region Deutsche Schweiz 33 300 33.3 301 Französische Schweiz 33 300 33.

8 Measurement BSP motives and barriers Motives, 7 scales: Well-being, meaningfulness, usefulness, self-efficacy, donor-identity, social/moral standards, ethic Barriers, 3 scales: Risk aversion, structural barriers, inner barriers Reliability of the scales good: a=

social/moral standards, ethic Barriers, 3 scales: Risk aversion,

9 Analysis approach: Cluster Analysis Analysis of persons on the basis of the 10 scales : Hierarchical cluster-analysis, merger according to ward, distance measure=euclidean Squared Distance Cluster solution Empirical optimal solutions: 2-solution, 4-solution or 6-solution Decision for 4-solution (2-solution: in content unsatisfactory, only differentiation by low vs. high motive expression; 6-solution: partly small sample sizes of the clusters, difficult to interpret). 9

2-solution, 4-solution or 6-solution Decision for 4-solution (2-solution: in content unsatisfactory, only

10 Lifetime prevalence blood donation (% per population group) Blood donation of the Swiss Population %-Confidence interval y y y y German French Italian Men Women Language region Switzerland 10

25 20 15 10 5 0 95%-Confidence interval 18-32 y 33-45 y 18-32 y

11 Groups with specific donor motivation Individual barriers Structural barriers Risk assessment Ethical principles Social / moral standards C1 (N=95) C2 (N=219) C3 (N=165) C4 (N=211) n.s. 95%-K.I. Of the overall average Donor identity Self-efficacy Usefulness Meaningfulness Well-being negative extension Z-scale standardized positive extension 11

I. Of the overall average Donor identity Self-efficacy Usefulness Meaningfulness Well-being

12 Characterization of the motive types Two significant donor groups C1 C2 C3 C4 Motives Barriers : positive values (z>0); negative values (z<0); number of symbols: 1=up to one third of the barriers / motives with +/ extension, 2=two-thirds of the barriers / motives with +/ extension, 3=all of the barriers / motives with +/ extension C1: low motivated, strong barriers C - + C4: strong motivated, low barriers C + - Two mixed donor groups C2: both low motivated and low barriers C - - C3: average motivated with larger barriers C

barriers / motives with +/ extension, 3=all of the barriers / motives with +/ extension C1: low motivated, strong barriers C - + C4: strong

13 Socio-demography of the donor motivation Verteilung Blustpendemotivations-Cluster nach soziodemografischen und geografischen Merkmalen C - + (C1) C - - (C2) C 0 + (C3) C + - (C4) 2 (p); CC Geschlecht Frau (N=292) 14.4% 16.4% 35.6% 33.6% Mann (N=398) 13.3% 43.0% 15.3% 28.4% Alter Jahre (N=353) 17.0% 28.6% 24.1% 30.3% Jahre (N=337) 10.4% 35.0% 23.7% 30.9% Bildung Volksschule (N=50) (24.0%) (16.0%) (26.0%) (34.0%) Berufslehre (N=357) 14.3% 31.4% 23.5% 30.3% Matura (Abitur) (N=87) (9.2%) 44.8% (18.4%) 27.6% Höhere FS, FH (N=122) (12.3%) 33.6% 24.6% 29.5% Universität (N=68) (8.8%) (23.5%) (32.4%) (35.3%) Sprachregion 67.9 (p<.001); CC= (p=.052); CC= (p=.049); CC=.173 gewichtete Daten Deutsche Schweiz 12.1% 26.6% 27.0% 34.4% CC=.146 Französische Schweiz 10.2% 36.2% 21.4% 32.2% Italienische Schweiz 17.9% 32.7% 23.4% 26.0% Stadt vs. Land gewichtete Daten Stadt 11.8% 30.7% 25.9% 31.6% CC=.061 Land 12.9% 26.1% 24.4% 36.7% Gesamt 13.8% 31.7% 23.9% 30.6% Werte in Klammern: Stichproben-N<30; CC: Kontingenzkoeffizient 13

0%) (16.0%) (26.0%) (34.0%) Berufslehre (N=357) 14.3% 31.4% 23.5% 30.3% Matura (Abitur) (N=87) (9.2%) 44.8% (18.4%) 27.6% Höhere FS, FH (N=122) (12.3%) 33.6% 24.6% 29.5% Universität (N=68) (8.8%) (23.

14 Blood donation status and motivation Active (N=114, 17%) 1.8% 42.1% 3.5% 52.6% C - + C - - C 0 + C + - Former/Inactive (N=164, 24%) 11.6% 35.4% 22.6% 30.5% 2 =74.0***; CC=.314. Non-donors (N=401, 59%) 18.0% 27.2% 30.2% 24.7% Total 13.7% 31.7% 23.9% 30.8% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Proportion Persons 14

5% 2 =74.0***; CC=.314. Non-donors (N=401, 59%) 18.0% 27.2% 30.2% 24.

15 Prevalence Motivation and blood donation behavior so far 55% 53.1% 50% 50.2% 1) Donation prevalence 12 mths; 2 =62.1***; CC= ) Donation prevalence life; 2 =45.0***; CC= % 41.9% 40% 35% 30% 25% 24.2% 26.3% 26.7% 30.8% 20% 19.4% 15% 10% 5% 2.2% 5.5% 0% C - + (N=95) C - - (N=219) C 0 + (N=165) C + - (N=211) Total 15

2) Donation prevalence life; 2 =45.0***; CC=.247 45% 41.9% 40% 35% 30% 25% 24.

16 Blood donation intention 6 mths* Motivation and blood donation intention C - + C - - C 0 + C + - Types of motivation *) Blood donation intention next 6 months: 1 impossible or very improbable' 2 rather improbable' 3 'open' 4 more probable.' 5 very probable to sure 16

17 Blood donation intention next 6 mths. Motivation Blood donation behavior? Blood donation last 12 mths. no yes 1 C - + C - - C 0 + C + - Types of motivation 17

18 Conclusion 1 Four groups ( types ) of persons identified, each with specific motivations for blood donation Two significant ( contrary ) groups: low motivated with strong barriers vs. highly motivated with low barriers Two less significant groups: low motivated with low barriers, average motivated with stronger barriers Gender-specific extension of the blood donation motivation Men often low motivation and low barriers Women often average motivation and stronger barriers Hardly socio-demographic differences in the motivation for age, education, language region and urban/rural 18

highly motivated with low barriers Two less significant groups: low motivated with low barriers, average motivated with stronger barriers

19 Conclusion 2 Clear correlation of the blood donation motivation with: Blood donation status, previous blood donation behavior and future blood donation intention The most joyful donator group are highly motivated persons with low barriers But: even people with moderate motivation to donate and lower risk aversion are donating exceptionally often The decisive factor seems to be mainly the Risk assessment, the motivational aspects are secondary. 19

with low barriers But: even people with moderate motivation to donate and lower risk aversion are donating

20 Inferences Both, for new-recruitment of blood donors and for taking care of the active donor pool: Docking to specific motivations is important New-recruitment of blood donors: Both, for former / inactive donors and for non-donors: the primary focus must be on modification of the risk assessment: * Correcting the incorrect information * Reducing fears Secondary focus on promoting positive motivations 20

inactive donors and for non-donors: the primary focus must be on modification of the risk assessment:

21 Inferences Taking care of the active donors Binding by supporting positive attitudes and motivations for blood donation Specific addressing to men with inconspicuous motivation? 21

22 Thank you for your attention 22

23 Tabellen 1 Spendeabsicht und Spendeschwierigkeit in den nächsten 6 Monaten nach Spendemotivations-Typ (einfaktorielle ANOVA) C - + (C1) C - - (C2) C 0 + (C3) C + - (C4) ANOVA Scheffé Spendeabsicht 6 Mte. 1.5 ( ) 3.0 ( ) 2.3 ( ) 3.9 ( ) Spendeschwierigkeit 6 Mte. 2.0 ( ) 3.3 ( ) 2.5 ( ) 3.7 ( ) F=126.5; p<.001; Eta 2 =0.361 F=74.9; p<.001; Eta 2 =0.252 alle Einzelvergl p<.05 alle Einzelvergl p<.05 23

24 Tabellen 2 Blutspendeabsicht nächste 6 Monate in Abhängigkeit von Blutspendemotivation und Blutspendeverhalten letzte 12 Monate (2- faktorielle ANOVA) Faktoren F, p Eta 2 A: Cluster der Blutspendemotivation 26.3, < B: Blutspende letzte 12 Monate 46.3, < A B 2.3,

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