Blood donation among individuals of African origin in the Netherlands: how are barriers and motivators associated with intention?

Abstract

Background: Blood donors of African origin are under-represented in high-income Western countries, while their extended blood types closely match chronic transfusion patients with similar ancestral backgrounds. To prevent alloimunisation, it is important to recruit and retain more African blood donors. The aim of this study was to gain insight into blood donation barriers and motivators of individuals of African origin, and to assess how these are associated with the intention to donate blood.

Materials and methods: An online survey sample included 300 participants of sub-Saharan African, Afro-Surinamese and Afro-Caribbean origin living in the Netherlands. They ranked 25 barriers and 19 motivators on the level of impediment and facilitation in blood donation. We compared differences in barriers and motivators between ever- and never-donors and tested associations with the intention to donate blood using univariate and multivariate linear regression analyses, adjusted for gender, age, ethnicity, immigrant generation, educational level, and blood donation history.

Results: Receiving information about the donation procedure was a highly ranked motivator especially among never-donors (50%) and was positively associated with the intention to donate (p<0.05). Non-monetary incentives, convenience factors and awareness were other important motivators. Highly ranked barriers related to fears and not feeling healthy enough to donate, although only "believing donation is scary or stressful" (reported by 8% of the ever-donors and 25% of the never-donors) remained significantly associated with intention to donate in the multivariate model (p<0.05). Recipient preferences, religion and distrust were less often reported and were not associated with donation intention.

Discussion: The highest ranked barriers and motivators were not necessarily the best predictors of donation intention. These findings have valuable implications for future interventions focussing on individuals of African origin.

Figure 1. Butterfly chart representing the percentages and differences of ever- and never-donors who agreed (light grey) and fully agreed (dark grey) on donation barriers

*p<0.05, **p<0.01, ***p<0.001

Figure 2. Butterfly chart representing the percentages and differences of ever- and never-donors who agreed (light grey) and fully agreed (dark grey) on donation motivators

*p<0.05, **p<0.01, ***p<0.001

Figure 3. Forest plot with unstandardised regression coefficients and standard errors of multivariate linear regression associations of barriers and motivators with donation intention

The dots represent the unstandardised regression coefficient of donation intention for the given barrier or motivator. The horizontal lines represent the standard errors. When the unstandardised regression coefficient and the standard errors have a positive number (thus without the inclusion of zero), the barrier or motivator has a positive association with donation intention. When the unstandardised regression coefficient and the standard errors have a negative number (thus without the inclusion of zero), the barrier or motivator has a negative association with donation intention. The farther the regression coefficients are from zero, the stronger the association with donation intention is.