JMIR Publications

ABSTRACT

Background:

Studies have shown that repeat blood donors are safe blood sources because of their voluntary blood donation education and frequent blood screening . However, the high loss rate of first-time voluntary blood donors and the low rate of repeated blood donation among the population were common problems in the world. The repeated blood donation rate in Zhejiang Province from 2006 to 2015 was 30.8%, which was lower than the global repeated blood donation rate of 50%, and fell within the average range of 24.3%-38.8% in China. How to fully guarantee clinical blood use, increase the rate of repeated blood donation, and ensure blood safety was a common problem that needs to be solved in Zhejiang Province, the whole country and even the world. At present, there were few researches on the intervention of blood donation behavior, and the content was mostly focused on changing blood donation knowledge, attitude, and willingness through education . Most of the methods are traditional text messages, phone calls, and brochures ,lack of robustness and methodological reporting , lack of intervention studies on repeated blood donation behavior, and few studies were on prospective randomized controlled trials of repeated blood donation intervention. At present, as a health intervention method, video has been widely used in behavioral interventions such as patient education for different diseases and patient family care, but there were few studies on its application in blood donation environments.

Objective:

To conduct a prospective randomized controlled trial， testing the effect of online short video intervention guided by the extended theory of planned behavior on repeated blood donation among non-fixed blood donors.

Methods:

From the blood information system of Zhejiang Province, whole blood donors who had donated whole blood in 2019 and did not donate again in 2020, or who had donated blood less than 3 times in total and had not donated blood in the last 6 months (including those who had not donated blood in past) were randomly selected as research subject pool, and were randomly divided into two groups, the online intervention group and the short message service(SMS) control group. The SMS control group received regular blood donation interval reminder message, while the online intervention group was guided by ETPB, including 9 factors: attitude, subjective behavioral norms, perceived behavioral control, blood donation willingness, outcome expectations, self-identity, blood donation anxiety, blood donation environment cognition and previous blood donation experience. Using WeChat as the network platform, during the 3-month intervention period, short videos designed for these 9 factors were regularly pushed and related consultations were answered in real time. After the observation period of 6 months, the blood re-donation rate of the two groups was evaluated, and the repeated blood donation behavior assessment scale based on ETPB was used to measure the improvement of the 9 factors of repeated blood donation in the online intervention group before and after the intervention. Statistical analysis was performed by t-test, Chi-square test and analysis of variance.

Results:

The re-donation rate of the online intervention group was 16.14%, which was significantly higher than that of the SMS control group, 5.16%, p<0.001. Male, 31-45 years old, blood donors who donated blood twice in the past had a higher blood donation rate after online intervention than other groups, p<0.05. After the online short video intervention, the blood donors' attitude, subjective behavioral norms, perceived behavioral control, blood donation willingness, outcome expectation, blood donation anxiety, and blood donation environment cognition were significantly improved, all were p<0.001, but there were no statistically significant difference with the changes in "self-identity" and " previous blood donation experience". The improvement of blood donation anxiety (p=0.011) and outcome expectation (p=0.008) of blood donors after online intervention were significantly higher than that of those who did not donate blood again after online intervention.

Conclusions:

Extended theory of planned behavior can be used in the repeated blood donation behavior intervention. The online short video intervention method designed for the 9 factors included in. Extended theory of planned behavior can be used for the re-donation behavior intervention of non-regular blood donors, which can effectively improve the re-donation rate of non-regular blood donors, and can effectively improve attitudes, subjective behavior norms, and perceived behavior control, blood donation willingness, outcome expectation, blood donation anxiety, blood donation environment cognition, especially, the improvement of outcome expectation and blood donation anxiety can directly promote non-fixed blood donors to donate blood again.