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7207MKT – Market Research Problem Definition Report Blood Donation Shortage: The Determinants of Blood Donation Behavior in Australia and Nationwide Course Convenor: Dr. Charles JebarajakirthyAuthor: Aruzhan Jakanova, S5246180 2021
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Introduction Blood donation has always played a tremendous role in saving lives, as blood cannot be produced artificially and can thus be obtained only from human blood sources. Most surgeries, medical disorders, and potentially life-threatening conditions require blood transfusions as part of their key management. Subsequently, blood donation has become a vital process that each health care department should consider. According to the World Health Organization (WHO) and the International Federation of Red Cross and Red Crescent Societies, blood donors are usually volunteer donors, replacement donors, and paid donors (World Health Organization, 2017). Moreover, The WHO recommends that countries should build their own systems, structures, and processes to effectively manage all aspects of blood donation to maintain the availability of blood whenever needed (World Health Organization, 2020). However, not all of them can maintain the given protocol. Nowadays, even the world's most developed nations have difficulties with such operations. Countries like the United States, the United Kingdom, and Australia have been experiencing challenges with the shortage of blood donors and increased demand for blood, as per the Australian Red Cross Blood Service's report (Australian Red Cross Blood Service, 2007; Ferguson, Farrell, & Lawrence, 2008; Sullivan, Cotton, Read, & Wallace, 2007). Therefore, the main priority stands on targeting and recruiting potential new donors, as well as retention. The evidence says that returning contributors provide a safer and more stable source (Ibrahim & Mobley, 1993). Referring to Australia, around 3% of the population gives blood annually, yet one in three people needstheproductduringtheirlifetime(AustralianRedCrossBloodService,2018). Furthermore, only 60% of newly recruited donors return within two years to proceed with another donation; it is consistent with Great Britain and the States (Flood P. et al., 2006). Given this information, theresearch aims at understanding donors and producing insights regarding what moves, motivates, and precludes them make such voluntary contributions.Furthermore, the study seeks to address demographic, cultural, and attitudinal problems regarding blood donation in Australia and worldwide. Further, the literature review will be supported by a few research objectives/hypotheses and a wide range of journal articles/official non-profit organizations' data. 3
Research Objectives: To determine the motivators for blood donation between older and younger generations. To explore all possible challenges for blood donations between older and younger generations. To investigate the behavioral patterns for blood donation worldwide and nationwide. Hypotheses: The older generation is more motivated through the normative influence (i.e., peer-to- peer), whereas the younger relies on the informational (i.e., social media). The blood donation motivators are plural and are not strictly dependent on the age factor. The older generation's motivators regarding blood donation are more altruistic compared to the younger one. The main blood donation obstacle for the older generation is poor health or specific age limits. The behavioral patterns regarding blood donation decision-making are more impulsive than rational. 4
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1.Literature Review 1.1Blood Donation Motivators As blood donation considers to be acharitable activity,the author decided to begin studying the issue from a broader, voluntary viewpoint. In the early 90s, American psychologists Mark SnyderandAllenM.OmotodevelopedtheVolunteerProcessModel(VPM)toreveal motivations underlying a voluntary action (Omoto and Snyder, 1995; Omoto, Snyder, and Martino, 2000). The theoretical framework envisions three stages (antecedents, experience, and consequences) on three different levels (individual, organizational, and social). As explained by Omoto & Snyder, the stages represent one volunteer's journey through defining motivations, exploring situations to promote the engagement, and focusing on its effects (Pozzi M. et al., 2016). The term motivation implies the process of stimulating an individual to achieve a goal within any organization. Regardless, the researchers highlight the point of people who engage in voluntary activities (i.e., blood donation) are encouraged byplural motivationsat one time. This approach reveals that volunteerism serves various functions for anyone who may possess different motivations from those held by other people (Pozzi M. et al., 2016). The motivations rely on the function volunteerism execute for an individual. The six motivating variables in the VPM are social (getting acquainted), values (similar priorities), self-enhancement (personal growth), ego- protection (reducing the sense of guilt), understanding (acquiring new skills), and career (employment).Several studies that have applied this model to blood donation reveal that these motivations are not constant but differentiate themselves based on the life cycle phase in which the donors find themselves, gender, historical period, and other factors. (Alfîeri et al., 2016; Guiddi et al., 2015; Stukas, Snyder, and Clary, 1999). Amongst these,satisfactionhas a strong influence as an antecedent to the maintenance of donor engagement (Thomson et al., 2006). Anothermodelthatexplainsblooddonationmotivators-wassuggestedbyGodinand collaborators in 2005 (Pozzi M. et al., 2016). The group of researchers determined two types of variables related to the donation nature: personal and organizational-contextual. Godin concludes that subjective norms powered by normative influence (i.e., peer-to-peer) play a vital role in the former variables. In addition, Godin partially echoed Thomson's viewpoint; in his words, satisfaction has an enormous weight on predicting donors' behaviors.No specific demographic data was found in both models. 5
It is also worth mentioning that two years after Godin's research, the Sojka duo from Sweden concluded in their study thataltruismwas the most common general motive for actively and continuously donating blood. The stimulus for addressing such social issues is often powered by feelings, leading us to participate, which an impulsive yet positive attitude toward blood donation(Bennett,2009).However,therelevantmessagedistributionvianormativeand informational influence channels was even more common, with no regard to donors' age or sex. (B. Nilsson Sojka and P. Sojka, 2007). 1.2Blood Donation Obstacles In this paragraph, the author compares the Eastern and the Western ethnicities and their blood donation obstacles, straight from the sources. In Western Asian practice,fearis the most reported negative attitude that acts as a barrier to blood donation. Furthermore, the Saudi researcher Alfouzan notices that potential donors relate fear to several misconceptions that serve as additional barriers: assumptions about physical weakness, gender, age limitations, high risk of infections, and blood being sold to patients (Alfouzan, 2014). A similar "sister" characteristic isanxiety.A decade ago, from Alfouzan's article, the English researchers McVittie and Harris shaped the non-donor framework in their work, citing: "The anxieties expressed indicated a fear of the unknown and appeared to reflect a lack of knowledge both of the procedure involved and of location." However, the recorded answers did not reflect definite actions ("I would donate blood") but increased possibilities ("I would most likely be donatingblood").TheBritsalsoreplicatedtheSaudi'sfearsaboutbloodcontamination; however, they were more specific on the disease - in their words, it might be either hepatitis or AIDS infection (McVittie et al., 2006). It is clear that non-donors are enthusiastic; however, thereisanotherpracticalfactorpreventingthemfromdonatingblood-alackof information/knowledge, as well as alternative possibilities (McVittie et al., 2006). One of the participant's answers focused on the information spread: "Advertising where to go to donate blood may be of help. I have no idea where to go, and donation drives in this area are so infrequent that I never seem to be available when they are around." (McVittie et al., 2006). An exact similar concern - anxiety was also observed by Australian researchers. Nonetheless, according to the research outcome, new and returning donors expressed their fear about needles, blood exposure, and pain (Masser et al., 2009). An extra impressive finding -anticipated regret, an expectation about the future experience of sorrow in response to either donation or non- 6
donation of blood (Masser et al., 2009). Notwithstanding negative affections, the enlisted challenges may serve as a key to understanding the donor's motivation to continue donating (Masser et al., 2009). 1.3Cultural and Demographic Issues Affecting Blood Donation Behavior "Despite many efforts to increase the recruitment of blood donors, blood donation rates have continuously decreased over the past decade around the world," - concluded by Wallace and researchers in 1994. The issue remains the same in 2021 - especially given that the world constantly changes culturally, socially, and demographically. Current studies evaluating the demographic attributes of new and returning donors reveal that, although disparities between sexes in donation rates have narrowed, people of color remain less likely to donate blood than whites, and those with a lower education level are less likely to donate blood than those with a higher educational level (Ownby et al., 1999). According to a few ethnic studies, including Thompson's research on Hispanics, it appears that racial disparities may decrease with the rise of socioeconomic and educational status. The US studies confirmed thatfemale sex and black raceare major ethnic-demographic issues influencing the blood donation shortage (Boulware et al., 2002). A variety of reasons may account for lower rates among women, including concerns about health such asanemia, pregnancy, low body weight, or prior history of deferralof blood donation in the past summoned by those issues. For Afro-Americans, potential demotivators includefear of needles, fear of pain, and fear of contracting HIV,as mentioned in the previous books (Oswald and Gordon, 1993; Moore, 1991). In multicultural Australia, where 44% of the population is foreign, the first cultural issue implies targeting and segmenting various ethnic groups (Polonsky et al., 2010). The information is often not available in the mother tongues of Australian citizens. This factor plays a vital role in raising awareness of blood donation. One of the possible segments might be Sub-Saharan Africans (SierraLeoneandSudan),afast-growingcommunity.SimilartoAfro-Americans,they expressed fears of needles but also fears oflosing manhood. Blood donation in that community has a powerful cultural meaning -helping 'strangers' may not be viewed positively(Polonsky et al., 2010). To conclude, African donors are more likely to perform a charitable act for a person they know. 7
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Another riveting insight was discovered by the researchers from the Australian College of Nursing (ACN). There is still aprejudice on the queer community(especially gay men) spreading HIV - the cause of AIDS. Hence, to donate blood, they must abide by a 12-month deferral period to be eligible to participate (ACN, 2020). A year ago, the ACN called the local government to reconsider the policy, as it seemed stereotypical. So far, there are no updates provided. However, in France, for example, the deferral period lasts four months only. In Italy and South Africa, there is no such thing as differentiation between homo- and heterosexuals; everyone can donate. (ACN, 2020). To sum up, demographic issues summoned by fear or anxiety, cultural issues related to sacred values and traditions. The problems vary from one country/community to another. References 1.World Health Organization (WHO). (2017).Towards 100% Voluntary Blood Donation, AGlobalFrameworkforAction.Retrievedfrom: http://www.who.int/bloodsafety/publications/9789241599696/en/. 2.WHO. Fact Sheet No. 279. (2020)Blood Safety and Availability.Retrieved from: http://www.who.int/mediacentre/factsheets/fs279/en/index.html. 3.Australian Red Cross Blood Service. (2007).Australia needs you.Retrieved from:http://www.donateblood.com.au. 4.Australian Red Cross Blood Service Statistical Data, (2018, 2020). Retrieved from:http://www.donateblood.com.au. 5.Ferguson, E., Farrell, K., Lawrence, C. (2008). Blood donation is an act of benevolence rather than altruism.Health Psychology,27(3), 327–336. 6.Sullivan, M. T., Cotton, R., Read, E. J., & Wallace, E. L. (2007). Blood collection and transfusion in the United States in 2001. Transfusion, 47, 385–394. 7.Flood, P., Wills, P., Lawler, P. (2006).Review of Australia’s plasma fractionation arrangements.Canberra:CommonwealthofAustralia.Availableat: http://www.donateblood.com.au/admin%5Cfile%5Ccontent1%5Cc5%5Creportdec06.pdf 8.Ibrahim, N.A., Mobley, M.F. (1993). Recruitment and retention of blood donors: a strategic linkage approach.Health Care Management Review, 18(3):67-73. 9.Omoto, A.M., Snyder, M. (1995). Sustained Helping Without Obligation: Motivation, gevity of Service, and Perceived Attitude Change Among Aids Volunteers.Journal 8
sonalityandSocialPsychology,68,671-686.Availableat: http://dx.doi.Org/10.1037/0022-3514.68.4.671. 10.Omoto, A.M., Snyder, M., Martino, S.C. (2000). Volunteerism and the life course: Investigating age-related agendas for action.Basic and Applied Social Psychology,22, 181-198. 11.Pozzi, M., Gozzoli, C., Marzana, D., Aresi, G. (2016) Determinants of blood donation: A study on organizational satisfaction.Rivista Internazionale di Scienze Sociali, 1, pp. 49- 60. 12.Alfieri, S., Guiddi, P., Saturni, V., Marta, E. (2016). Economic How are Donors' MotivationsChanging?TransfusionandApheresisScience.DOI: 10.1016/j.transci.2016.03.001. 13.Guiddi, P., Alfieri, S., Marta, E., Saturni, V. (2015). New donors, loyal donors, and retained donors: Which motivations sustain blood donation?Transfusion and Apheresis Science,52(3), 339-344. 14.Stukas, A.A., Snyder, M., Clary, E.G. (1999). The effects of "mandatory volunteerism" intentions to volunteer.Psychological Science,10, 1, 59-64. DOI: 10.1111/1467-00107. 15.Thomson R.A., Bethel J., Lo A.Y., Ownby H.E., Nass C.C., Williams A.E. (2002). Retentionof"safe"blooddonors.TheRetrovirusEpidemiologyDonorStudy. Transfusion,38, 4, 359-367. 16.Godin G., Sheeran P., Conner M., Germain M., Blondeau D., Gagné C., Beaulieu D., Nac cache H. (2005). Factors explaining the intention to give blood among the general population.Vox Sanguinis, 89, 140-149. 17.Sojka, N.B., Sojka, P. (2008). The Blood Donation Experience: Self-reported Motives and Obstacles for Donating Blood.Vox Sanguinis, 94, 56-63. 18.Alfouzan, N. (2014). Knowledge, attitudes, and motivations towards blood donation among King Abdulaziz Medical City population.Int J Family Med, 2014:539670. 19.McVittie, C., Harris, L., Tiliopoulos, N. (2006). "I intend to donate but…": Non-donors' views of blood donation in the UK.Psychology, Health & Medicine,11:1, 1-6. DOI: 10.1080/13548500500159455. 20.Masser, B.M., White, K.M., Hyde, M.K., Terry, D.J., Robinson, N.G. (2009). Predicting blood donation intentions and behavior among Australian blood donors: testing an extended theory of planned behavior model.Transfusion,49(2). pp. 320-329. 21.Bennett, R. (2009). Impulsive donation decisions during online browsing of charity websites.Journal of Consumer Behaviour,8(2–3), 116–134. 9
22.Wallace, E.L., Churchill, W.H., Surgenor, D.M., et al. (1998). Collection and transfusion of blood and blood components in the United States, 1994.Transfusion,38:625-36. 23.Ownby, H.E, Kong, F., Watanabe, K., et al. (1999). Analysis of donor return behavior. Retrovirus Epidemiology Donor Study.Transfusion,39:1128-35. 24.Thompson, W.W. (1993). Blood donation behavior of Hispanics in the lower Rio Grande Valley.Transfusion,33:333-5. 25.Oswalt, R., Gordon, J. (1993). Blood donor motivation: a survey of minority college students.Psychol Rep,72:785-6. 26.Moore, R.J. (1991). Promoting blood donation: a study of the social profile, attitudes, motivation and experience of donors.Transfus Med.,1:201-7. 27.Polonsky, M.J., Renzaho, A.M.N., Waters, N., Dr. McQuilten, Z. (2010).Blood Donation in a Multicultural Australia - Complexities of Cultural Misunderstanding and Intergenerational Conflict for African Communities.Deakin School of Management and Marketing,Melbourne. 28.Australian College of Nursing (ACN). (2020). Blood Donation in Australia – Issues Brief No.1. 2020-21,ACN,Canberra. 10
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